Cold sore also called fever blisters is a common viral infection. They are tiny, fluid-filled blisters on and around your lips. These blisters are often grouped together in patches. After the blisters break, a crust forms over the resulting sore. Cold sores usually heal in two to four weeks without leaving a scar.

Cold sore is infectious and spread from person to person by close contacts, such as kissing and touch. They’re caused by a virus (HSV-1) closely related to the one that causes genital herpes (HSV-2). Both of these viruses can affect your mouth or genitals and can be spread by oral sex. Cold sores are contagious even if you don’t see the sores.
There’s no cure for HSV infection, and the blisters may return. Antiviral medications can help cold sores heal more quickly and may reduce how often they return.

Symptoms

Tingling and itching. Many people feel an itching, burning or tingling sensation around their lips for a day or so before a small, hard, painful spot appears and blisters erupt.
Blisters are small fluid-filled blisters typically break out along the border where the outside edge of the lips meets the skin of the face. Cold sores can also occur around the nose or on the cheeks.
The small blisters may merge and then burst, leaving shallow open sores that will ooze fluid and then crust over.
Signs and symptoms vary, depending on whether this is your first outbreak or a recurrence. They can last several days, and the blisters can take two to four weeks to heal completely. Recurrences typically appear at the same spot each time and tend to be less severe than the first outbreak.

Some people also experience:

Fever
Headache
Painful eroded gums
Sore throat
Swollen lymph nodes
Muscle aches

Children under 5 years old may have cold sores inside their mouths and the lesions are commonly mistaken for canker sores. Canker sores involve only the mucous membrane and aren’t caused by the herpes simplex virus.

Cold sores generally clear up without treatment.You need to visit your dentist if-

You have a weakened immune system
The cold sores don’t heal within two weeks
You experience irritation in your eyes
You have frequent recurrences of cold sores
Symptoms are severe

Causes

Cold sores are caused by herpes simplex virus (HSV). HSV-1 usually causes cold sores. HSV-2 is usually responsible for genital herpes. However, either type can cause sores in the facial area or on the genitals. Most people who are infected with the virus that causes cold sores never develop signs and symptoms.

Cold sores are highly infectious when it is oozing. But it may transmit the virus to others even if you don’t have blisters. Shared eating utensils, getting touched, razors and towels, as well as kissing, may spread HSV-1. Oral sex can spread HSV-1 to the genitals and HSV-2 to the lips.

Once you’ve had an episode of herpes infection, the virus lies dormant in nerve cells in your skin and recur at the same place as before. Recurrence may be triggered by-

Viral infection or fever
Exposure to sunlight and wind
Stress
Hormonal changes, such as those related to menstruation
Changes in the immune system
Fatigue

Risk factors

About 90 percent of adults worldwide, even those who’ve never had symptoms of an infection — test positive for evidence of the virus that causes cold sores.

People who have weakened immune systems are at higher risk of complications from the virus. Medical conditions and treatments that increase your risk of complications include:

HIV/AIDS
Cancer chemotherapy
Severe burns
Eczema
Anti-rejection drugs for organ transplants

Complications

In some people, the virus that causes cold sores can cause problems in other areas of the body, including-

Fingertips.
Both HSV-1 and HSV-2 can be spread to the fingers. This type of infection is often referred to as herpes whitlow. Children who suck their thumbs may transfer the infection from their mouths to their thumbs.
Eyes.
The virus can sometimes cause an eye infection. Repeated infections can cause scarring and injury, which may lead to vision problems or blindness.
Widespread areas of skin.
People who have a skin condition called eczema are at higher risk of cold sores spreading all across their bodies. This can become a medical emergency.
Other organs.
In people with weakened immune systems, the virus can also affect organs such as the spinal cord and brain.

Prevention

Your doctor may prescribe an antiviral medication for you to take on a regular basis, if you develop cold sores frequently or if you’re at high risk of serious complications. If sunlight seems to trigger your recurrences, apply sunblock to the spot where the cold sore tends to erupt.

To help avoid spreading cold sores to other people or to other parts of your body, you might try some of the following
precautions:

Avoid skin-to-skin contact with others while blisters are present. The virus spreads most easily when there are moist secretions from the blisters.
Avoid sharing items. Utensils, towels, lip balm and other items can spread the virus when blisters are present.
Keep your hands clean. When you have a cold sore, wash your hands carefully before touching yourself and other people, especially babies.

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