Cold sores are something that many people have gotten at some point in their lives. While a cold sore isn’t preventable and does not have a cure, there are a few ways to keep them from happening so frequently. What we know about the cause of cold sores is that they are caused by the herpes simplex virus (HSV). Both types of HSV (HSV-1 and HSV-2) are extremely contagious when in close contact with another individual. HSV-2 can result from engaging in oral sex with someone who is infected with genital herpes, but HSV-1 is only the result of oral-to-oral contact with an infected individual.
Since the virus tends to remain inactive following infection, it is difficult to know right away whether you actually have HSV. Of course, the first step in doing so is knowing what symptoms to look for. Signs of these sores tend to manifest only after something triggers them to do so. In some cases, an infected individual might only show signs once and never have them manifest again. Meanwhile, other people with HSV might get several breakouts per year. In other cases, a cold sore never even develops since HSV can be entirely dormant. Children are the most likely to show severe symptoms.
Seeing as how you will only know that you are infected once symptoms begin to appear, it’s crucial that you know what to look for. Your first cold sore could likely result from a primary infection, in which case it will be more severe than most successive cold sores.
1. Sore Lip
The first stage of a cold sore is experiencing a sore lip. This normally happens during the first day or two of an outbreak. Generally, the area of the lip that is infected with the sore will feel tender to the touch, although nothing will look very irritated or swollen at first. A sore lip will often start off as a mild annoyance and progressively become more noticeable as time goes on. This is typically how a cold sore starts, and it has been estimated that at least 85% of those who have HSV first experience a sore lip. These sores often develop around the outer rim of the lip and, in many cases, manifest near the corner of the mouth.
2. Tingling Lips
Your second main indicator and the second stage of cold sore development is the sensation of having tingling lips. The tingling sensation is generally what tips people off to the fact that they are developing a cold sore. Normally, the tingling sensation will start off as being somewhat mild and barely noticeable, but it will progress over the course of a day or so. The tingling does not impact your ability to speak, eat, or otherwise use your mouth, but it can be a bit of a distraction. If you start to notice tingling lips, it is important that you begin cold sore treatment, as this can lessen the developing cold sore’s severity.
3. Skin Blister
Stage two of the development of a cold sore is that you will begin to notice a skin blister developing in the area of your mouth where you have been experiencing tingling. You will develop at least one blister when you experience an outbreak. On some occasions, you might have multiple skin blisters manifest. For example, if your symptoms are triggered by stress and you’re under a great deal of it, several blisters might emerge. You will notice a reddening of the skin beneath the blister when it starts to grow around the outer edge of your lip or corner of your mouth.
4. Skin Rashes
In addition to noticing a skin blister, you might notice skin rashes start to develop in the area of the cold sore. HSV-1 can actually cause what is known as Eczema Hepeticum. This skin rash is most commonly seen in children who also have eczema, although it certainly can show up in adults. The rash will look like a cluster of little blisters that are all about the same size. They are all filled with either yellowish pus or a clear liquid which might be seen oozing or seeping out of the blister. These rashes tend to become crusty as the skin becomes dried out. This is generally treated with an antibiotic or antiviral prescription medication.
5. Skin Redness
Some people tend to experience skin redness or blotching in the area of the cold sore when it develops and even as it is healing. If the cold sore is developing, the redness is caused by inflammation in the infected area of the skin. At this point, it might be helpful to apply a cold compress to reduce the swelling. If the cold sore is already in the healing process and you begin to notice red marks on your skin, do not panic. These red marks are often the result of irritation caused by you touching the area of the skin or by sun exposure. If you have a darker skin tone, these red marks will be more noticeable.
6. Fever
A cold sore will not always result in the presence of a high temperature, but this can occur. Cold sores are, after all, nicknamed “fever blisters”. Fevers tend to be fairly mild, usually reaching no higher than 100.5 degrees Fahrenheit (or 38 degrees Celsius). This tends to happen within the first two days of the cold sore’s development, which is also known as the prodromal period. On occasion, these temperatures will go higher, but this tends to be rare. Fever themselves should break by the end of the prodromal period. If you notice that your fever is ongoing, you should contact your doctor.
7. Headache
Although headaches are not very common with HSV-1 or HSV-2, they have been known to occur and can worsen if left untreated. In fact, sore-related headaches have caused people to lose consciousness once the virus had breached the barrier to the brain. HSV-1, in particular, seems to be the main culprit behind sore-related headaches and blackouts. Headaches can be a strong indicator that HSV-1 is causing encephalitis (or inflammation of the brain). If you have HSV-1 and are experiencing migraines, you should contact your doctor and arrange an appointment to be seen. The loss of consciousness caused by encephalitis is serious and has a sudden onset, which can lead to accidents and injuries. Encephalitis can worsen if not promptly treated.
8. Muscle Aches
Muscle aches and pains are not a common symptom of HSV-1 or HSV-2 but are known to sometimes occur, especially in children. They often occur along with a heightened temperature and are known to last for as long as two weeks. Essentially, when this happens, you will feel like you have contracted a strain of the flu. However, the one noticeable difference will be the presence of the sore. Muscle aches can be treated with over-the-counter medications such as NSAIDs and acetaminophen, but if you have a co-occurring elevated temperature, these drugs might not be terribly effective overall. Again, if you experience this symptom for several weeks, you should consider seeing your doctor, as they might be able to prescribe a more effective medication.
