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Cold Sores (Herpes Simplex Type 1)
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What are Cold Sores (Herpes Simplex Type 1)?

Cold sores (fever blisters) are small, painful, fluid-filled blisters that occur on the lips, mouth, nose, chin, cheeks, and throat. They are most commonly caused by the herpes simplex type 1 virus (HSV-1). Less often, however, they can be caused by herpes simplex type 2 (HSV-2), the virus that most often causes genital herpes . Having a herpes simplex virus (HSV) infection around the mouth is very common. Nine out of ten older adults have been exposed to HSV, but not everyone who is exposed will develop cold sores.

Herpes Simplex on the Lips
Herpes Simplex on the Lips
© 2009 Nucleus Medical Media, Inc.

The virus can be spread by:

  • Contact with the fluid from a cold sore of another person through kissing and other close contact
  • Contact with the eating utensils, razors, towels, or other personal items of a person with active...

A risk factor is something that increases your likelihood of getting a disease or condition.

It is possible to develop cold sores with or without the risk factors listed below. However, the more risk factors you have, the greater your likelihood of developing cold sores. If you have a number of risk factors, ask your doctor what you can do to reduce your risk.

The viruses that cause cold sores are easily spread. They come out of the skin and are “shed” from the site of the cold sore for 1-2 days before the sore appears. Then they are in the fluid of the cold sore blisters. Although cold sores typically form in response to stress or illness, they can sometimes form without an identifiable trigger.

Risk Factors for Becoming Infected With Herpes Simplex 1 Virus

Exposure to...

After being exposed to the herpes simplex 1 virus for the first time, you may develop a blistering rash in the mouth and/or lips that may be accompanied by a body-wide, flu-like illness. This first outbreak of cold sores is usually gone within 7-10 days, but it can last up to 20 days.

© 2009 Nucleus Medical Media, Inc.

The symptoms of the first outbreak are:

  • A blistering, painful rash of small ulcerations across the lips, gums, tongue, and the inside of the mouth (more common in children)
  • Pain and blistering on the soft roof of the mouth, tonsils, and throat (more common in adults)
  • Flu-like symptoms:
  • Swollen, sore throat
  • Mouth sores
  • Fever
  • Decreased energy
  • Muscle aches and pains
  • Difficulty breathing
  • Swollen glands (lymph nodes) in the neck

After these initial...

Because they have very recognizable features, cold sores are most often diagnosed by physical exam and by your medical history. If your doctor is not sure, she may take a sample of the fluid or tissue from the blister or a blood sample for testing.

Testing may include any of the following:

  • Viral culture—With a cotton swab, a sample of the fluid from the cold sore blisters is taken as soon as possible after an outbreak begins. The virus is then grown in the laboratory and identified. This test is very accurate if the sample is taken while there are still clear blisters.
  • Tzanck test—The cold sore is lightly scraped to collect cells onto a glass slide. These cells are then examined under a microscope to identify them. This test is quick, but is accurate in only 50%-70% of cases. ...

Most people are exposed to herpes simplex virus (HSV) when they are children. However, some contract the virus when they are adults. Once you have HSV, it cannot be cured, but changing some lifestyle activities can lower the risk of contracting it or having recurrent outbreaks.

Here are some of the tips for reducing your risk of contracting HSV or having recurrent outbreaks of cold sores:

  • Avoid exposure to the virus that causes cold sores.
  • Avoid excessive exposure to the sun.
  • Reduce physical and emotional stress.
  • Practice good hygiene habits.
  • Avoid certain foods.
  • Get adequate sleep and eat a healthful diet.

Avoid Exposure to the Virus that Causes Cold Sores

HSV can be spread by close contact with someone who has a cold sore or by using items...

American Academy of Dermatology


P.O. Box 4014
Schaumburg, IL 60618-4014


1-866-503-SKIN (7546)

Internet Address:

Description of Services Provided:

This site provides education, support groups, and a physician locator. The information is comprehensive and contains color photos of cold sores at different stages of infection.

Australian Herpes Management Forum


c/o-STIRC, Marian Villa
Westmead Hospital, Westmead
NSW 2145


+61 (2) 8230 3843

Internet Address:

Description of Services Provided:

This organization provides succinct, easy-to-understand information on oral and other forms of herpes. Its website...

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