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How to handle cold sores

A woman dabs medicine around her lips with a cotton swab.

Feb. 7, 2020—If you get cold sores—small blisters that usually form on your lips or around your mouth—you're hardly alone. By the time they're adults, more than half of all people in the U.S. are infected with the virus that causes them, the American Academy of Pediatrics reports.

But even after cold sores clear, the virus can remain dormant in the body. If it reactivates, you may get cold sores again. Some people get them repeatedly.

Still, as common as cold sores may be, how much do you really know about them? Here are answers to common questions about these pesky sores, drawn on information from the American Academy of Dermatology:

Question: What are the warning signs that a cold sore is developing?

Answer: You may never have any symptoms at all if you're infected with the cold sore virus. But if you do get a cold sore, about two days before you may have one or more of these symptoms in the area where it will show up:

  • Burning.
  • Itching.
  • Stinging.
  • Tingling and slight numbness.

Once they appear, colds sores usually break open. They ooze fluid and then crust over.

The good news: Cold sores are typically not serious. In healthy people, they usually go away on their own in 5 to 15 days.

Question: Are there any home treatments that can ease the symptoms?

Answer: Non-prescription antiviral medicine can shorten the healing time. Look for one that contains docosanol or benzyl alcohol. Apply it gently at the first sign of a cold sore.

To soothe pain, itching or irritation, these steps may help:

  • Place ice on the cold sore.
  • Place a clean, cold, wet towel on the cold sore for 5 to 10 minutes a few times a day.
  • Apply a non-prescription pain-relieving gel or ointment. Typically these medicines contain benzocaine, lidocaine, dibucaine or benzyl alcohol.
  • Take ibuprofen or acetaminophen.

Spicy, salty or acidic foods (like tomatoes and citrus fruits) may cause burning if they touch a cold sore. It's best to steer clear of them until cold sores heal.

Question: Are cold sores contagious?

Answer: Yes—highly. They can spread through saliva, skin-to-skin contact or by touching an object handled by someone infected with the virus. If you have cold sores, you can spread the virus until all the sores have crusted over.

Question: Are cold sores the same thing as herpes?

Answer: Cold sores are caused by a strain of the herpes virus. But it usually isn't caused by the same strain that causes genital herpes. Most people with cold sores were infected at a young age from non-sexual contact.

Question: How can you avoid infecting other people?

Answer: Take these precautions until the sores have crusted:

  • Don't kiss people, especially children.
  • Avoid other intimate contact.
  • Avoid close contact with anyone who has a weakened immune system, including newborn babies.
  • Don't share personal items like lip balm, towels or razors.
  • Don't share drinks or food.
  • Wash your hands frequently.
  • Try not to touch your cold sores. You can spread them to other parts of your body, as well as to other people.
  • If you do touch a cold sore or apply medicine to it, wash your hands immediately.
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