Cold Sores Patient Information Leaflet

• Cold sores are caused by the Herpes Simplex Virus (HSV).
• About 1 in 5 people have recurring cold sores.
• Cold sores usually get better without treatment in 7-10 days.
• Antiviral creams or tablets may help to reduce the severity of symptoms.
• These medications are most effective the sooner they are started after symptoms develop

What causes cold sores to develop?

• Most cold sores are caused by Herpes Simplex Virus Type 1 (HSV1)
• Herpes Simplex Virus Type 2 (HSV2) causes genital herpes but very occasionally can cause cold sores around the mouth.
• Most people develop their first cold sore in childhood.
• HSV1 is usually spread by skin to skin contact, such as kissing someone who has an ‘active’ cold sore.
• The first infection may not cause any symptoms.
• After the first infection, the virus may stay inactive, not causing any symptoms.
• Cold sores may be triggered by the following:
• Viral illnesses or other infections
• During menstrual periods
• Stress or fatigue
• Direct sunlight/UV exposure

What are the symptoms?

• A tingling sensation before the blister appears, around the lip/mouth area.
• Fluid-filled sores/blisters, which may cause pain/discomfort
• The cold sores may weep and then form scabs.
• Once they have ‘scabbed over’ they are no longer infectious and usually settle without any scarring.

Are cold sores contagious?

• Yes, they are contagious until they scab over.
• Skin-to-skin contact with the affected area should be avoided.
• It is important to avoid spreading infection to newborn babies and anyone who has a poor immune system/immunocompromised people (for example, those having chemotherapy for cancer).
• If you do not have any active cold sores you are not usually infectious.

Do I need any tests to confirm the diagnosis?

• Usually no tests are required- the symptoms and typical appearance of cold sores are enough to confirm the diagnosis.
• A swab can be taken from the blister fluid, which can help confirm the diagnosis.

What treatments are available for cold sores?

• Most cold sores will get better without any treatment in 7-10 days.
• General advice includes:
  • Avoid touching cold sores, unless applying creams.
  • Wash hands thoroughly after touching cold sores
  • Avoid sharing lip balms/sunscreen
  • Careful hand hygiene is needed if you wear contact lenses- it is better to wear your glasses when your cold sores are flaring up. If you develop any eye symptoms, you should seek medical advice immediately.
  • Pain can be eased by over the counter painkillers such as paracetamol or ibuprofen.
  • Soothing gels or creams such as lidocaine (a local anaesthetic gel) can help with pain. These are available from your pharmacy.

Antiviral creams

• Antiviral creams can be bought over-the-counter at pharmacies and is usually applied five times a day.
• These treatments do not kill the virus but prevent the virus from multiplying and so they can help reduce the severity of symptoms.

Antiviral tablets

• Oral antiviral tablets can be used to treat cold sores.
• Their aim is to stop the virus multiplying and to reduce the severity of symptoms.
• Oral antiviral tablets may be prescribed if you have:
  • Severe cold sore infections
  • Recurrent cold sore infections
  • A weak immune system

Treatment for cold sores is available at qoctor.com.au