Although it isn’t dangerous, herpes labialis remains inconvenient! Here are a few tips to avoid the unpleasantness of cold sores.

Cold sores: tenacious little blisters

Cold sores (also called “herpes labialis” in medical terms) are caused by the presence of a virus in the body: herpes simplex virus type 1 (HSV-1). According to the World Health Organization, it is estimated that 67% of people under the age of 50 are affected by HSV-1. Although it is very often contracted during childhood, this highly contagious virus can also be contracted later in life.

After infection, the virus remains "latent" and can periodically recur if a person is exposed to certain triggers. It is estimated that roughly 1 out of 4 people have recurrences of herpes labialis. Therefore, it can be said that many people are unknowingly carriers of the virus. 

Triggering factors of herpes labialis

Among the factors that can trigger a cold sore outbreak we find the following:

• ultraviolet rays (from sun exposure or tanning beds)
• the cold
• dry lips or of the skin around the lips
• fever, a cold or the flu
• stress
• fatigue
• menstruation
• mouth trauma (following dental work)

The signs and symptoms of herpes labialis

Herpes labialis outbreaks, characterized by the eruption of a lesion, are usually preceded by certain warning signs. A cold sore generally lasts between 8 and 10 days in total (14 days maximum). Here is a description of the various stages of a cold sore:

Days 1–2: The tingle stage

Before any visible symptoms appear, a tingle, itch or burning sensation may be felt. This stage lasts about six hours. The infection is already at this stage, so it is important to avoid close physical contact.

Days 2–4: The blister stage

The blister appears. A group of small painful lumps multiply or become enlarged. White blood cells travel to the blister and fight the infection. The cold sore filled with vesicle fluid (pus), contains millions of virus particles. Herpes is very contagious during this stage.

Day 4: The ulcer stage

During the ulcer stage (typically the most painful), you will notice a shallow, cold sore develop. Inflammation can also cause a red ring around the affected area.

Days 5–8: The crusting stage

As the cold sore dries out, a golden-brown crust appears on the ulcer site. As the scab hardens, painful fissures may appear and bleed. Significant itching or burning is also common.

Days 8–10: The healing stage

As the cold sore heals and the scab begins to detach, some dry scaling and residual swelling may be experienced. The skin may also remain slightly pink or red.

Preventive measures

HSV-1 is usually transmitted through close physical contact, such as kissing. It can also spread through contaminated objects, such as utensils, a straw, lipstick, etc. If someone close to you has a cold sore, use caution to avoid being contaminated.

Frequent handwashing can help to prevent contracting the virus, including HSV-1.

If you are prone to cold sores, here are ways to prevent their appearance:

• regularly use moisturizing lip balm
• protect your lips from sun rays (some lip balms provide sun protection)
• cover your mouth (for example, with a scarf) when you are exposed to the cold
• avoid stress and fatigue, and
• avoid close contact with people with colds or the flu

Treatment options

There is currently no treatment available to permanently eliminate the HSV-1 infection. Fortunately, cold sores heal on their own over time. Prescribed or over-the-counter treatments help to reduce their intensity and duration. These medications come in topical (ointment or cream) or tablet format.

Beginning treatment in the first days following the onset of a cold sore and ideally as soon as warning signs appear (such as a tingling sensation) significantly improves the chances of reducing the intensity and duration of the symptoms of herpes labialis.

If you have any questions regarding cold sores or their treatment, don’t hesitate to speak to your pharmacist, who can offer you advice.