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Mouth, Teeth or Throat Symptoms
Cold Sores

Care at Home

General Information - Cold Sores:
- Fever blisters or cold sores occur on one side of the outer lip.
- Typically lasts 7-10 days.
- Treatment with a cold sore cream can reduce the pain and shorten the course by a day or two.
Docosonal 10% Cream:
- Apply OTC docosanol cream (trade name Abreva) to the cold sore 5 times daily until healing occurs.
- Begin using this cream as soon as you first sense the beginning of an outbreak.
- Read and follow the package instructions. Ask your physician's opinion.
Contagiousness:
- Herpes from cold sores is contagious to other people. Discourage picking or rubbing the sore. Don't open the blisters. Wash your hands frequently. The cold sores are contagious until dry (approximately 5 days). Adults with cold sores need to be especially careful not to spread the virus to a baby less than 2 months of age. The virus spreads rapidly through their whole system in these infants and can even be deadly.
- Most cold sore sufferers note a tingling in the lip before the sore appears (prodromal phase). Patients are also contagious during this time period.
- Eyes - Avoid spreading the virus to someone's eye by kissing or touching; an eye infection can be serious (Herpes keratitis).
- Mouth - Since the blisters and mouth secretions are contagious, avoid kissing other people during this time. Avoid sharing drinking glasses, eating utensils, or razors.
- Sex - Avoid oral sex during this time. Herpes from sores on your mouth can spread to your partner's genital area.
- Contact with Immunocompromised People - Avoid contact with anyone who has eczema or a weakened immune system.
Expected Course: The pain typically subsides over 4-5 days and the sores typically heal over a 7-10 day period. On average, patients note recurrences 2-3 times per year.
Prevention: Since cold sores are often triggered by exposure to intense sunlight, use a lip balm containing a sunscreen (SPF 15 or higher).
Recurrence: Tingling or burning on the outer lip where cold sores previously occurred is an early sign of the new onset of recurrent cold sores
National Herpes Hotline: Phone number - (919) 361-8488. Counselors provide information about transmission, treatment, prevention, and emotional issues. The hotline is open from 9 AM to 7 PM, Eastern Time, Monday through Friday.
Call Your Doctor If:
- Sores look infected (spreading redness).
- Sores occur near or in the eye.
- Sores last longer than 10 days.
IF your symptoms become worse: Review Should I Call? recommendations.

REFERENCES & RESOURCES

Emmert DH. Treatment of common cutaneous herpes simplex virus infections. Am Fam Physician. 2000;61(6):1697-706, 708.
Sacks SL. Clinical efficacy of topical docosanol 10% cream for herpes simplex labialis: A multicenter, randomized, placebo-controlled trial. J Am Acad Dermatol. 2001;45(2):222-30.
Spruance SL. Penciclovir cream for the treatment of herpes simplex labialis. A randomized, multicenter, double-blind, placebo-controlled trial. JAMA. 1997;277(17):1374-9.