One topic that is very common and can be quite distressing for patients is ‘cold sores’ sometimes referred to as ‘fever blisters’. A very common presentation to the doctor! 

What are cold sores? 

- Small fluid filled blisters appear on the skin, often in patches. 

- Usually on the lips, chin or cheeks, or nostrils. 

- Sometimes can occur in the roof of the mouth or gums. 

- Often start with tingling or itching. Over 48 hours blisters develop, then burst and ‘crust over’, and dry out. 

- Can take 2-3 weeks to heal completely. 

- Occasionally you also get a temperature, sore throat, and headache. 

What causes them? 

- They are caused by a virus – herpes simplex virus 1. 

- They can be spread through close contact – kissing, shared utensils, towels. 

- More likely to spread when the blisters burst. 

- The virus can hide in nerve cells and be triggered by: 

- Stress, fatigue, fever, trauma, sun, or wind. 

How do you treat them? 

- They get better over 2-3 weeks. 

- Use sunblock lip balm outside. 

- Paracetamol can help the pain. 

- Avoid salty food. Also, ice or warm flannels. 

- You can be prescribed or buy antiviral cream from a chemist to speed up the healing. 

Is there anything else I should think about? 

- It’s important to avoid close contact such as kissing, touching, or sharing towels when you have cold sores. 

- They can recur and be triggered, so avoid trigger factors if possible – sun, stress. 

- There is a natural remedy: kanuka honey-based cream shown to be effective. 

- See your GP if it’s not healed within 14 days, occurs near the eye, very large, or you have other issues such having chemotherapy. 

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