Cold sores, sometimes known as fever blisters, are one of the most common viral infections. They are a group of small, painful blisters caused by the Herpes Simplex Virus Type 1 (HSV-1). Outbreaks occur outside your mouth and lips, but you can also get them on your nose, chin, and cheeks. Cold sores are highly contagious and can quickly spread to other body parts or pass from person to person.

Once someone has contracted the virus, it usually stays dormant for some time but can be activated by specific triggers leading to an outbreak. Although there is no cure for the herpes simplex virus, cold sores can stay inactive for a long time with a healthy diet and lifestyle.

Signs and Symptoms

Most symptoms reappear regularly, but the amount of recurring outbreaks varies from person to person. Below are the stages of a cold sore:

Tingling Stage

Most cold sore sufferers will experience tingling, tightness, and itching symptoms around the lips 1-2 days before the cold sore blister appears. The affected area will likely become red and start to swell.

Blister Stage

Painful clusters of fluid-filled blisters will start to appear around the area where the tingling stage occurred about 48 hours after the first detected symptom. The blister stage typically lasts for 2-4 days before the blister ooze. The blister fluid contains the cold sore virus (HSV-1, herpes simplex virus type 1) and is highly infectious. It’s important not to pop the blister, so the contagious fluid isn’t released, potentially infecting other body areas or other people.

Ulcer Stage

Blisters ooze around day 4-5, causing open sores, and are known to be the most painful stage of the cold sore outbreak and the most contagious. Wash the ulcerated sores with soap and water to help minimize the spreading of the virus.

Scabbing Stage

Around days 5-8 of an outbreak, the body will start to heal, and the cold sore will begin to dry and form a scab over the once-opened wound or blister. During this period, you could experience painful cracking, itching, burning, and bleeding as the scab shrinks.

Healing Stage

Usually, 8-10 days after the first symptom occurs, the body should be able to control the virus. The tiny scabs will begin to fall off, and the cold sore will heal. The skin may appear slightly red or pink for some time. Typically, cold sores do not leave scars, but it’s essential to avoid peeling off the scab to reduce the damage to the new skin.

Cold sores are contagious at all stages, but the Ulcer Stage is the most infectious due to blisters opening and oozing infected fluids containing the virus.
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