Everything About a Cold Sore or Fever Blister

If you experience recurrent crusting lesions in the same area as that of the last time, chances are you have a herpes infection. Herpes labialis, commonly known as a cold sore or fever blister, is a very contagious form of infection wherein blisters are formed on and around the lips.

The blisters rupture and ulcerates creating a painful condition. This ulcer than scabs creating unsightly crusting. Anesthetic creams can lessen the pain associated with the blister. The antiviral cream can reduce the duration of the lesion which typically lasts for 10 to 12 days. Other natural fever blister remedies include lemon balm, ice pack, stress-free life, etc.


Let us understand in detail about cold sores and also how to get rid of a cold sore naturally.

What are Cold sores?

Cold sores also known as herpes labialis are scabbing lesions that occur as a result of herpes simplex virus infection. Herpes labialis mostly occurs to herpes simplex virus-1 (HSV1) infection.

It is a recurrent lesion as the herpes simplex virus can permanently reside in the host body (1). It mostly remains dormant in the facial nerve ganglion (2).

Every once in a while when the immunity drops, a person can experience fever due to infection, and this opportunistic virus produces a blister. Hence they are also known as a fever blister.

What exactly is herpes?

Herpes is a viral infection caused by a family of over 70 related viri.  Herpes simplex virus is the leading cause of genital and facial herpes.

Herpes simplex virus is of eight types, amongst these herpes simplex virus 1 (HSV1) and herpes simplex virus 2 (HSV2) are the most common.

HSV1 is the offending cause of cold sores whereas HSV2 causes genital herpes. These viri are contracted through other people with active infection either by touching, kissing or sexual contact (3).

Five stages of cold sores

A cold sore goes through five stages, each stage with a different appearance. The phase of the cold sore also correlates with its level of contagiousness. The life of a cold sore, from the first sign to complete healing lasts between 8 and 12 days.

1) The Tingle stage

The Tingle stage is also known as Prodrome stage and is usually on the first and second day after the infection. The area where the cold sore or the fever blister is starting to form will have burning, stinging, itching, soreness, tautness, or swelling sensation.

The area will become slightly reddened, and a small raise or elevation will occur indicating a papule formation. These are the initial symptoms of inflammation.

2) The Blister stage

The blister stage occurs on the third day after the infection.  The visible sign of cold sore occurs as the appearance of multiple fluid-filled blisters appears on and around the elevated area. The blisters are usually smaller and form in a cluster.

In some cases, small individual blisters may join together to create a single larger one. In this stage, the total number of herpes virions is the greatest. The overall size of the lesion correlates with the relative amount of virions present.

In about 25% of cases, the herpes infection is brought under control by your body’s immune system before blisters can develop. In such instances in which no blisters or following ulceration form, they are referred to as aborted lesions.

3) The Weeping stage

Around the fourth to fifth-day blisters begin to rupture.  As they crack they release a clear fluid containing herpes virions. The lesion then transforms into ulceration. Immediately after rupture, the lesion appears as a shallow red ulcer.

The surface begins to have a grayish appearance after a day. This phase of ulceration is the most painful stage and also one of the most contagious. The inflammation reaction by the virions damages the skin lining making the area appear bright red. Swelling and tenderness also accompany the ulceration.

4) The Crusting stage

It starts from days five and lasts until day eight. In this stage, the ulcer begins to crust forming a scab. The crusting makes the lesion appear yellow, or dark red to brown. The scab often breaks which results in bleeding, the ulceration is again exposed, and the process starts over.

An itching or burning sensation often accompany the formation of the scab.

5) The Healing stage

After the entire lesion has crusted, flaking will occur through day nine till day twelve. A new scab one will replace each flaking. The further crusting will be smaller than the previous one. This happens until finally the lesion entirely resolves.

Location of a fever blister

  • Edge of the lip.
  • Lip commissure
  • The lower portion of the nose.

Cold sores typically form in the same location as they have during previous outbreaks which are essential characteristic features that help in the identification of recurring lesions as cold sores (4).

How cold sore spreads?

Cold sores are highly contagious. The liquids coming from them and even your saliva can transfer virions to other people. Not only that, but the fluid on coming in contact with other parts of your body can result in scabbing.

Transmission to others

Direct contact.

The most common spread of herpes virus is via direct skin-to-skin contact. Activities, like kissing, hugging can produce an infection. Research suggests that the transmission of the virus also occurs during asymptomatic period.

Asymptomatic viral shedding is difficult in the prevention of transmission as the infected person is unaware that the event is happening (5).

Indirect contact

The virus can also spread to others by way of their communication through intermediary objects which comes in contact with the cold sore. Avoid sharing articles like an eating utensil, cup, glass, or items such as a razor, lipstick or lip balm, toothbrush, or towel.

Transfer to other body parts

Continuously touching the cold sore can cause herpetic whitlow, a painful infection of the fingers. Infection of the eye by the HSV can even result in corneal blindness.

If you wear contact lenses, discard them after an episode of infection if you suspect contamination. Being intimate during an episode can cause infection of your partner’s genitals.

Who is at risk?

Some people are at higher risk for herpetic infections. This includes immunocompromised people such as those undergoing chemotherapy or HIV patients (6). People with weak immune systems like newborn babies and geriatric patients.

Herpes infections involving newborn children can be a dangerous as the possibility of the infection results in death. Neonatal herpes occurs due to the immature immune system of the babies, as they are unable to fight the infection resulting in complications.

In the majority of cases, the virus is passed to the child from their mother during delivery. A newborn can also develop an infection on coming in contact with a carrier individual during a kiss, touching or shared contact with an intermediary object.

How to get rid of a cold sore?

Herpes labialis or cold sores resolves on its own. You can reduce the duration of the infection by applying antiviral cream and taking antiviral medication (7). Zinc sulfate containing cream can be topically applied to prevent the scabs from breaking and bleeding (8). Anesthetic creams can reduce the pain and inflammation of the cold sores (9).

Some of you may ask how to get rid of cold sore naturally? Let’s some of them these natural remedies.

Lemon balm

Lemon balm is one of the most popular ways of treating cold sores. It reduces the redness and swelling associated with a fever blister. You should go for a lip balm with at least 1% lemon balm. People also like to go for tea infusion with lemon balm in it.

Apply ice pack

Ice can come in handy providing relief from inflammation and pain related to cold sores. You can apply the ice pack directly to the infected area.

Aloe Vera Gel

Aloe Vera is an amazing plant which has several benefits on our skin. You can get many nonprescription Aloe Vera gels in the nearby store. It has anti-inflammatory properties which can provide relief when core sore erupts.

Sunscreen lotion

You can also apply sunscreen lotion on your lips while going outside in sunlight. It can reduce the further spread of cold sores and save from harmful sun rays.

Change in lifestyle

Herpes virus activates when you are under stress. Lead a healthy lifestyle with yoga, exercises, meditation, etc. Eat health foods and live a stress-free life.



Prevention is always better than cure. Therefore, always wash your hands after coming in contact with a cold sore. Besides while treating a sore, wash your hands repeatedly throughout the day (10). Don’t touch or pick at cold sores. Only touch them when treating them.

Dab medication on a lesion rather than rubbing on it. Change your towels, bed sheets, pillow covers after an episode of infection to reduce the chance of recurrence.

Over to you

The most contagious stage of a fever blister is the weeping stage because at this stage the liquid is spilled out from the blisters after it ruptures.  These blisters hold millions of herpes simplex virions and anything coming in contact with the fluid is a possible source of infection.

Cold sores, resolves on its own, lasting a week or two. Care should be taken that proper measures are applied to stop the spread of infection. To prevent the recurrence of the herpes simplex infection, take proper immune modulating measures.


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