Cold sores are a common viral infection and are also known as fever blisters. Cold sores are caused by the herpes simplex virus type 1 (HSV-1). Infection with the herpes simplex virus -1 causes tiny, fluid-filled blisters on your lips or other mucosal surfaces. Usually, the cold sores disappear in 10 to 14 days without leaving a mark, and there are nearly six critical cold sore stages.

Cold sores are contagious even before they are visible and even after they are scabbed over and spread from close contact between individuals, such as kissing. Proper hygiene is necessary to ensure that transmission to others does not happen during the various cold sore stages.

Presently there is no cure for cold sores but treatments to manage the outbreak are available. Oral medications may help reduce the severity and perhaps even the frequency of future outbreaks. Medicated lotion, ointments and creams can speed up the healing process of cold sores in various stages.

What are some of the critical cold sore triggers?

Many individuals have Herpes simplex Virus-1 but most are asymptomatic since HSV-1 usually remains dormant in the body unless triggered by external factors. Cold sores can get triggered by stress and anxiety and by a weak immune system. Hormonal imbalance can also cause cold sores. Too much sun can also contribute to the recurrence of cold sores amongst healthy individuals. HSV-1 that causes cold sores can lay dormant for really long periods, but if you are experiencing frequent outbreaks, you need to consult a doctor to pinpoint the reason behind recurrent high-frequency outbreaks of cold sores.

Early Stage Cold Sores Signs and Symptoms

The first symptoms of cold sores can occur many days before their actual appearance meaning, the ”reddish bump/s”. Signs and symptoms may also vary if the outbreak isn’t your first. It may take up to 20 days for symptoms to emerge from the first day of infection. Itching and tingling are usually by far the most common and the very first sign of cold sores. Repeat incidents usually happen at the site of the first outbreak and heal a little faster in comparison to previous occurrences. In a first-time outbreak, the early-stage cold sores may also be accompanied by painful gums, fever, muscle aches, sore throats, and swollen lymph nodes. The redness of lips usually marks the beginning of the first stage of cold sores.

Six Critical Stages of Cold Sores


Six Critical Stages of Cold Sores

Cold Sore Stage One – tingling, itching, and redness

If you experience tingling and/or itching feeling on and around your lips, you may have a cold sore coming on. Medication is most effective at this stage. Taking oral medications during the cold sore’s first stage may reduce the intensity of the outbreak but will not eliminate it completely. In the first stage of cold sores, redness of lips is also prevalent, and swelling may also occur in some cases. This stage usually lasts just one to two days.

Cold Sore Stage Two – red bumps

After the passage of a day or two, the red itching spots on the border of your lips may start bumping up and blistering.

These tiny bumps may feel a little rough on touching and need to be cleaned appropriately. This is the next best stage to intercept the cold sore by starting to use ointments to treat the cold sores. Also, it is highly recommended that you increase your daily water intake. During this stage, you should maintain proper hand hygiene and should avoid touching the surface of the blisters except to clean or to apply the treatment. This stage usually lasts for one to two days.

Cold Sores Stage Three – fluid-filled blisters

After almost 3-4 days from the day itching and/or tingling starts, you may see that the blisters are getting tighter and filling up with fluid. It is recommended to limit intimate contact at the very first symptom of a cold sore. Kissing and oral sex can spread the virus to other individuals. This is one of the most contagious stages. This stage is usually accompanied by increased pain and throbbing. One may experience discomfort while eating. Spicy and salty food along with hot liquids can exacerbate these symptoms and citrus for example can irritate the surface. It would be best to avoid these types of foods. Stay hydrated if your throat feels parched. This stage usually lasts for another one to three days.

Cold Sore Stage Four – Weeping

This stage is the messiest of all stages of cold sores and lasts for one to three days. The fluid blisters burst open and will be red and shallow. This is the most contagious stage of cold sores, and the risk of transmission is very high if proper precautions are not taken. Other than to treat it is highly recommended not to touch the open blisters or try to pick the edges as it may lead to a bacterial skin infection. Medicated OTC cream and lotions can provide excellent relief during this critical stage of cold sores and heal the reddish wounds caused by the rupture of the blisters.

Cold Sore Stage Five – Crusting

During this stage, the healing process begins and can last between four to fourteen days. The lesions collapse and the crust falls away, leaving behind a tender red area. It is highly imperative that you do not pick the crust as it may lead to spots being left behind once the sores heal up. Application of medicated OTC creams and lotions can shorten the healing process.

Cold Sore Stage Six – Healing

The redness fades away, and the skin turns back to normal. There is no more irritation present at the surface of the infection. The herpes simplex virus-1 returns to dormancy.

Treatment of Cold Sores

Even though there is no cure available for HSV-1 that causes cold sores, treatments can help manage the infection and also speed up the healing process. Oral medications like antivirals are prescribed by doctors to inhibit the HSV-1 replication cycle and are most effective during the early stages of the cold sore outbreak. Anyone with a prescription by a doctor can access these medicines. Unfortunately, antivirals need to be taken within the first 24 to 72 hours. For immediate relief and overall management and cold sore treatment during all stages of cold sores, medicated OTC cream/lotions are found to be highly effective. TriClara® (NDC 72158-001) (National Drug Code) is one such product with great results and can provide effective symptomatic relief treatment along with rapid clearing during any stage of the cold sore outbreak.