​Cold Sores

Cold sores (also known as fever blisters) are a common form of viral infection. These usually appear (often as a group) as small, fluid-filled blisters around your mouth (usually around the edges of your lower lip) or on your lips. The skin around your blister can be red, tender, and quite sore. Once the blister breaks, they will leak a clear fluid, and a scab will form over the subsequent sore. Cold sores usually heal without any scar within two to four weeks.

Cold sores are contagious and can spread through coming in direct contact with an infected individual, even if they are not visible. They are usually caused by the simple virus HSV-1 (and in some cases HSV-2, which causes genital herpes), and can affect both your mouth and genital area. Thus, cold sores of HSV-2 are commonly contracted and spread through sexual intercourse. Currently, there is not a cure for cold sores. The blisters can heal and remain dormant for a while, but may reappear at another time due to a trigger (e.g. fatigue or injury to the infected area). However, the highly trained staff at Teeth and Skin Service Line at The Aga Khan University and Hospital is able to provide expert advice and prescribe treatment that will help cold sores heal faster and reduce how frequently they come back.


The symptoms of cold sores may  not always be visible during the initial attack (the primary infection). However, you may experience flu-like symptoms and ulcers in and around your mouth. However, once the cold sore has developed and becomes more severe, you may notice blisters around your mouth (usually around the edges of your lower lip), or on your lips.

Even though each person may experience different symptoms of cold sores, some of the common signs of cold sores include:

  • Tingling or burning sensation on your lips, usually before the cold sores become visible

  • Small blisters around your mouth or lips, that grow, burst, ooze a clear fluid, and then form scabs. Occasionally blisters may form around your nose or on your cheeks.

  • Irritated, dry and itchy lips and mouth

  • Soreness or pain felt in your lips or around your mouth, which may make eating, drinking a sleeping difficult.

Other symptoms might include:

  • A fever

  • A headache

  • Nausea

  • Painful and swollen gums

  • Muscle aches

  • A sore throat

  • Swollen lymph nodes in your neck

  • Drooling (in small children)

An outbreak can usually be set off by a trigger, such as exposure to sunlight, stress or fatigue or food allergies. Consult your doctor if you have any of the symptoms of cold sores, or if you feel like a cold sore may be reoccurring.  ​

Cold sores typically heal on their own without treatment with a few weeks. However you should seek the advice of a doctor about cold sores if:

  • You have a weakened immune system

  • Your cold sores have not healed within a few weeks (around two weeks)

  • The symptoms are severe, and you are experiencing great pain and discomfort

  • You experience cold sores frequently

  • Your eyes feel irritated

In severe or recurrent cases of cold sores, you should visit a specialist to help alleviate the symptoms. The Aga Khan University and Hospital is the only internationally accredited hospital in Pakistan, and ​

Your time with your doctor may be limited, so make sure to prepare for your visit beforehand. Here are some tips to help get you started. ​
It is usually quite easy for a doctor to tell if you have cold sores, and diagnosing the ailment is typically straightforward. Your doctor will ask you questions about your general overall health and about you medical history. They may also ask if you have come in contact with anyone with cold sores, as the illness is highly contagious. They will then conduct a physical examination of the infected area. You will probably not need any test, unless the doctor is uncertain about your diagnosis for some reason. In this case, your doctor may take a sample of fluid from your sore for further testing in a laboratory. This will enable them to be more convinced about a diagnosis of cold sores.​
Most cold sores tend to heal within a seven to ten days on their own without any treatment. There are some over-the-counter cold sore creams available; however these are only effective during the initial and first signs of infection.

If your cold sores are causing you discomfort, are making you feel self-conscious, and are more persistent and recurring, there are a number of treatment options available to help and speed up the healing process and reduce the frequency with which they reoccur. Treatment options include topical treatments (applied on the skin), such as antiviral creams, lotions, and ointments. Some forms of medication may not be suitable to all people, especially if you are expecting. Therefore it is important to consult your doctor before taking any prescription medication. ​
The Aga Khan University Hospital offers various support services to help with managing or recovering from the disease or condition. These include but are not limited to nutrition, physiotherapy, rehabilitation, specialized clinics and some patient support groups. Your doctor or nurse will advise you accordingly.
 
The Aga Khan University Hospital offers financial assistance to those who are in need and fulfil the eligibility criteria. For further information, you can contact the Patient Welfare Department. You can find the contact number of the Patient Welfare Department in the ‘Important Numbers’ section on the website homepage.
 
The financial counselling staff is available during office hours, at the main PBSD (Patient Business Services Department), to answer your financial queries on treatments’ costs and authorize admissions on partial deposit as per hospital policies allow. The financial counsellor in the emergency room is open 24/7. You can find the contact number of the Patient Business Services in the ‘Important Numbers’ section on the website homepage.​
Your doctor and or nurse will give you specific instructions about the prescribed medication. Please ensure that you take or use the prescribed medicine as advised. It can be dangerous to your health if you self-prescribe. Please inform the doctor or nurse beforehand if you have experienced any adverse reactions to any medications in the past. If you experience any symptoms of drug poisoning, overdose or severe reaction please contact the Pharmacy Service at The Aga Khan University Hospital immediately. You can find the contact number of the Pharmacy Services in the ‘Important Numbers’ section on the website homepage.​
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The information provided on our website is for educational purposes and not intended to be a substitute for medical advice, diagnosis or treatment. You should always seek the advice of your doctor or other healthcare professional provider.