Cold Sores (Fever Blisters)

What are cold sores?

Cold sores are small, painful bumps or blisters on the outer lip. They happen only on one side of the mouth and appear in a cluster. Just before a cold sore develops, your child may feel a tingling or burning on the outer lip at the same place where he had cold sores before.

What is the cause?

Cold sores are caused by the herpes simplex virus. The sores happen for the first time after your child has had contact with someone with herpes. Once infected, the virus stays in the body and can cause cold sores again. About 20% of adults have recurring cold sores. The sores come back because of sunburn, fever, friction, stress, injury during dental procedures, or physical exhaustion.

How long do they last?

The blisters will rupture, scab over, and dry up. After the sores are dry your child is not contagious. The whole process takes 7 to 10 days. The sores do not cause scars. If started early, treatment with antiviral pills can shorten the course by many days.

How can I take care of my child?

  • Ice

    If you feel tingling in the usual place but the blisters are not yet present, apply an ice cube or ice pack continuously for 20 minutes. This may stop the infection from progressing.

  • Cold sores ointment

    Once you get fever blisters, start applying a special cold sore ointment as soon as any small bumps appear. Docosanol (Abreva) is an example of one nonprescription cream. If you don’t have a special ointment, cover the fever blisters with petroleum jelly to reduce the pain. Reapply it 4 times a day.

  • Oral medicines

    Give acetaminophen or ibuprofen for pain relief. Once you get fever blisters, you usually can’t make the sores heal faster unless you have antiherpes pills and start them as soon as any small bumps appear. These require a prescription. Antiherpes ointments do not heal the sores faster.

How can cold sores be prevented?

Fever blisters are often triggered by exposure to sunlight. Using a lip balm that contains sunscreen with an SPF of 30 can help prevent cold sores.

Infection is spread through contact with fluid from the blisters. Avoid spreading this germ to another person’s eye because an eye infection can be serious. Therefore, discourage picking, and wash the hands frequently. Since the condition is contagious, have your child avoid kissing other people during this time. If your child is young and puts everything in his mouth, avoid sharing toys with other kids for a week.

When should I call my child’s healthcare provider?

Call during office hours if:

  • Any sores occur near the eye.
  • The sores last longer than 2 weeks.
  • You have questions about prescription medicines for herpes.
  • You have other concerns or questions.
Written by Barton D. Schmitt, MD, author of “My Child Is Sick,” American Academy of Pediatrics Books.
Pediatric Advisor 2015.1 published by RelayHealth.
Last modified: 2013-06-03
Last reviewed: 2014-06-10
This content is reviewed periodically and is subject to change as new health information becomes available. The information is intended to inform and educate and is not a replacement for medical evaluation, advice, diagnosis or treatment by a healthcare professional.
Copyright ©1986-2015 Barton D. Schmitt, MD. All rights reserved.

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