What are oral (lips) cold sores? 

Written by Janna Mustafina MSN, FNP-C

A cold sore is a set of clustered fluid filled blisters that develop and grow together forming one sore. The blisters rupture over a few days making the sore scabby. In most cases it takes about 10-14 days for a cold sore to heal. In the beginning, the area where the cold sore will develop starts tingling and itching. This is a very important time one should catch. In most cases, if you start treatment for your cold sore during  this "tingling phase" you may even prevent the sore from developing. The best time to start treatment is within 24 hours of symptoms onset. Two most common pills of choice for cold sores are Acyclovir and Valacyclovir (Valtrex). 

What causes cold sores?

Cold sores are contagious. They are caused by a contagious virus - Herpes Simplex type 1 or type 2.  Herpes Simplex Virus (HSV) can be transmitted through skin-to-skin contact.  Kisses, sharing kitchen utensils, drink glassware, straws, biting each other food items, sharing lipsticks, lip balsam, chopsticks etc - can facilitate transmission of the herpes simplex virus. 

I have a sore inside of my lips. Is this a cold sore?

Most likely it is not. There are several different other types of skin lesions around the mouth that can be mistakenly taken for cold sores. Those lesions are canker sores, angular cheilitis, impetigo, eczema, and rosacea acne. Below we will describe each of those skin conditions to help you recognize if you have a true cold sore. 

Canker Sore.

Canker sores or aphthous ulcers are painful, white mouth sores with a bright red outline. The size varies from 2mm to 10mm.  You may develop a several canker sores at one time or just one.  They are very painful and bothersome . Canker sores always develop inside of the mouth and never outside. They are not contagious and not considered an infection. They can be caused by many different factors. Most common causes of canker sores: decrease in immune system, physical or emotional stress, smoking, recent dental procedure, iron deficiency, vitamin B12 and/or folic acid deficiency. 

Angular cheilitis.

 

 

 

 

 

 

 

Angular cheilitis are sores at the corners of the mouth. At the early phase the lesions are small and non-visible. Over the time they develop in more established scaly, erythematous patches at the mouth corners.  In most cases angular cheilitis is bacterial or fungal infection and requires either antibacterial and/or anti-fungal topical agent to treat. 

Angular cheilitis is a common condition and can occur at any age. The most common causes of this type of mouth sores are Vitamain B2, 9, or 12 deficiency, iron deficiency, immunosuppression, hyper-salivation, drooling, lip licking.

 

Impetigo:

 

Peri-oral impetigo is a bacterial skin infection. The sores are fluid filled pustules that turn into yellow or honey-color crust after they pop. The sores are highly contagious and can be transmitted to others via skin-to-skin contact. The infection is common in children.

 

Lip eczema

If one has a history of eczema it can affects the mouth area including the lips. The lips with eczema look dry, scaly, flaky, and may have surrounding itchy red rash. Lip eczema is not an infection and is treated with topical steroidal cream/ointment. 

Rosacea

Rosacea is facial redness with small red pus-filled bumps. In most cases it affects cheeks, nose, and chin areas. The red bumps can be also present around the lips. It is a chronic skin condition and treated with oral antibiotics and topical creams or ointments. The medication for cold sores will not be effective with rosacea acne. 

Now that you reviewed the information above, do you still think you have a cold sore? If yes, please click on the button below to start the intake form to request a prescription for Acyclovir or Valacyclovir. Be advised there is $30.00 professional fee for the evaluation and treatment of cold sores.

Are you having a medical emergency?
Please call 911

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