• Wednesday May 27,2020

Cold sores (herpes labialis)

Cold sores (herpes labialis) is one of the best known types of herpes. Of cold sores, almost 90 percent of all people are infected. However, the disease does not break out in everyone. Especially people who have a weak immune system are overawed for this disease. Typical signs of herpes are oozing or festering blisters on the mouth and lips. In addition, there are strong itching in this area.

What is cold sore?

Infection, severity and duration of cold sores vary from patient to patient. The first phase of the infection is characterized by tingling, tightening and burning in the lip area.
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Herpes infections and cold sores (herpes labialis) are caused by viruses and belong to the family of Herpesviridae. It is believed that more than 90 percent of the world's population is infected with herpes viruses. The cold sores are caused by the "herpes simplex virus type 1". This is again subdivided into HSV type 1 and HSV type 2. The subform HSV type 1, which is called cold sore (herpes labialis), is usually limited to the lips and mouth and is one of the most frequent herpes infections.

Genital herpes, the HSV type 2, on the other hand affects mainly the genitals. The infection with cold sores (herpes labialis) is often already in childhood and can go unnoticed for a lifetime. The actual cold sore (herpes labialis) occurs when the immune system is weakened. As a rule, the infection is relatively harmless and manifests itself in itchy and weeping blisters.


In principle, each person can be infected by various types of contact with cold sores (herpes labialis). The herpesviruses of an infected person are transmitted by direct contact or by lubrication and droplet infection. Thus, there is a risk of infection when sneezing, coughing, talking, kissing or sharing glasses.

The onset of the cold sore (herpes labialis) can be favored by the following factors:

  • Weakening of the organism for example by illnesses or colds
  • strong sunlight
  • hormonal fluctuations, pregnancy or menstruation
  • mental stress
  • Stress, fatigue
  • air stimuli

In more than one third of the affected people, there is a tendency for recurrent onset of cold sores (herpes labialis).

Symptoms, complaints & signs

Cold sores can go for a long time between the bridges without symptoms. The first outbreak is usually characterized by a mild course. Even before the appearance of the typical vesicles there is a feeling of tightness, numbness or pain in the lips. [[[Skin redness, redness]], tingling or itching also occur.

These sensations last a few hours or days. Then it comes to the formation of bubbles, which can also run into each other. The initial infection is often accompanied by swelling of the lymph nodes on the neck. It can lead to a general feeling of illness. These include fatigue, fever and general malaise. The bubbles appear thicker and fill with liquid until they finally burst.

The bubbles are highly infectious. After chipping, open wounds are created, which are finally discarded and heal within two weeks. The infection can also occur at the entrance of the nose, on the cheeks or around the eyes. In rare cases, the infections are found in the inner mouth and are then referred to as oral rot. Here, cold sores express themselves with small ulcers, which quickly disintegrate and cause severe pain. Herpes labialis brings in this form usually strong fever with it.


Infection, severity and duration of cold sores vary from patient to patient. The first phase of the infection is characterized by tingling, tightening and burning in the lip area. These symptoms are typical warning signs of a cold sore outbreak. Within a short time it comes to the formation of bubbles. The vesicles filled with a clear fluid or purulent substance are highly contagious and are considered very painful.

After one to two days, the cold sores open, forming a red border around the wound. In the further course, the bubbles close and dry out. The healing process begins by crusting the wound. Due to the constant strain on the lips when eating or talking, those affected usually suffer from a painful bursting of the crust. At this time, however, there is no risk of infection. After two weeks at the latest, the cold sore (herpes labialis) infection healed.


In the case of burgeoning herpes with blistering and associated skin irritation, it can lead to a secondary infection with bacteria. In these cases, the skin is severely damaged and herpes viruses such as bacteria spread beyond the lips. Symptoms can be itching, dry, weeping or aching head items.

In particular, complications may occur during initial infection with HSV-1 or HSV-2. Here, the frequently occurring blisters, which are present in some cases, merge into ulcers - this affect is also amplified by a secondary infection - or spread to the mouth. Symptoms such as fever or headache are more pronounced. Children are more likely to be affected.

In addition, herpes simplex viruses can colonize by dragging on almost any part of the skin, with injuries represent a particularly easy to colonize target. In combination with psoriasis, they can cause serious eczema that causes pain and a strong sense of illness. Migratory viruses can also infect other areas via the blood flow. Retinal infections, infections of the esophagus and others are possible.

Especially dangerous is an extension of the infection to the central nervous system. Untreated, the mortality rate is 70 percent. Even in the blood lingering viruses can lead to more and more new infections, leading in the worst case, a generalized infection and so-called herpes simplex sepsis. People with a weakened immune system are more affected by these complications than otherwise healthy people.

When should you go to the doctor?

With cold sores does not have to be consulted in all cases a doctor. If the person suffering for the first time under the changes of the lip, is recommended a fundamental clarification by the doctor. If it comes repeatedly to an infestation of the lips in the course of the supply of the patient with offered drugs from the pharmacy is often sufficient. Creams or patches should be applied immediately to the altered areas so that the virus does not spread further. If the cold sores heal independently within the next few days, a visit to the doctor can be avoided. A doctor's visit is necessary when it comes very often to the formation of a cold sore.

If the sites on the lip do not heal or the blisters continuously increase, a doctor should be consulted. If there are strong problems with food intake or unwanted weight loss, a visit to a doctor is advisable. Complaints with a denture or when dealing with braces should be discussed with a doctor. If the inside of the mouth is affected or if more bubbles develop on the body, a doctor's visit is also recommended. If there is a strong malaise, persistent weakness or pain in the face, a doctor should be consulted. Numbness or sensory disturbances on the face should also be clarified by a doctor.

Treatment & Therapy

Cold sores (herpes labialis) are usually treated only in severe symptoms. In this case, only the symptoms, but not the cause are treatable. The bubbles can be treated locally with disinfecting additives. To inhibit virus proliferation, antiviral ointments are used. In severe or recurrent onset of cold sores (herpes labialis), the doctor may prescribe antiviral drugs. If complications or fever occur, a doctor's visit is advisable. Normally, a cold sore infection heals without consequences.

The use of home remedies for cold sores (herpes labialis) such as toothpaste, tea tree oil or garlic is widespread. However, the effectiveness has not been proven. Creams containing antiviral drugs are available over-the-counter in the pharmacy and can be applied several times a day with a cotton swab to the blisters.

Outlook & Forecast

The prospects can be described as extremely favorable. Cold sores is not a serious disease. Only a transmission should be prevented, so that do not infect other people or the disease extends to other endogenous regions. Especially the contact to small children and old people is to be avoided at times. They are considered to be relatively susceptible to infections. For the characteristic vesicles to disappear, patients usually do not have to do anything. After a good two weeks, the irritations and tensions have resolved by itself and the cosmetic problem is resolved. Certain medications and ointments even shorten the healing process.

It seems problematic that the triggering viruses remain in the body. The renowned Robert Koch Institute estimates that about 85 percent of the adult, German population is infected with HSV1. This condition allows repeated emergence of the cold sore. The runs then but usually as mild as the first time. If a transfer to other parts of the body takes place, this is due to inadequate hygiene. However, the eye, skin, brain and genitals are statistically very rarely affected by infection. A vaccine against the virus is not yet available.


Cold sores (herpes labialis) occur mainly in a weakened immune system. To prevent this, the organism can be strengthened by a healthy balanced diet, adequate sleep and exercise. Furthermore, the following measures can help to prevent recurrence of cold sores (herpes labialis):

  • In strong sunlight apply appropriate sun creams in the mouth area.
  • Never touch your own vesicles or other infected persons. In particular, the liquid is highly infectious. Thus, a contagion or transmission to other body parts can be largely excluded.
  • In case of contact with the cold sore blisters, the hands should be thoroughly cleaned and disinfected.


In severe cases, in which the spread repeats regularly, patients should always consult a doctor. This makes a diagnosis on the basis of external consideration. Only rarely the pathogen is determined separately in the laboratory. The nature of the disease means that no scheduled follow-up is required.

Usually, cold sores either self-terminate or are successfully controlled with antiviral drugs. In order to prevent the recurrence of the disease, no special precautions are appropriate, based on medical practice. An effective vaccine does not exist so far.

Patients should therefore be careful not to replace lipsticks or cups and cups. They should strengthen their immune system by eating well, exercising regularly, and sleeping well. Permanent stress can also contribute to the weakening of the immune system. After the symptoms have resolved, there are generally no particular complications to be feared.

You can do that yourself

Cold sores usually announce themselves by itching or burning of the affected skin. Already at the very first signs, over-the-counter antivirals from the pharmacy should be applied. Small amounts are sufficient for the application, but the application should be repeated at short intervals during the early phase of the infection. These agents, such as acyclovir, inhibit virus replication, thereby stopping the progression of the infection. Already existing bubbles form back faster.

Those who prefer natural remedies can try a cure with echinacea preparations, which strengthen the immune system and thus prevent the onset of the disease. For acute cases, there are also creams and ointments for the treatment of cold sores based on Echinacea. Also tea tree oil is said to favor the healing of the bubbles. Once the blisters have spread to the mouth, rinsing with sage tea can alleviate pain and reduce the risk of secondary infection.

The cold sore virus is highly contagious. The affected person must therefore absolutely make sure that he does not transmit the viruses by lack of hygiene or careless gestures on other parts of the body. Particularly at risk are the mucous membranes and the eyes. Under no circumstances should the affected person touch the infected area on the lips and then brush his nose or rub his eyes. Within a household, no objects, especially towels, glasses or cutlery should be shared until the bubbles have completely healed.

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