Cold Sore Stages
There’s nothing like a cold sore for ruining your mood and knocking your confidence. These unsightly blisters on your lip or mouth, sometimes called fever blisters, can take a week or more to clear up on their own. Knowing the beginning stages of cold sores can help you minimize discomfort and speed up healing at each stage. Recognizing the early signs, even before the blister appears, lets you fight back with Abreva® Cream to reduce how long your cold sore lasts.
Keep reading to discover the typical cold sore stages with pictures, from the first tingle to when it’s fully healed.
Always keep a tube of Abreva® Cream with you so you can apply it at the first sign of cold sore. For best results, apply five times a day.
* Median healing time 4.1 days. 25% of users healed in 2½ days.
Early Stages of a Cold Sore
Stage 1: Telltale Tingling
The beginning of a cold sore is known as the ‘prodrome’ stage and usually lasts from several hours to a couple of days. You'll feel a tingling, itching, or burning sensation on your lip, mouth, or nose where a cold sore is imminent.i This cold sore early stage is your body's reaction to the herpes simplex virus (HSV-1), which is responsible for cold sores. Once you’ve caught the virus, it stays with you for life, but most of the time it lies dormant in a nerve sheath in your cheek until something sets it off. i Find out more about the most common cold sore triggers.
Apply Abreva® Cream at the first sign of a cold sore. It creates a barrier to protect healthy skin cells, blocking the spread of HSV-1. In clinical trials, Abreva® could heal a cold sore in just 2½ days * when applied at the earliest stage, compared with 8–10 days with no treatment.
For instant relief, put ice in a bag and wrap in a thin cloth before placing it on the area for no longer than 20 minutes. Ice slows blood flow to the affected skin, reducing the inflammation, swelling, and nerve activity that leads to discomfort.iv
Beginning of a Cold Sore
Stage 2: Blister Breakout
Within 48 hours, a cold sore blister may appear around your mouth or lips, though you can get them anywhere on your face, including around your nose. A cold sore results in a swollen lip as the blister develops.
The blister may look like a group of small, fluid-filled bumps surrounded by red, swollen skin. The bumps may grow and multiply and can be painful, too.i
You can soothe pain and discomfort with over-the-counter painkiller medication such as ibuprofen or acetaminophen. Alternatively, local anesthetic creams such as lidocaine or benzocaine temporarily block nerve signals in your skin, numbing pain and stopping itching. Never squeeze the blisters as this can help spread the virus and even lead to scarring.iv
Use a disposable applicator such as a cotton swab to apply Abreva® Cream, sunscreen, lip balm, or make-up to your cold sore or the surrounding area.
Midpoint of a Cold Sore
Stage 3: Ulcer Eruption
This stage can be the most painful cold sore stage, as the blisters burst, leaving open sores.i You may also see a red ring of inflammation around the affected area. Stage 3 is the most infectious stage, so take care to avoid spreading the virus until your cold sore has completely healed and disappeared.
The HSV-1 virus is highly contagious. It spreads through skin-to-skin contact or via the moist inner skin that lines the mouth, eyes or genitals. iv In most cases, the virus causes a mild infection, but it poses a more serious risk for newborns and those with a weakened immune system. It can also be sight-threatening if it reaches your inner cornea, the transparent layer at the front of your eye, and is left untreated.ii
Avoid touching your cold sore and always wash your hands after applying cream or before touching your eyes, genitals, or areas of broken skin. Avoid sexual contact (including kissing) and do not share any personal items that may have come into contact with your saliva, such as cutlery or toothbrushes.iv
Don’t pick or peel the scab as you may damage the delicate, new skin underneath, slowing the healing process, and even leading to scarring. Let the scab fall off naturally.
Cold Sore Scab Stage
Stage 4: Scab Formation
Your burst blister will dry out forming a yellow-brown scab.i Although this is unsightly, it’s a sign that your cold sore has begun healing.
As the scab shrinks, it may create painful cracks in your lip that bleed. The area may itch, burn, or feel tight. To ease discomfort, try a cream or balm containing protectants, such as allantoin, petrolatum, cocoa butter or glycerin.iii
It’s a good idea to wear a sunscreen of at least SPF30 when outside. Sunscreen protects your lips while the cold sore heals and may help prevent future breakouts as UV light is a cold sore trigger for many people.ii
Check whether or not you need to buy more Abreva® so you’re prepared for the next tingle.
Start of the Cold Sore Healing Stage
Stage 5: Healthy Healing
As your scab starts to flake off, there may be some residual swelling in the area. The cold sore is completely healed when the scab and flakiness disappear, leaving healthy skin underneath. Cold sores typically don’t leave scars.
If you frequently get cold sores, keep a symptom diary to help you spot the triggers – avoiding or managing them can help prevent cold sores. Discover more ways to maintain your lip care routine.
Clicking any of the links below takes you to an external website that is independently operated and not managed by GSK. GSK assumes no responsibility for the content on the website. If you do not wish to leave this website, do not click on the links below.
i. Cold Sores. Cleveland Clinic. https://my.clevelandclinic.org/health/diseases/21136-cold-sores. Accessed 05/12/19.
ii. Cold sore: diagnosis and treatment. Mayo Clinic. https://www.mayoclinic.org/diseasesconditions/cold-sore/diagnosis-treatment/drc-20371023. Accessed 08/28/19.
iii. Cold Sore Outbreak? Pharmacy Times. https://www.pharmacytimes.com/publications/issue/2006/2006-11/2006-11-6075. Accessed 09/17/2019.
iv. Cold Sores/Fever Blisters. Universty Health Services, The University of Texas, https://www.healthyhorns.utexas.edu/HT/HT_coldsores.html. Accessed 05/12/19.