Cold Sore Stages
There’s nothing like a cold sore for ruining your mood and knocking down 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, and Abreva Rapid Pain Relief helps relieve your pain from the first use until your cold sore heals.
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.1 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 lies dormant in your cheek until something sets it off.1 Find out more about the most common cold sore triggers.
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.
This blister may look like a group of small, fluid-filled bumps surrounded by red, swollen skin. Never squeeze the blister as this can help spread the virus and even lead to scarring.4 The bumps may grow and multiply and can be painful, too.1
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: UCLER ERUPTION
This stage can be the most painful cold sore stage, as the blisters burst, leaving open sores.1 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 and not touch the surrounding area with your hands until your cold sore has completely healed and disappeared.1
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.4 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.2
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.4
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.1 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.3
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.2
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.
How to Shorten Cold Sore Duration and Relieve Pain
Apply Abreva® Cream at the first sign of a cold sore to block the spread of HSV-1 and shorten your cold sore’s duration. In clinical trials, Abreva® was able to heal a cold sore in just 2½ days* when applied starting at the earliest stage. But without early and ongoing treatment, cold sores lasted 8–10 days. For cold sore pain and discomfort, use Abreva Rapid Pain Relief. This clear gel is a powerful analgesic that numbs the area causing you pain. Its maximum-strength lidocaine temporarily blocks nerve signals in your skin, numbing pain and stopping itching. Abreva Rapid Pain Relief also hydrates to prevent cracking.
Understanding cold sore stages and knowing how to manage an outbreak from its onset can provide healing, relief and peace of mind. If you frequently get cold sores, you might also keep a symptom diary to help you spot the triggers . Avoiding or managing triggers is another powerful tool in cold sore prevention. To maintain healthy lips, learn more about keeping up your lip care routine.
1. Cold Sores. Cleveland Clinic. https://my.clevelandclinic.org/health/diseases/21136-cold-sores. Accessed 05/12/19.
2. Cold sore: diagnosis and treatment. Mayo Clinic. https://www.mayoclinic.org/diseasesconditions/cold-sore/diagnosis-treatment/drc-20371023. Accessed 08/28/19.
3. Cold Sore Outbreak? Pharmacy Times. https://www.pharmacytimes.com/publications/issue/2006/2006-11/2006-11-6075. Accessed 09/17/2019.
4. Cold Sores/Fever Blisters. University Health Services, The University of Texas, https://www.healthyhorns.utexas.edu/HT/HT_coldsores.html. Accessed 05/12/19.