What Does a Cold Sore Look Like?

What Are Cold sores?

Cold sores appear when the body is under stress or when you have fever and thus cold sores are also called fever blisters. Actually, cold sores are caused by an infection of the herpes simplex virus-1. Cold sores are very common around the mouth, as well as on the face, in the genital area, and inside the nose. 90 percent of people get a cold sore at least once in their lifetime. The first time you get one, the symptoms are usually severe.

What Cold Sores Look Like

Even though the symptoms of cold sores are consistent, they differ in the first outbreak. The symptoms experienced at this time are not experienced again during later outbreaks. These symptoms that appear the first time include:

• Sore throat
• If the cold sores are in the mouth, then the gums become painful or eroded
• Fever
• Headache
• Muscle aches
• Swollen lymph glands

By looking for early indicators, you can predict when cold sores will appear after your outbreak has passed. The area where the sore is going to appear will suddenly feel itchy and tingly, and some numbness may also be experienced. About 40 to 60 percent of people with cold sores experience this stage, which is also called the prodomal stage. Early symptoms of cold sores include soreness, inflammation, redness, and hypersensitivity. Blisters will appear in the exact area.

In the beginning, cold sores may look like a pimple that is starting. It will possibly be painful and sore. The area will be raised and red, and the skin surrounding it will also be red. Several small blisters may be noticed that develop together. As other blisters fill the area between them, they tend to merge. The size of the cold sore may vary, ranging from 2-3mm up to 7mm.

Gradually, the raised area may appear as a blister. The blister becomes filled with fluid containing the virus when the white blood cells rush to the area to fight against the herpes simplex virus-1. You should never pick at cold sores since they are filled with infectious fluid. The virus may spread to others or it may spread to your eyes or genitals if you get the virus on your hands.

The most painful stage in the development of a cold sore is waiting for the blisters to break. Around the open sore, the area becomes red and moist. The most contagious stage is when the blisters leak fluid. Hence, to prevent spreading infection, make sure you wash your hands regularly. It will take up to three days for the cold sore to move to the next stage.

A crust will form over the top of the blister once it bursts. This crust is then followed by a protective scab, which may crack open and bleed as it heals. During this stage, itching and pain may also be experienced. By reopening the wound, you can slow down the healing process, so avoid touching the sore.

The scab falls off naturally to reveal intact, healthy skin. Until this time, you may remain contagious. The skin beneath may become dry and a little flaky when the scab falls off. Also, the area may be red and swollen. It can take eight to twelve days from the time the tingling and itching starts until the scab comes off.

Stages of Cold Sores

A lifelong infection can be caused by the herpes virus, and these infections can be dormant for years before cold sores start to appear. Typically, cold sores form on or in the mouth, but they may also occur on the cheeks, eyes, and nose. Usually, something triggers the reoccurrence of the virus once you are exposed to it. These triggers include:

• Fatigue
• Stress
• Fluctuation in hormone levels
• Illness
• Exposure to the sun

Many people have this virus and develop this condition at an early age. However, the symptomatic cold sores are not experienced by everyone.

The appearance of a cold sore progresses as follows:

• First around the mouth, an unexplained tingling is experienced. This may indicate that a cold sore is developing. It is better to treat the cold sore at this stage.
• Then, on the skin surface, after a day or two, one or more blisters appear. These blisters are filled with fluid. The skin around the blisters and under the blisters will be red.
• Then, the cold sore will break open within a few days of appearing. The open sores will be red and shallow.
• The blister will then look yellow or brown. At this time, the blisters will have dried out. This stage is also known as the crusting stage.
• Slowly, the crusted blister scabs over and slowly disappears by flaking away. This is the final healing stage.

Cold sores can be described in the following stages:

Stage 1 — tingling

The cold sore might be on its way when you experience tingling around the mouth. It is a sign that a cold sore is about to appear. Also, burning and itching may be experienced. During the tingling phase, if the cold sore is treated, it may help to reduce its duration and severity, however, the formation of the cold sore will not be prevented. In order to prevent or limit outbreaks, medication can be used daily.

Stage 2 — blistering

The cold sore will typically move to the blistering phase about a day or two after the initial tingling phase. This happens when, on the skin’s surface, one or more fluid-filled blisters appears, either on the mouth or inside the throat. To alleviate the symptoms of cold sores, some people use oral medication, pain relievers, or topical cream. Stay hydrated and increase your water intake, particularly when the cold sore is in the mouth.

Stage 3 — weeping

Often, within a few days of appearing on the skin, the cold sore will break open. When open, the sores will be shallow and red. During this time, they are at their most contagious. To help ease the symptoms, you can use an oral pain reliever or a topical medication.

Stage 4 — crusting

The blister will dry after the weeping stage. This is known as the crusting stage. The blister, when dried may look brown or yellow in color. You should see to it that the blister is not aggravated. Tt this stage, zinc oxide ointment and cold and warm compresses are usually recommended.

Stage 5 — healing

The healing stage is the final stage of a cold sore. When the crusted blisters scab over, that is when healing begins. Try using emollients that contain zinc oxide or aloe Vera, as they help to reduce irritation and keep the scab soft. Generally, no scars are left behind by cold sores.

When To See a Doctor 

You can use home treatments if you experience cold sores only on occasion. These treatments may help to speed up the healing process and minimize discomfort. For prescription medication, see your doctor if you have regular cold sores. These medications will limit the frequency of the sores as well as their severity. See your doctor if:

• The cold sore spreads to the eye
• The cold sore is accompanied by a fever
• The cold sore does not heal within a week or two
• The cold sore is surrounded by oozing or crusted skin

Bottom Line

When you experience cold sores, it is better to take careful precautions, such as:

• Avoid sharing hygiene products and utensils.
• Avoid physical contact while you have cold sores.
• As you treat the cold sores, do not share products.
• After treating a cold sore, wash your hands.
• When the cold sores are open and unhealed, they are most contagious. However, before or after the cold sores appear, the virus may be contagious as well.