Infectious Disease Specialist Questions Cold Sores

Does a cold sore mean herpes?

My daughter has a cold sore on her mouth, and I heard that this is a sign of herpes. I've never had one before, but my husband's side of the family gets them a lot as well. Can they come from family history?

6 Answers

Herpes simplex is the cause of fever blisters. Herpes is a nearly universal infection, although most people are asymptomatic but will shed the virus periodically from their mouth, but be unaware of it. So, it is likely that someone in your family had contact with you daughter when they were shedding the virus... it could have come from a symptomatic or asymptomatic person.
Herpes simplex is the cause of the common cold sore. Keep in mind that the presence of one can be a sign that lack of sleep, poor nutrition, or contact with someone who has an active viral ulcer/cold sore is the common mode of transmission.
‘Cold sores’ typically are herpes simplex type 1 virus. These are transmitted from an infected individual to a recipient and the virus is activated from a dormant (latent) infection by an insult- for which a viral infection, sun exposure, etc. have been factors. These need to be differentiated from other mouth sores (canker sores). The canker sores are not infectious (transmitted) are not on the lips or skin around the mouth, and are painful but not scarring. The treatment of herpes associated sores can be topical or oral antivirals. These may shorten the infectious period, or given early may inhibit active infection (in persons for whom they have history of recurrent active infection with particular insults).
Typically, cold sores do mean Herpes simplex virus type 1. This is a routine cold sore virus that is not inherited, but is transmitted relatively easily. If they run in the family, then they likely transmitted the virus to your daughter.

Andrew Jameson, MD, FACP
About 90 percent of adults worldwide — even those who've never had symptoms of an infection — test positive for evidence of the virus that causes cold sores. Once you've had an episode of herpes simplex virus infection, the virus lies dormant in nerve cells in your skin and may emerge as another cold sore at the same place as before. Recurrence may be triggered by factors like, viral infection or fever, hormonal changes, such as those related to menstruation, stress, fatigue, exposure to sunlight and wind, changes in the immune system, etc.

To help avoid spreading cold sores to other people or to other parts of your body, you might try some of the following precautions: avoid skin-to-skin contact with others while blisters are present. The virus spreads most easily when there are moist secretions from the blisters. Avoid sharing items. Utensils, towels, lip balm and other items can spread the virus when blisters are present. Keep your hands clean. When you have a cold sore, wash your hands carefully before touching yourself and other people, especially babies.
No. Cold sores caused by Herpes Simplex Virus I are spread by direct contact with a lesion or a Herpes carrier usually by kissing.