Cold sore stages: Pictures, duration, and treatment

There are five stages of cold sores. These lead from the initial tingling in the area to the healing stage.

Cold sores, also known as herpes labialis, are caused by nongenital herpes simplex virus type 1. People can develop a cold sore on their lips or in their mouth.

Transmission of the nongenital herpes simplex virus type 1 (HSV-1) occurs during childhood through nonsexual contact, but adults can contract the infection through sexual activity. HSV-1 hibernates inside skin cells and neurons under the skin until a trigger stimulates it.

Before the cold sore appears, people may feel a burning, stinging, or itching sensation on their lips. For best results, doctors recommend starting treatment as soon as the tingling begins, before the cold sore appears.

In this article, we discuss the stages of a cold sore and what to do if a cold sore develops. We also explore how doctors treat the infection and how people can avoid getting a cold sore.

A cold sore develops in five stages and will typically last between 9 and 12 days.

Stage 1

Initially, people will feel a tingling, itching, or burning sensation underneath the skin around the mouth or base of the nose. Doctors call this the prodrome stage.

Other symptoms that may occur during this stage include:

• malaise
• fever
• tender or swollen lymph nodes

At this first stage of the cold sore, people will not see a blister. People with recurring cold sores may present milder symptoms. Doctors recommend starting treatment as soon as these symptoms begin.

Treatment for cold sores may include oral or topical medications. Sometimes people will use both types to treat a cold sore.

Oral medications for cold sores include:

• acyclovir (Zovirax)
• famciclovir (Famvir)
• valacyclovir (Valtrex)

Topical treatments for cold sores include:

• acyclovir (Zovirax) cream
• docosanol (Abreva)
• penciclovir (Denavir) cream

Treatment aims to shorten the duration of the cold sore. In one study published in Antimicrobial Agents and Chemotherapy, researchers found that high doses and short courses of valacyclovir may reduce the duration of a cold sore by about 1 day.

Taking medication when symptoms first appear can prevent or block the cold sore from appearing.

Stage 2

If the person does not use any medication, a fluid-filled blister will likely develop around 1 to 2 days after the initial symptoms.

Stage 3

The third stage, which occurs around day 4, involves the blister opening up and releasing its fluid. Doctors call this stage the ulcer or weeping stage. If another person comes into contact with the blister’s fluid, they may develop a cold sore as well.

Cold sores are contagious and tend to be painful during this stage.

Stage 4

Between days 5 and 8, the cold sore will dry up, leaving a yellow or brown crust. The crust will eventually flake off.

People must take care of the scab during this stage because it can crack or break.

Stage 5

The final stage of a cold sore is the healing stage.

Several scabs may form and flake off during this stage. Every new scab will be smaller and smaller until the wound heals completely. Most often, the cold sore will not leave a scar.

Some doctors suggest that a cold sore can last around 2 to 6 weeks.

People who come into contact with another person’s cold sore may be at risk of infection. However, they would have to come into contact with the fluid when the blister ruptures.

Some people may develop recurring cold sores. According to the American Family Physician (AAP), various stimuli can awaken the hibernating virus, such as:

• stress
• fever
• sun exposure
• extremes in temperature
• ultraviolet radiation
• a compromised immune system
• injury

When a cold sore enters the ulcer or weeping stage, around the fourth day, the cold sore becomes contagious.

People who come into contact with the fluid from another person’s open blister can develop a cold sore between 2 to 20 days after contact.

People can come into contact with fluid from another person’s cold sore through kissing or sharing utensils, drinkware, cosmetics, or towels.

Doctors suggest that treating a cold sore at the start of symptoms, before the blister appears, may prevent the cold sore from appearing.

People with a history of cold sores can usually detect the initial symptoms and know they need to start treatment right away.

Some people get chronic cold sores and may require preventive treatments. Taking acyclovir or valacyclovir every day may prevent cold sores.

According to the AAP, the recommended doses for each drug are:

• acyclovir 400 milligrams (mg), twice daily
• valacyclovir 500 mg, once daily

People with chronic cold sores will need to take preventive treatments regularly. Also, doctors and dentists recommend:

• eating foods high in lysine, such as red meats, fish, and dairy
• applying sunscreen to the face and lips before going outside throughout the year
• shaving with a disposable razor blade when a cold sore appears
• replacing toothbrushes
• avoiding stress

People should avoid intimate contact with people who have cold sores. Avoid sharing utensils, toothbrushes, towels, and razors.

People with cold sores should avoid touching the blister, and if they do, they need to wash their hands thoroughly.

Cold sores are a common infection of nongenital HSV-1 that people can contract through sexual and nonsexual activities.

People who start treatment when they feel tingling and itching around their lips may block the cold sore from appearing.

If a cold sore appears, it will go through five stages from the prodrome stage to healing. During the ulcer stage, people can transmit the virus to another person. The fluid in the blister contains the virus. People with cold sores must avoid kissing and sharing utensils, towels, and drinkware.

A person may have a cold sore for about 2 weeks, but some doctors suggest that a cold sore can last up to 6 weeks. Medications can help shorten the duration of a cold sore.

Cold sore stages: Pictures, duration, and treatment

There are five stages of cold sores. These lead from the initial tingling in the area to the healing stage.

Cold sores, also known as herpes labialis, are caused by nongenital herpes simplex virus type 1. People can develop a cold sore on their lips or in their mouth.

Transmission of the nongenital herpes simplex virus type 1 (HSV-1) occurs during childhood through nonsexual contact, but adults can contract the infection through sexual activity. HSV-1 hibernates inside skin cells and neurons under the skin until a trigger stimulates it.

Before the cold sore appears, people may feel a burning, stinging, or itching sensation on their lips. For best results, doctors recommend starting treatment as soon as the tingling begins, before the cold sore appears.

In this article, we discuss the stages of a cold sore and what to do if a cold sore develops. We also explore how doctors treat the infection and how people can avoid getting a cold sore.

A cold sore develops in five stages and will typically last between 9 and 12 days.

Stage 1

Initially, people will feel a tingling, itching, or burning sensation underneath the skin around the mouth or base of the nose. Doctors call this the prodrome stage.

Other symptoms that may occur during this stage include:

• malaise
• fever
• tender or swollen lymph nodes

At this first stage of the cold sore, people will not see a blister. People with recurring cold sores may present milder symptoms. Doctors recommend starting treatment as soon as these symptoms begin.

Treatment for cold sores may include oral or topical medications. Sometimes people will use both types to treat a cold sore.

Oral medications for cold sores include:

• acyclovir (Zovirax)
• famciclovir (Famvir)
• valacyclovir (Valtrex)

Topical treatments for cold sores include:

• acyclovir (Zovirax) cream
• docosanol (Abreva)
• penciclovir (Denavir) cream

Treatment aims to shorten the duration of the cold sore. In one study published in Antimicrobial Agents and Chemotherapy, researchers found that high doses and short courses of valacyclovir may reduce the duration of a cold sore by about 1 day.

Taking medication when symptoms first appear can prevent or block the cold sore from appearing.

Stage 2

If the person does not use any medication, a fluid-filled blister will likely develop around 1 to 2 days after the initial symptoms.

Stage 3

The third stage, which occurs around day 4, involves the blister opening up and releasing its fluid. Doctors call this stage the ulcer or weeping stage. If another person comes into contact with the blister’s fluid, they may develop a cold sore as well.

Cold sores are contagious and tend to be painful during this stage.

Stage 4

Between days 5 and 8, the cold sore will dry up, leaving a yellow or brown crust. The crust will eventually flake off.

People must take care of the scab during this stage because it can crack or break.

Stage 5

The final stage of a cold sore is the healing stage.

Several scabs may form and flake off during this stage. Every new scab will be smaller and smaller until the wound heals completely. Most often, the cold sore will not leave a scar.

Some doctors suggest that a cold sore can last around 2 to 6 weeks.

People who come into contact with another person’s cold sore may be at risk of infection. However, they would have to come into contact with the fluid when the blister ruptures.

Some people may develop recurring cold sores. According to the American Family Physician (AAP), various stimuli can awaken the hibernating virus, such as:

• stress
• fever
• sun exposure
• extremes in temperature
• ultraviolet radiation
• a compromised immune system
• injury

When a cold sore enters the ulcer or weeping stage, around the fourth day, the cold sore becomes contagious.

People who come into contact with the fluid from another person’s open blister can develop a cold sore between 2 to 20 days after contact.

People can come into contact with fluid from another person’s cold sore through kissing or sharing utensils, drinkware, cosmetics, or towels.

Doctors suggest that treating a cold sore at the start of symptoms, before the blister appears, may prevent the cold sore from appearing.

People with a history of cold sores can usually detect the initial symptoms and know they need to start treatment right away.

Some people get chronic cold sores and may require preventive treatments. Taking acyclovir or valacyclovir every day may prevent cold sores.

According to the AAP, the recommended doses for each drug are:

• acyclovir 400 milligrams (mg), twice daily
• valacyclovir 500 mg, once daily

People with chronic cold sores will need to take preventive treatments regularly. Also, doctors and dentists recommend:

• eating foods high in lysine, such as red meats, fish, and dairy
• applying sunscreen to the face and lips before going outside throughout the year
• shaving with a disposable razor blade when a cold sore appears
• replacing toothbrushes
• avoiding stress

People should avoid intimate contact with people who have cold sores. Avoid sharing utensils, toothbrushes, towels, and razors.

People with cold sores should avoid touching the blister, and if they do, they need to wash their hands thoroughly.

Cold sores are a common infection of nongenital HSV-1 that people can contract through sexual and nonsexual activities.

People who start treatment when they feel tingling and itching around their lips may block the cold sore from appearing.

If a cold sore appears, it will go through five stages from the prodrome stage to healing. During the ulcer stage, people can transmit the virus to another person. The fluid in the blister contains the virus. People with cold sores must avoid kissing and sharing utensils, towels, and drinkware.

A person may have a cold sore for about 2 weeks, but some doctors suggest that a cold sore can last up to 6 weeks. Medications can help shorten the duration of a cold sore.

Acute herpetic stomatitis

Herpes is the most common viral infection. About 90% of people on earth are infected with herpes. Herpesvirus infections have become one of the most significant medical and social problems in the United States and Western Europe 20 years ago. However, in our country this group of infectious diseases remains little known. This is due to the fact that patients are observed by different specialists – dermatologists, dentists, gynecologists, ophthalmologists, therapists, etc.

Currently, one of the most common diseases in childhood is herpes infection, which is explained not only by the widespread prevalence of the herpes simplex virus (HSV), but also by the peculiarities of the formation of the immune system in the developing child’s body. Herpes infection in general is among the most common and poorly controlled. According to WHO, among viral infections, diseases caused by HSV take the second place after influenza.

Infection with HSV in children aged 6 months to 5 years is 60%, and by the age of 15 it is already 90%. The incidence of acute (primary) herpetic stomatitis in children increases every year.

For the first time, the role of HSV in diseases of the oral mucosa was indicated at the beginning of the 20th century by N.F. Filatov (1902). He suggested the possible herpetic nature of the most common acute aphthous stomatitis among children. This evidence was obtained later, when HSV antigens began to be detected in the epithelial cells of the affected areas of the oral mucosa.

According to the international classification of diseases and health problems, the last (tenth) revision (ICD 10, Geneva, 1995), this disease is registered as acute herpetic stomatitis (AHS). OGS not only ranks first among all lesions of the oral mucosa, but also belongs to the leading group among all childhood infectious diseases. At the same time, in every 7-10th child, ACS early turns into a chronic form with periodic relapses.

The widespread occurrence of the disease in children from 6 months to 3 years is explained by the fact that at this age the antibodies received from the mother through the placenta disappear in children and the lack of mature systems of specific immunity. Among older children, the incidence is much lower due to acquired immunity after a herpes infection in its various clinical forms.

The structure of the oral mucosa in children of different ages and the activity of local tissue immunity are of great importance in the development of herpetic infection, which manifests itself mainly in the oral cavity. The highest prevalence of ACS at the age of up to 3 years may be due to age-related morphological features, manifested by high permeability of histohematic barriers during this period and a low level of cellular immunity reactions due to the thinness of the epithelial cover with a low level of glycogen and nucleic acids, friability and poor differentiation of the basement membrane and fibrous connective tissue structures (abundant vascularization, high content of mast cells with their low functional activity, etc.).

The appearance of lesions on the oral mucosa is preceded by lymphadenitis of varying severity.

In moderate and severe clinical forms, bilateral inflammation of the submandibular lymph nodes often develops, but all groups of cervical lymph nodes can also be involved in the process. Lymphadenitis in OGS not only precedes rashes of lesions in the oral cavity, but accompanies the entire course of the disease and persists for 7-10 days after complete epithelialization of the elements.

Both specific and non-specific factors of immunity play a role in the resistance of the organism to the disease, in its protective reactions. Studies of non-specific immunological reactivity in acute hepatitis C revealed violations of the body’s protective barriers, reflecting the severity of the disease and periods of its development. Moderate and severe forms of stomatitis led to a sharp suppression of natural immunity, which was restored 7-14 days after the clinical recovery of the child.

Clinical picture

OHS, like many other infectious diseases, occurs in mild, moderate and severe forms. In the period of development of the disease, two phases are distinguished – catarrhal and rashes of the elements of the lesion.

During this period, symptoms of lesions of the oral mucosa appear. Initially, there is intense hyperemia of the entire mucous membrane, and after a day, less often two, elements of the lesion are usually found in the oral cavity. The severity of ACS is assessed by the severity of manifestations of toxicosis and the nature of mucosal lesions.

A mild form of ACS is characterized by an external absence of symptoms of intoxication of the body, the prodromal period is not clinically manifested. The disease begins suddenly with an increase in temperature to 37-37.5 ° C. The general condition of the child is quite satisfactory. In a child, minor phenomena of inflammation of the mucous membrane of the nasal cavity, upper respiratory tract are sometimes found.

Sometimes in the oral cavity there is hyperemia, slight swelling, mainly in the area of ​​the gingival margin (catarrhal gingivitis). The duration of this phase is 1-2 days. The vesicle stage is usually viewed by the parents and the doctor, as the vesicle quickly bursts and turns into an aphthae. Aphtha – erosion of a rounded or oval shape with smooth edges and a smooth bottom with a rim of hyperemia around.

In most cases, against the background of increased hyperemia, single or grouped lesions appear in the oral cavity, the number of which usually does not exceed 6. Rashes are single. The duration of the period of development of the disease is 1-2 days.

The period of extinction of the disease is longer. Within 1-2 days, the elements acquire a kind of marble color, their edges and center are blurred. They are already less painful. After epithelialization of the elements, the phenomena of catarrhal gingivitis persist for 2-3 days, especially in the area of ​​the anterior teeth of the upper and lower jaws.

In children with this form of the disease, as a rule, there are no changes in the blood, sometimes a slight lymphocytosis appears only towards the end of the disease.

Natural immunity with a mild form of stomatitis suffers slightly, and during the period of clinical recovery, the defenses of the child’s body are almost at the level of those in healthy children, that is, with a mild form of acute hepatitis C, clinical recovery means a complete restoration of the impaired defenses of the body.

The moderate form of acute hepatitis C is characterized by a fairly pronounced toxicosis and damage to the oral mucosa during all periods of the disease. Already in the prodromal period, the child’s well-being worsens, weakness, whims, loss of appetite appear, catarrhal tonsillitis or symptoms of an acute respiratory disease are possible. Submandibular lymph nodes increase, become painful. The temperature rises to 37-37.5°C.

As the disease progresses during the development of the disease (phase of catarrh), the temperature reaches 38-39° C, headache, nausea, pallor of the skin appear. At the peak of the rise in temperature, increased hyperemia and severe swelling of the mucous membrane, elements of the lesion pour out both in the oral cavity and often on the skin of the perioral region. In the oral cavity, usually from 10 to 20-25 elements of the lesion. During this period, salivation intensifies, saliva becomes viscous, viscous.

Pronounced inflammation and bleeding of the gums are noted.

Rashes often recur, which is why when examining the oral cavity, you can see elements of the lesion that are at different stages of clinical and cytological development. After the first rash of elements of the lesion, the body temperature usually drops to 37-37.5 ° C. However, subsequent rashes, as a rule, are accompanied by a rise in temperature to the previous level. The child does not eat, sleeps poorly, symptoms of secondary toxicosis increase.

ESR rises to 20 mm / h, leukopenia is more often noted, sometimes slight leukocytosis. The level of stab neutrophils and monocytes is usually within the upper limits of normal, lymphocytosis and plasmacytosis are detected. An increase in the titer of herpetic complement-fixing antibodies is detected more often than after a mild form of stomatitis.

The duration of the period of extinction of the disease depends on the degree of resistance of the child’s body, the presence of carious and decayed teeth, the rationality of therapy. Under unfavorable conditions, the elements of the lesion merge, their subsequent ulceration develops, ulcerative gingivitis develops. Epithelialization of the elements of the lesion is delayed up to 4-5 days. Gingivitis, severe gum bleeding and lymphadenitis persist the longest.

Severe form of ACS is much less common than moderate and mild. In the prodromal period, the child has all the signs of an incipient acute infectious disease: apathy, weakness, headache, musculoskeletal hyperesthesia, arthralgia, etc. Symptoms of damage to the cardiovascular system are not uncommon: bradycardia or tachycardia, muffled heart sounds, arterial hypotension. Some children have nosebleeds, nausea, vomiting, and pronounced lymphadenitis not only of the submandibular, but also of the cervical lymph nodes.

During the development of the disease, the temperature rises to 39-40 ° C. The child has a mournful expression of lips, suffering sunken eyes attract attention. There may be mild runny nose, coughing, somewhat edematous and hyperemic conjunctiva of the eyes. Lips dry, bright, parched. The mucous membrane of the oral cavity is edematous, brightly hyperemic, gingivitis is pronounced.

After 1-2 days, elements of the lesion begin to appear in the oral cavity – up to 20-25. Often, rashes in the form of typical herpetic vesicles occur on the skin of the perioral region, eyelids, conjunctiva of the eyes, earlobes, and on the fingers like panaritium. Rashes in the oral cavity recur and therefore, at the height of the disease in a seriously ill child, there are about 100 of them.

Elements merge, forming extensive areas of mucosal necrosis. Not only lips, cheeks, tongue, soft and hard palate are affected, but also the gingival margin. Catarrhal gingivitis turns into ulcerative necrotic. There is a sharp putrid smell from the mouth, profuse salivation with an admixture of blood. Inflammatory phenomena on the mucous membrane of the nasal cavity, respiratory tract, and eyes are aggravated. In the secret from the nose and larynx, streaks of blood are also found, and sometimes nosebleeds are noted.

In this condition, children need active treatment from a pediatrician and a dentist, and therefore it is advisable to hospitalize the child in an isolation ward of a pediatric or infectious diseases hospital. The period of extinction of the disease depends on the timeliness and correctness of treatment and on the presence of concomitant diseases in the child’s history. Despite the clinical recovery of a patient with a severe form of acute hepatitis C, there are profound changes in homeostasis during the period of convalescence.

Diagnosis

For the diagnosis of HSV, the following research methods are used:

• virological methods for the detection and identification of herpes simplex viruses
• polymerase chain reaction (PCR)
• detection of HSV antigens
• registration of immune response to HSV
• cytomorphological methods
• assessment of immune status

The presence of HSV antigens in biological material is determined using serological methods:

• neutralization reactions (PH)
• enzyme immunoassay (ELISA)
• radioimmunoassay (RIA)
• Complement fixation reaction (CFR)
• passive hemagglucination tests (RPHA)

The diagnosis of ACS is made on the basis of the clinical picture of the disease. The use of virological and serological diagnostic methods in practical public health is difficult. This is primarily due to the complexity of special research methods. In addition, with the help of these methods, results can be obtained at best towards the end of the disease or some time after recovery. Such a retrospective diagnosis cannot satisfy the clinician.

Treatment of herpes in the mouth – articles of the dental clinic “Medical Star”

Herpes is a viral disease, which is a blistering rash that manifests itself both on the skin and on the mucous membranes. Laser treatment will allow you to get rid of the symptoms in the early stages of its inception.

Experts note that people suffering from herpes, during the active phase of the virus, can easily infect others with them through household items, any close contact or airborne droplets. In nature, there are about 80 types of herpes. The most popular among them is herpes simplex type 1, which causes a blistering rash on the lips.

In the people it is called “cold” or “fever” on the lips. Herpes is invariably accompanied by weakness, general malaise and severe itching, in fact depriving a person of a normal life. Only a comprehensive treatment that combines medical and modern laser methods that have been successfully used in our Medikstardent dentistry for more than a year will help return everything back to normal as soon as possible.

The benefits of laser treatment for herpes

Laser radiation is the latest treatment method, which has already become one of the most effective in most areas of medicine. Cases with herpes on the oral mucosa are no exception. Our dental center Medikstardent offers you to get rid of the symptoms of this unpleasant disease at the earliest stages of its inception.

The American Picasso diode laser from AMD Lazers, which we have been successfully using for many months, has repeatedly shown its effectiveness not only in Russia, but also abroad. Practice shows that with it you can easily and painlessly remove all the symptoms of herpes in just 2-4 days.

The miraculous effect of the laser is due to its unique wavelength of only 810 nm, which allows it to quickly destroy viruses without causing the slightest harm to surrounding tissues. Did you notice “bubble fever” only at the second stage, and decided to contact us already at its third or fourth stage? It’s okay, because laser equipment is equally effective at any stage of herpes development, quickly healing virus-infected tissues.

Signs of herpes

To treat herpes in the mouth, like any other disease, it is better to start at an early stage of its development. So you will not only reduce the risk of infecting other people with it, but will also return a healthy appearance very soon. The restoration of normal health, by the way, will not keep you waiting.

Herpes is a peculiar disease, the symptoms of which are purely individual. For example, in a child, “fever on the lips” is often not even noticeable, and in adults, the disease can immediately go into the stage of herpetic gingivostomatitis. However, there are a number of signs, the presence of which indicates the onset of the disease:

• Increased headaches;
• High body temperature;
• Increased fatigue, loss of strength;
• Pain while eating and drinking;
• Inflammation of soft tissues and gums around ulcers;
• Visible white or yellowish watery vesicles up to 3 mm in diameter.

In children, the appearance of herpes is most often indicated by sleep disturbances, excessive irritability and vomiting after eating.

Laser herpes treatment process

The use of a laser allows you to minimize and completely remove the symptoms of herpes on the lips in 2-4 days. Laser exposure destroys viruses; for this, a wavelength of 810 nm that is safe for tissues is used. Note that not all dental lasers can be used in this wavelength range. Laser radiation with a wavelength of 810 nm kills viruses and bacteria without injuring body tissues. The same effect is used in periodontal treatment and sterilization of tooth canals.