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What are the 5 Stages of Cold Sores & How to Get Rid of It?

Cold sores or fever blisters are caused by the herpes simplex virus (HSV-1 or HSV-2). This virus causes a lifelong infection, which remains dormant in the body for years before triggering the appearance of a cold sore. Although cold sores typically form on or in the mouth, they can also develop on the cheeks, eyes, and nose. Once exposed to the virus, certain triggers like illness, fatigue, stress, food allergies, sun exposure and hormonal fluctuations can cause the recurrence of cold sores. About 90% of adults have HSV, and nearly 50% of people develop cold sores by the kindergarten age. Cold sores are not symptomatic for everyone, and usually appear in 5 stages, namely tingling, blistering, weeping, crusting and healing. The initial breakout is generally the worst and can be accompanied by symptoms like fever, aches and pains, sore throat and headache. Read on to know more about the stages of cold sores & ways to get rid of it.

What are the 5 Stages of Cold Sores & How to Get Rid of It?

What are the 5 Stages of Cold Sore

The 5 different stages of cold sore are:

Stage-1 of Cold Sore: Tingling

Feeling of unexplained tingling around the mouth is a sign of a potential cold sore formation. Burning and itching can also be experienced in the affected region of the skin where the cold sore is about to develop. By treating a cold sore during the tingling phase, its severity and duration can be decreased, but its development still cannot be stopped. Oral medications like valacyclovir and famciclovir are most effective during this phase and they need to be used daily to prevent or restrict outbreaks. People, who develop cold sores only once a while, can find topical treatments like docosanol, acyclovir, and penciclovir is beneficial. If pain is experienced in this initial stage of cold sore, pain relievers can be used to manage the condition.

Stage-2 of Cold Sore: Blistering

A day or two after the initial tingling phase, the cold sore moves to the blistering phase. This second stage of cold sore is marked by the appearance of one or more clear fluid filled blisters on the dermal surface. The skin around and beneath the blisters is red and these fluid filled bumps appear on, or inside the mouth and throat. Along with using a pain reliever, topical cream or oral medication to ease the cold sore symptoms in the second stage, the patient should also increase their water intake. This is important for staying hydrated, specifically when the mouth is sore. The cold sores on the surface of the skin can spread easily. So, the patient should wash their hands with warm, soapy water every time after touching the affected area, and also avoid sharing food or drink during this time. The virus can also spread through oral sex and kissing. So the patients should limit intimate contact until the blisters get fully healed. Since blisters and their following stages can cause discomfort while eating, patients should avoid having hot liquids and foods which are spicy, salty or citrus.

Stage-3 of Cold Sore: Weeping

A cold sore often breaks open within a few days of its appearance on the dermal surface and this is its third stage. Open sores are generally red, shallow and extremely contagious in the third stage of cold sores. Topical or oral pain relievers and cold or hot compress can be used to ease the symptoms occurring in the third stage of cold sores. The patient should avoid picking at the sores, as this can cause the worsening or spread of this condition and even lead to a bacterial skin infection.

Stage-4 of Cold Sore: Crusting

The blisters or the cold sores dry up after the weeping stage. This is known as the crusting stage and is the fourth stage of cold sores. Dried cold sores look yellow or appear as a brown blister. Warm and cold compresses and zinc oxide treatment can prove helpful in this stage of cold sores.

Stage-5 of Cold Sore: Healing

The last stage of the cold sore is the healing stage where the crusted blister scabs over. Emollients containing zinc oxide or aloe vera should be used on the dried cold sores to reduce irritation and keep the scab soft. The scab gradually disappears by flaking away and no scars are left behind.

How to Get Rid of Cold Sore?

Cold sores usually go away on their own in a few days, but there are many prescription treatments, which can be used to accelerate the healing process and help to get rid of them faster. OTC antiviral medications and products containing benzyl alcohol or docosanol can help to reduce the duration of the cold sore. Ibuprofen and acetaminophen are some medications, which can relieve the pain associated with cold sores. Ones who experience several outbreaks a year can take oral antiviral medication, like valacyclovir, penciclovir, acyclovir, all year round to prevent cold sores. Few other things which the patient can do to calm or shorten the duration of a cold sore outbreak are:

Use Lemon Balm: Lemon balm can help to reduce the swelling and redness associated with cold sores/blisters. However, this remedy does not prove effective in improving symptoms like pain and scabbing from cold sores. It is best to use a lip balm with at least some percentage of lemon balm. Even a compress made of a lemon balm infusion (tea) can be used to derive similar benefits. Lemon balm can also help to prevent future outbreaks of cold sores.

Ice Compress: Although it may not help to reduce the duration of a breakout, but ice can still ease the discomfort and inflammation of cold sores. A cold pack should be applied directly on the cold sores for temporary relief.

Apply Aloe Vera: Aloe vera is known for its powerful anti-inflammatory properties. Studies have found that topical application of aloe vera gel can help to soothe the skin during a cold sore break out. Using aloe vera is an effective way to get rid of cold sores faster.

Use Sunscreen: Not only does sunscreen protect the lips while the cold sore is healing, but its daily application on the lips can also help to reduce the chances of future outbreaks of cold sores. A sunscreen containing at least SPF 30 should be applied before going out in the sun to get rid of cold sores effectively and to also prevent cold sores.

Reduce Stress: Since stress can cause the herpes virus to become active again, reducing the amount of stress in life is another way of preventing cold sores. Stress can be reduced by exercising regularly, practicing yoga and meditation and avoiding the causes of stress. Reducing your stress level is an effective way to prevent cold sores and also to get rid of cold sores by healing them faster.


  1. Mayo Clinic – Cold Sores: https://www.mayoclinic.org/diseases-conditions/cold-sore/symptoms-causes/syc-20371017
  2. Centers for Disease Control and Prevention (CDC) – Herpes (HSV-1, HSV-2): https://www.cdc.gov/std/herpes/default.htm
  3. WebMD – Understanding Cold Sores — Treatment: https://www.webmd.com/skin-problems-and-treatments/understanding-cold-sores-treatment#1

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Team PainAssist
Team PainAssist
Written, Edited or Reviewed By: Team PainAssist, Pain Assist Inc. This article does not provide medical advice. See disclaimer
Last Modified On:July 25, 2023

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