Medically reviewed by Leah Millheiser, MD
Written by Our Editorial Team
Last updated 6/19/2020
There are few things on Earth as painfully inconvenient as a cold sore. They’re embarrassing, they hurt and once they’re there, they can take some time to heal up.
When a cold sore develops, it’s totally normal to rush to the internet to find out how long you’ll have it. Unfortunately, there’s no clear answer. While cold sores generally resolve themselves with time, certain medications can speed the lifecycle of a cold sore. Read on to learn more:
Most cold sores do not need medical treatment — they will heal themselves with time.
Prescription antiviral medications can lessen the severity of cold sore symptoms and speed healing time.
While everyone’s experience with cold sores can be unique, cold sores can last anywhere from one to two weeks.
Cold sores — also known as fever blisters — are a symptom of an incurable virus known as herpes. The majority of oral herpes infections are caused by Herpes Simplex Virus Type 1 (HSV-1).
HSV-1 is most often spread by close human contact, such as kissing, sharing drinking vessels, eating utensils, makeup, razors, towels, etc. Occasionally, oral herpes can develop after an uninfected person performs oral sex on an individual with genital herpes. With oral herpes, cold sores form in and around the mouth when the virus is active. While most people contract oral herpes during childhood, you can contract the virus at any age.
Cold sores most commonly appear where the skin of your lips meets the skin of your face, though they can also appear around your nose or inside of the mouth. Like most blisters, they’re filled with fluid and can burst and ooze. Once the fluid is expelled, cold sores crust or scab over before healing completely.
Once you’ve been exposed to the herpes virus for the first time, symptoms of an outbreak will likely occur within two weeks — if you experience them at all. Many people with oral herpes exhibit no symptoms at all, or symptoms so mild they remain unaware that they’re uninfected.
That said, when cold sores arise, the first sign is often a warning period, known as “prodrome.” One or two days before a cold sore appears, you may experience itching, burning, tingling or pain at the spot where the cold sore will later appear. During the prodrome period, you are considered contagious and can pass the virus to others.
The cold sore will grow into a fluid-filled blister or cluster of blisters. They will eventually burst, and a crust will form over the sore(s). During your first outbreak, you may experience additional, more severe symptoms, including: head and muscle aches, swollen lymph nodes, a sore throat, fatigue, sore gums and fever.
The amount of time that passes between the moment a cold sore rears its ugly head until it’s completely healed varies from person to person. Herpes outbreaks generally resolve themselves with time, which means you don’t have to take medication for them. But medication may help lessen the time you’re afflicted.
Reputable sources put the time to complete untreated (unmedicated) healing at anywhere from one to two weeks. However, depending on the severity of the outbreak and your body’s ability to heal, it can take longer.
Recurrences of cold sores after the initial outbreak are likely, though they don’t happen with everyone. Most often, the first outbreak is the worst and subsequent outbreaks are more mild.
The bad news is that there is no cure for herpes. The good news is that there are treatments that can help speed the healing of an outbreak and lessen pain.
Prescription antivirals may lessen the amount of time it takes for cold sores to heal. Prescription antivirals come in pills such as famciclovir, acyclovir and valacyclovir.
While a study found topical antivirals provide some early relief, the differences weren’t as dramatic as with oral medications.
Over-the-counter medications that include drying agents may also speed healing, although these are less well-researched compared to the oral medications. Additionally, things like lip balms, cool compresses and pain-relief creams can lessen the pain and discomfort associated with cold sores.
There are certain things that can increase your risk of future outbreaks. Managing these risk factors may help prevent future oral herpes infections. Staying healthy overall will reduce the likelihood of a resurgence, as being ill or having an impaired immune system can increase your risk of recurrence.