It can be tempting to pop a cold sore. However, popping a cold sore releases infectious fluid from inside the blister, increasing the risk of further cold sores, infection, and scarring. This article explores what happens when someone pops a cold sore, what to do instead, and how long cold sores usually take to heal.
Understanding Cold Sores
Cold sores are small, fluid-filled blisters that usually form around the mouth. They are also referred to as fever blisters or oral herpes. Cold sores occur following infection with the herpes simplex virus (HSV).
According to the World Health Organization (WHO), most people contract HSV during childhood. Once a person has the virus, it stays in their body, leading to recurring cold sores throughout life. The virus can remain dormant, causing symptoms only once, or it can reactivate and cause more cold sores.
Triggers for Cold Sores
Cold sores may appear in response to certain triggers, such as:
- Sun exposure
- Dry weather and wind
- Stress
- Changes in hormones (e.g., during menstruation or pregnancy)
- Sickness or fatigue
- Trauma to the mouth area
Knowing your triggers can help you avoid some outbreaks, but outbreaks can also happen unpredictably.
Contagiousness of Cold Sores
HSV is very contagious and spreads through oral contact, including kissing, sharing food and drinks, and oral sex. Cold sores are contagious from the moment symptoms start until they are completely healed. They are most contagious when they are open and oozing, and particularly within the first 24 hours of formation.
The virus can spread through skin-to-skin contact and saliva. Therefore, it is important to avoid:
- Kissing someone with a cold sore.
- Sharing items that touch the mouth, such as forks, spoons, straws, cups, or lip balm.
- Touching a cold sore (on yourself or someone else).
- Engaging in sexual activity that involves contact with a cold sore.
If you touch a cold sore, you should wash your hands thoroughly with soap and water afterward.
The Risks of Popping a Cold Sore
Popping a cold sore releases fluid that contains the herpes virus. This act interferes with the natural healing process and can lead to several problems:
- More Cold Sores: If the fluid transfers to other parts of the face, it may cause more cold sores to appear.
- New Infections: An open sore provides an entry point for other viruses, bacteria, and fungi, potentially leading to secondary infections that slow down healing and worsen the appearance.
- Scarring: Popping or squeezing a cold sore can inflame the area, making it more prone to scarring. While cold sores usually don't scar when left to heal naturally, squeezing can increase this risk.
- Increased Pain and Swelling: Popping a cold sore can irritate the skin, worsening the pain and swelling associated with the blister.
It is especially important not to pop a cold sore if you have a compromised immune system due to an underlying condition or medical treatment. People with skin conditions like eczema or psoriasis are also at a higher risk of spreading the virus to other areas of their body.
What to Do Instead of Popping a Cold Sore
Cold sores naturally burst and then scab over during the healing process. It is not necessary to pop them. Instead, people with cold sores can focus on managing symptoms and promoting healing:
Over-the-Counter (OTC) Treatments
- Topical Antiviral Medications: Creams containing active ingredients like aciclovir (Zovirax), penciclovir (Denavir), docosanol (Abreva), or benzyl alcohol (Zilactin) can help speed up recovery. These are most effective when used at the first sign of a cold sore (tingling, itching, or soreness) and should be applied gently with a clean cotton swab.
- Pain Relievers: OTC pain relievers such as ibuprofen (Advil, Motrin) or acetaminophen (Tylenol) can help ease discomfort.
- Cold Compresses: Applying an ice pack wrapped in a towel or a cold, wet cloth can help reduce pain, burning, itching, inflammation, redness, and swelling.
- Moisturizers: Once the cold sore starts to crust over, applying petroleum jelly or a moisturizing lip balm can help reduce the appearance of flakes and cracks, preventing the sore from cracking and bleeding.
Home Remedies and Natural Approaches
While scientific evidence for some home remedies is limited, some people find them helpful:
- Aloe Vera and Tea Tree Oil: These are often used to soothe irritation. A patch test is recommended before widespread application.
- Lysine: This amino acid is available as a cream or oral supplement and may help shorten the duration of cold sores, though more research is needed.
- Hydrogen Peroxide: A small amount of diluted hydrogen peroxide can be applied with a clean cotton swab. It acts as an antiseptic and may aid healing. If irritation occurs, discontinue use.
Anecdotal reports suggest toothpaste may work by drying out cold sores due to sodium lauryl sulfate, but toothpaste also contains other ingredients that may irritate the skin. There is no scientific evidence to support this remedy.
Lifestyle Adjustments
- Diet: Avoid acidic, salty, or spicy foods, as they may cause stinging or irritation.
- Sun Protection: Protect cold sores from the sun by wearing a broad-spectrum lip balm and sunscreen with an SPF of 30 or higher.
Healing Time and When to Seek Medical Help
Cold sores typically heal on their own within 5-15 days, usually without leaving a scar. The first cold sores a person experiences may take longer, up to 3 weeks, to heal. OTC treatments or antiviral medications may help speed up the healing process by approximately one day.
Most people do not need to see a doctor for cold sore treatment. However, a person should seek medical help if they:
- Have a cold sore close to their eye.
- Notice signs of an infection spreading to other areas.
- Have a cold sore for longer than 15 days.
- Have a weakened immune system (e.g., due to cancer treatment or HIV).
- Have atopic dermatitis, particularly children.
- Are caring for a baby under 8 weeks old and have cold sores.
- Experience frequent outbreaks.
- Have cold sores that spread to other parts of the body, such as the eyes, hands, or genitals.
Prescription Antiviral Medications
For severe and recurring cold sores, oral or intravenous antiviral medication may be necessary. Doctors can prescribe medications such as acyclovir (Zovirax), valacyclovir (Valtrex), penciclovir (Denavir), or famciclovir (Famvir) to help cold sores heal faster and reduce the frequency of outbreaks.