How to Prevent Cold Sores: 10 Steps (with Pictures) (2024)

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1Reducing Exposure Risks

2Eliminating Triggers

3Using Supplements and Medications

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Tips and Warnings

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References

Article Summary

Co-authored byDiana Lee, MD

Last Updated: June 3, 2022References

Cold sores are painful blister-like sores that usually appear around the lips. They are caused by the herpes simplex virus (predominantly the type 1 variety, but also type 2 in some cases), which can be transmitted from one person to another under certain circumstances. Herpes infections of the mouth are very common in the United States, with up to 40% of young adults testing positive for the virus, regardless of whether or not they show symptoms.[1] Herpes infections are considered incurable and it's not always possible to prevent an outbreak of cold sores, so reducing your risk of exposure in the first place is your best bet. If you have a history of cold sores, then practice the following strategies to help prevent them from reoccurring.

Part 1

Part 1 of 3:

Reducing Exposure Risks

  1. 1

    Know when cold sores are most contagious. Until a person is experiencing an outbreak, it is difficult to know if the virus is being shed — this is known as "asymptomatic shedding."[2] On the whole, a person is most contagious (viral shedding is at its highest) when blisters are present. Cold sores pass through different stages. Initially, they cause an itching, burning or tingling sensation for a day or so. Then small, hard, painful spots appear, which quickly turn into erupting blisters. The fluid-filled blisters then break, oozing an yellowish liquid before crusting over. The scabs then flake off and the skin returns to normal.

    • Cold sores persist for seven to 10 days and rarely leave scars.
  2. 2

    Be careful who you kiss and have sex with. The herpes simplex virus (HSV) is typically spread from person to person contact, either by kissing or close contact with the genitals (oral sex).[3] The most contagious period is when active and erupting blister-like sores are present, either near the lips or genitalia. Once the cold sores have dried and crusted over (which typically takes a few days), the risk of contagion is significantly reduced. However, keep in mind that HSV can spread without the presence of a cold sore of any kind, because it can infect saliva and other body fluids.

    • Ask all potential partners about their HSV status before being intimate with them. If unsure, avoid kissing any skin abnormalities and don't exchange fluids.
    • Cold sores on the mouth are mainly caused by the oral (type 1) herpes virus, but they can also be caused by contact with the genital (type 2) herpes virus.
    • A healthy immune response usually combats it and prevents infection. Thus, people with weakened immunity are at higher risk of HSV infection and complications.[4]

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  3. 3

    Don't share food and beverages. Normally, HSV lives within nerves (ganglions) near the spinal cord, then it eventually gets triggered and travels within smaller peripheral nerves to the surface of the skin (around the mouth or genitalia), where it erupts and causes the formation of a sore. However, as noted above, HSV can also live in saliva and blood at certain stages and under certain circumstances.[5] As such, reduce the risk of infected saliva exposure by not sharing food or beverages with anyone, regardless if they appear to have cold sores or not. In particular, refrain from sharing forks, spoons and straws.

    • For an infection to occur, HSV typically needs a way into tissue so it can access nerve fibers, which essentially act as "highways" for the virus. Thus, small cuts or abrasions around your mouth, on your lips and/or on your sex organs will increase the risk of infection. However, an infection can occur even without a cut.
    • Avoid sharing lip balms, lipstick and facial creams with other people also, as it's theoretically possible for HSV to survive on or in these mediums for short periods of time.
  4. 4

    Practice good hygiene. It's rare to catch HSV and cold sores from contaminated surfaces, such as toilet seats or countertops, or other mediums like towels and washcloths, but it can occur.[6] The herpes virus isn't well adapted to living outside the body, so it quickly dies when airborne or on surfaces — which is contrast to viruses that cause the common cold. However, you could easily get infected saliva or other body fluids directly on your hands from another person and then inadvertently rub your mouth or eyes, so washing your hands after touching people is a still good protective strategy.

    • Disinfect your hands by washing them with regular soap and water.
    • Cold sores pass through different stages. Initially, they cause an itching, burning or tingling sensation for a day or so. Then small, hard, painful spots appear, which quickly turn into erupting blisters. The fluid-filled blisters then break, oozing an yellowish liquid before crusting over. The scabs then flake off and the skin returns to normal.
    • Cold sores persist for 7-10 days and rarely leave scars.

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Part 2

Part 2 of 3:

Eliminating Triggers

  1. 1

    Reduce your stress levels. The exact reasons how or why HSV goes from its dormant stage within the spinal nerve ganglions to becoming active and spreading to the surface of the skin is not known, but stress certainly plays a factor.[7] It's likely that stress weakens the immune system, allowing HSV to take advantage of the opportunity to spread and proliferate itself. Therefore, reducing the stress from your work and personal life is a good strategy to prevent cold sore outbreaks.

    • Natural and effective stress-relieving practices include meditation, yoga, tai chi and deep breathing exercises.
    • In addition to emotional stress caused by financial and/or relationship issues, your immune system is also negatively impacted by physiological stressors, such as dealing with other chronic or acute infections, poor nutrition, and exposure to toxins (such as alcohol or cigarette smoke).
    • Work on keeping all types of stress in check through healthy lifestyle choices: nutritious diet, adequate sleep (at least 8 hours nightly) and some daily exercise.
  2. 2

    Avoid too much sun exposure. Another trigger to activate HSV from its dormant stage is excessive ultraviolet radiation from the sun, especially if coupled with lots of wind[8] Although exposure to the sun in moderation tends to be healthy for the skin and immune system (primarily due to vitamin D production), too much UV radiation damages skin cells and seems to trigger the ever-opportunistic HSV to make an appearance. As such, don't overdo it at the beach, especially on windy days, and always apply a sunscreen of SPF 15 or higher.

    • Although sunburn in general can trigger the formation of cold sores around the mouth, make a special effort to protect your lips and mouth from UV radiation exposure. Use a zinc oxide cream or balm on your lips when outside and keep them well moisturized.
    • Colds sores have a tendency to reoccur in the same places during each outbreak, which can happen on a monthly basis (related to menstruation for some women) or once or twice a year.[9]

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Part 3

Part 3 of 3:

Using Supplements and Medications

  1. 1

    Increase your intake of lysine. Lysine is an essential amino acid that has many benefits to human health, including anti-viral behavior. In essence, the anti-viral actions of lysine involve blocking the activity of arginine, which promotes HSV replication. Some scientific studies suggest that supplementing with lysine on a regular basis may help prevent outbreaks of cold sores and genital herpes. From scientific research, it appears that taking lysine is more effective for preventing HSV outbreaks than it is for reducing the severity or duration of outbreaks.

    • Not every study has shown positive results for using lysine as a preventive supplement for cold sores. Be aware that much supporting evidence is anecdotal, or not supported by scientific study.
    • Lysine is available in pill form and as a cream. If using pills, a typical preventive dose is at least 1,000 mg daily.
    • Lysine rich foods that are relatively low in arginine include most fish, chicken, beef, dairy products, green beans, and most fruits and veggies (except for peas).
  2. 2

    Supplement with vitamin C. Although there is very little quality research investigating the effects on HSV specifically, it is clear that the vitamin has anti-viral and immune boosting properties, both of which are helpful for preventing cold sores.[10] Vitamin C, also called ascorbic acid, increase the production and activity of specialized white blood cells, which seek out and destroy viruses and other pathogens. Vitamin C is also necessary for the production of collagen, the compound needed to repair skin and allow it to stretch. Perhaps not coincidentally, lysine is also involved in collagen production, so maybe weakened and unrepaired skin cells around the mouth contribute to triggering HSV and cold sores — just a theory.

    • Recommendations for cold sore prevention range from 1,000-3,000 mg of vitamin C daily, in 2-3 divided doses. Taking more than 1,000 mg at a time may trigger diarrhea.
    • Rich sources of vitamin C include citrus fruits, kiwis, strawberries, tomatoes and broccoli.
    • Eating too much acidic fruit can cause canker sores on the inside of your mouth — don't confuse these with cold sores, which almost always appear outside the mouth.
  3. 3

    Consider other immune boosting supplements. When trying to combat any infection, true prevention depends on a healthy and strong immune response. Your immune system is comprised of specialized cells that search and destroy harmful viruses and other potential pathogens, but when the system is weakened or compromised, then outbreaks and infections are more common. As such, focusing on ways to boost your immune system is a logical approach to naturally preventing cold sores. In addition to vitamin C, other immune boosting supplements include vitamins A and D, zinc, selenium, echinacea and olive leaf extract.[11]

    • Vitamin A reduces the risk of infection by maintaining moist mucosal membranes and by influencing specialized white blood cells of the immune system.
    • Vitamin D3 is produced in your skin in response to intense summer sunshine. Thus, D3 is a good choice of supplement during winter months.
    • Olive leaf extract is a strong anti-viral and may work synergistically with vitamin C.
  4. 4

    Ask your doctor about taking antiviral medications. Although there are many over-the-counter medicines (in pill form or creams) that claim to be helpful in reducing the symptoms of cold sores, there are none that have proven to prevent outbreaks. However, some prescription anti-viral medications can help treat the symptoms and potentially prevent outbreaks.[12] Commonly prescribed anti-virals include acyclovir (Xerese, Zovirax), valacyclovir (Valtrex), famciclovir (Famvir) and penciclovir (Denavir).[13] If you have frequent outbreaks, your doctor may recommend taking an anti-viral drug daily for a few months as a trial. But in most cases, anti-viral drugs are taken as soon as the characteristic tingle or itchiness is felt, which acts to prevent the blisters from appearing or at least minimize their duration.

    • Keep in mind that the vast majority of HSV infected people do not have enough cold sore outbreaks to justify taking a daily anti-viral.
    • Common side effects from taking anti-virals include: skin rash, stomach upset, diarrhea, tiredness, joint pain, headache and dizziness.

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      Tips

      • Apply coconut oil to soften the cold sore and make it less stiff so you can eat easier.

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      • Don't stigmatize people who have cold sores. HSV is an extremely common virus, and many people the world over get cold sores.

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      • If you have HSV and are in a relationship with someone, be honest and disclose your situation so as to minimize the risk of infecting them.

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      About this article

      How to Prevent Cold Sores: 10 Steps (with Pictures) (24)

      Co-authored by:

      Diana Lee, MD

      Family Medicine Physician

      This article was co-authored by Diana Lee, MD. Dr. Diana Lee is a Surgical Retina Fellow. She received her MD from Georgetown University in 2015, did her fellowship at UCLA's Jules Stein Eye Institute, and completed her first residency at USC's Roski Eye Institute. Currently, she is a resident at the Los Angeles County Department of Health Services and a clinical fellow with Associates in Ophthalmology. Her research interests are diverse and include: cataract surgery, dry eye, thyroid eye disease, retinoblastoma and diabetic retinopathy. This article has been viewed 162,268 times.

      7 votes - 100%

      Co-authors: 17

      Updated: June 3, 2022

      Views:162,268

      Article SummaryX

      While it’s not always possible to prevent a cold sore outbreak, there are ways you can reduce the likelihood of an outbreak. If you can, try to keep your stress levels low, since stress can cause the HSV virus that causes cold sores to become active. If you can’t eliminate the causes of your stress, try to cope with them through techniques like yoga or deep breathing exercises. Also, avoid spending too much time in the sun, since sunlight can trigger the HSV to become active. For tips from our Medical co-author on how supplements like lysine or vitamin C might help suppress HSV, keep reading!

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      • How to Prevent Cold Sores: 10 Steps (with Pictures) (25)

        Anonymous

        Jun 28, 2016

        "These are good things to know. I don't do any of these things, but good to look out for in the future."

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