March 26th, 2009
12:57 PM ET

Is a cold sore always permanent?

As a new feature of CNNhealth.com, our team of expert doctors will answer readers’ questions. Here’s a question for Dr. Gupta.

Asked by Kaley, Tucson, Arizona

“Dr. Gupta,

My roommate has been getting cold sores around her mouth since she was a little girl. I have never had one until very recently. Is it true that once you get a cold sores, you’ll get them for the rest of your life? What can I do to avoid getting another one? Thanks.”


Hi Kaley. Thanks for writing in. Cold sores – also known as fever blisters – are highly contagious. The virus can live on towels, razors, cooking utensils, cups among other everyday household places. So you can imagine how easy it is to pass to a roommate, as in your situation, or to a family member.

Fever blisters are the result of virus known as herpes simplex virus one (HSV-1). While the thought of the virus infecting your body may seem really serious, its actually relatively harmless and quite common. Eight in 10 Americans are HSV-1 carriers, according to the National Institutes of Health.

There is no currently no cure for cold sores. Once you have the virus, you have it for life. HSV-1 moves around your body and “sleeps” in your nerves cells until something triggers it to “wake up.” The virus will then move to the surface. Some people will go years without having an infection, while other people will experience them frequently.

You can limit your overall risk by identifying what triggers your cold sores. The most common reasons are exposure to the sun, stress, a low immune system or toothache. Even certain foods can be the trigger.

Some believe foods such as olive oil, citrus fruits, sea salt, garlic, asparagus as well as  soft drinks and chocolate can trigger a cold sore.   If your cold sore already is already formed, some of these foods may aggravate the infection. The best thing to do is eat a balance of these foods. Eating or drinking any of these items from time to time is not problematic, just be mindful of the triggers and eat a balanced diet.

And it’s worth noting that your body will give you warning signals when the cold sore is on the way. The infected area will feel warm, tingling, perhaps even itchy up to two full days before you see the physical signs. If you begin treatment during this early stage, you’ll limit the severity of the outbreak.

When the small red blisters bumps begin to surface on your lip, or corner of your mouth, it’s critical to not touch the area at all. This is most contagious stage and the fluid in those bumps will infect other areas of your body and the people around you.

The best treatment option in the early stages is a prescription antiviral medication. These come in pill or ointment form and will help limit the growth of the virus. There are some ointments to help relieve the pain and itchy senstations available over the counter. People often get relieve from a cool compress on the area for about 20 minutes.

So Kaley, although cold sores are often a nuisance phyiscally, there are several ways to limit the frequency or severity of a potential outbreak. Your doctor can help determin the best treatment option for you.

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Get a behind-the-scenes look at the latest stories from CNN Chief Medical Correspondent, Dr. Sanjay Gupta, Senior Medical Correspondent Elizabeth Cohen and the CNN Medical Unit producers. They'll share news and views on health and medical trends - info that will help you take better care of yourself and the people you love.