What Is a Cold Sore?

Are cold sores an STD? How can you tell if you have one? And how can cold sores be best treated and prevented?

Sanaz Majd, MD
Episode #232

Diagnosis of Herpes Simplex

The very best way to diagnose HSV is by exam. Tests are not often necessary, nor are they very accurate.

Your doctor can diagnose after a simple visual inspection of the sore, which has a very characteristic appearance. The sores are either blisters or vesicles with some fluid within, along with a reddish base surrounding the sore itself. It often scabs and heals over.

There is a swab and blood test for HSV, but it is not very reliable. Here’s why:

1.       People can carry the viruses without ever having symptoms.  In fact, most people have been exposed to it, carry the virus, and never display any symptoms.

2.       Like previously mentioned, there’s cross reactivity of the two types. Therefore, testing a specific spot will not accurately reveal whether it was sexually transmitted or not, which is often the main question at hand.

Treatment of Herpes Simplex

Unfortunately, like many other viruses (think cold and flu) there is no cure for herpes simplex. But treatment options can make the symptoms bearable until the breakout clears up and/or shortens the severity and duration of the outbreak.

Here are some ways to deal with HSV:

1.       No treatment:  If the symptoms are not bothersome, you don’t need to do a thing. The breakouts do self-resolve.

2.       Topicals:  Over-the-counter (OTC) gels that can provide some temporary pain relief, although often brief.

3.       Pain Relievers:  OTC acetaminophen or ibuprofen as needed may help take the edge off. Ibuprofen has an extra benefit because it also helps fight the inflammation, which often causes the discomfort.

4.       Anti-Virals:  Prescription acyclovir or valcyclovir can help shorten the duration of your symptoms and diminish the severity. However, in order to be effective it must be taken within 3 days of onset, and the earlier the better.

5.       Prophylaxis: If your symptoms occur too frequently, one option is to take a daily prescription antiviral to keep the virus suppressed. This requires a conversation with your doctor, in order to determine when the pros outweigh any cons of a daily antiviral.

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Please note that all content here is strictly for informational purposes only.  This content does not substitute any medical advice, and does not replace any medical judgment or reasoning by your own personal health provider.  Please always seek a licensed physician in your area regarding all health related questions and issues.

Image courtesy of shutterstock.


About the Author

Sanaz Majd, MD

Dr. Sanaz Majd, a board-certified Family Medicine physician who graduated from Drexel University College of Medicine in Philadelphia. She sees everything from pediatrics to geriatrics, but her special interests are women's health and patient education. She also loves to teach, and has been doing so since her college days.

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