The first exposure to the virus may result in a blistering rash in the mouth and/or lips with a body-wide, flu-like illness. This first outbreak of cold sores is usually gone within 7-10 days, but it can last up to 20 days. The sores can also develop in other locations on the skin.
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The symptoms of the first outbreak are:
After these initial symptoms, the virus may lie quietly in the nerves until it is reactivated. This may happen due to stress or illness. Direct sunlight, a weakened immune system, and menstruation can also trigger reactivation.
If reactivated, the virus will come out as a cold sore . A few days before the sore appears, you may notice some itching, burning, or pain in the area. Some people have outbreaks regularly. Some never have another symptom after the initial infection.
The symptoms of an active cold sore are:
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Herpes simplex. DermNet NZ website. Available at: http://dermnetnz.org/viral/herpes-simplex.html. Updated February 6, 2013. Accessed February 17, 2014.
Kuehl B. Cold sores: how to prevent and treat them. Skin Care Guide website. Available at: http://www.skincareguide.ca/articles/herpes/to_prevent_cold_sores.html. Accessed February 17, 2014.
Oral herpes. EBSCO DynaMed Plus website. Available at:http://www.dynamed.com/topics/dmp~AN~T115104/Oral-herpes. Updated October 5, 2015. Accessed October 4, 2016.
Last reviewed March 2017 by EBSCO Medical Review Board David L. Horn, MD Last Updated: 3/15/2015