Cold sore living in children

Overview

Cold sores are small, painful blisters that usually appear on or around the lips. They are caused by a common virus called herpes simplex. Cold sores are contagious, meaning they can spread to others through close contact.

Yes, cold sores are very common in children, especially after the age of 5. Most people get the virus by the time they are adults.

Children of all ages can get cold sores, but they are most common in school-age children. Babies under 6 months old can get them, but this is less common.

Symptoms

Common symptoms

• Tingling, itching, or burning feeling around the lips or mouth
• Small, fluid-filled blisters that may break open and crust over
• Pain or discomfort around the sores

Symptoms in children

• Fever and swollen glands
• Irritability or fussiness
• Drooling or difficulty eating because of soreness

Symptoms in older adults

• Similar symptoms, but may be more painful or take longer to heal

Causes

Main causes

• Herpes simplex virus type 1 (HSV-1) – the most common cause of cold sores
• Close contact with someone who has an active cold sore (kissing, sharing utensils, or towels)

Risk factors

• Stress, tiredness, or being unwell
• Exposure to strong sunlight or cold wind
• Weakened immune system

When to see a doctor

See a doctor urgently if:

• If your child is under 6 months old and has a cold sore
• If the cold sore is near the eye
• If your child seems very unwell, has a high fever, or has trouble eating or drinking

Book a routine appointment if:

• If cold sores keep coming back (more than a few times a year)
• If your child has a weakened immune system
• If the cold sore does not heal after 2 weeks

Diagnosis

A doctor can usually diagnose cold sores just by looking at them. The typical appearance of the blisters is often enough to make the diagnosis.

Tests that may be done

• A swab of the blister fluid may be sent to a lab if the diagnosis is not clear
• Blood tests are rarely needed

What to expect at your appointment

The doctor will ask about your child's symptoms and examine the sore. No special preparation is needed. The process is quick and painless.

Treatment

Cold sores often heal on their own. You can help your child feel more comfortable at home. In some cases, a doctor may recommend antiviral medicine to speed up healing.

Self-care at home

• Keep the area clean and dry
• Apply a cold, damp cloth to the sore for a few minutes to soothe pain
• Offer soft, cool foods (like yogurt or smoothies) if eating is painful
• Avoid picking or scratching the blisters – this can cause infection
• Wash hands frequently, especially after touching the sore

Medical treatments

A doctor or pharmacist can recommend antiviral creams or oral medicines that help the cold sore heal faster and reduce symptoms. These are most effective when started early, at the first sign of tingling. Always follow the dosage instructions and talk to your healthcare provider before using any medicine in children.

When is surgery considered?

Surgery is not used for cold sores.

Living with this condition

Cold sores are contagious until they are completely healed (when the scab falls off and new skin appears). Teach your child not to kiss others, share drinks, utensils, towels, or lip balm during an outbreak. Wash hands regularly to prevent spreading the virus to other parts of the body or to other people.

Lifestyle tips

• Help your child manage stress – a calm routine, enough sleep, and relaxation can reduce outbreaks
• Protect lips from sun and cold weather with a lip balm that has sunscreen
• Encourage good hygiene, such as not touching the face unnecessarily

Diet and exercise

Eating well and staying active supports a healthy immune system, which may help reduce how often cold sores appear. If the sores make eating painful, offer soft, cool, or lukewarm foods and plenty of fluids.

Mental health and emotional wellbeing

Older children may feel embarrassed or self-conscious about cold sores. Reassure them that cold sores are very common and temporary. Let them know that the blisters will go away and that they can still play and learn as usual. If your child is upset, talk to them openly and offer comfort.

Prevention

It is difficult to prevent cold sores completely because the virus is so common. However, you can reduce the risk by avoiding close contact with people who have an active cold sore, not sharing personal items, and encouraging good hand hygiene.

Vaccines

There is no vaccine for cold sores.

Screening programmes

There is no routine screening for the herpes simplex virus.

Complications

If left untreated

• In rare cases, the virus can spread to other parts of the body, such as the fingers (herpetic whitlow) or the eye (herpes keratitis), which can be serious
• In children with weakened immune systems, the infection can become severe and spread to internal organs

Long-term outlook

For most children, cold sores are a mild and temporary nuisance. They heal without problems, and outbreaks become less frequent over time. With simple home care and good hygiene, your child can stay comfortable and healthy. If you have any worries, your doctor can help.

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