Cold sore living in teenagers

Overview

A cold sore is a small, painful blister that usually appears on or around the lips. It is caused by the herpes simplex virus (HSV). Once you have the virus, it stays in your body and can cause cold sores from time to time.

Yes, cold sores are very common. In fact, most people carry the virus that causes them, though many never get symptoms.

Cold sores can affect anyone, but teenagers often get their first outbreak during their teenage years. This is because the virus is easily spread through kissing or sharing items like drinks or lip balm.

Symptoms

Common symptoms

• A tingling, itching, or burning feeling on the lip (this often happens a day or two before the sore appears).
• A small, fluid-filled blister, usually on or around the lip.
• The blister may break open, crust over, and then heal without leaving a scar.
• Sometimes a mild fever, swollen glands, or feeling unwell, especially with the first infection.

Symptoms in children

• Children may get cold sores around the mouth, but the first infection can be more severe, with painful blisters inside the mouth and a high fever.
• Young children might drool more, be irritable, or refuse to eat or drink because of the pain.

Symptoms in older adults

• Older adults can get cold sores too, but they may last longer or be more painful.
• If an older adult has a weakened immune system, the cold sore might spread or take longer to heal.

Causes

Main causes

• Cold sores are caused by the herpes simplex virus type 1 (HSV-1). Once you get the virus, it stays in your body and can reactivate from time to time.
• The first infection often happens in childhood – it can be passed by kisses, shared cups, or touching an active cold sore.

Risk factors

• Stress or feeling run down.
• Illness like a cold or the flu.
• Too much sun or wind on the lips.
• Fatigue – not getting enough sleep.
• Hormonal changes, like during your period.
• Having a weakened immune system (e.g., due to medicines or chronic illness).

When to see a doctor

See a doctor urgently if:

• If you have a cold sore near your eye or you notice eye pain, redness, or vision changes.
• If you have a very high fever or feel very unwell.
• If the cold sore is very large, painful, or spreading.

Book a routine appointment if:

• If you get cold sores often (many times a year).
• If a cold sore does not heal within 10 days.
• If you are worried about the way it looks or feels.

Diagnosis

Doctors can usually tell if you have a cold sore just by looking at the blister. They will ask about your symptoms and any triggers.

Tests that may be done

• Usually no tests are needed.
• In rare cases, if the diagnosis is not clear, a doctor might take a swab of the fluid from the blister to confirm the virus.

What to expect at your appointment

The doctor will examine the sore and ask about your health. They may recommend ways to manage symptoms or treatment to help it heal faster. For most teenagers, no special tests are needed.

Treatment

There is no cure for the herpes virus, but treatments can help cold sores heal faster and reduce pain. Medicines work best when started as soon as you feel the first tingle or itch.

Self-care at home

• Keep the area clean and dry.
• Avoid touching the sore – it can spread the virus to other parts of your body or to other people.
• Apply a cool, damp cloth to the sore to ease pain.
• Use a lip balm with sun protection (SPF 30 or more) to prevent sun-triggered cold sores.
• Avoid kissing or sharing drinks, utensils, towels, lip balm, or toothbrushes while the sore is active.
• Wash your hands often, especially after touching the sore.

Medical treatments

Antiviral creams or ointments are available from pharmacies and can help the sore heal faster if applied early. For frequent or severe cold sores, a doctor may prescribe antiviral tablets. These treatments do not kill the virus, but they can reduce the severity and duration of outbreaks. Always use treatments as directed by your pharmacy or doctor.

When is surgery considered?

Surgery is not used for cold sores.

Living with this condition

Having a cold sore can be annoying, but they usually go away quickly. You can still go to school, work, and do most activities – just avoid close contact until the sore has healed completely.

Lifestyle tips

• Manage stress – try relaxation techniques, enough sleep, and regular exercise.
• Protect your lips from extreme sun or wind with a lip balm that has SPF.
• If you get cold sores often, notice what triggers them and try to avoid those triggers.

Diet and exercise

Eating a balanced diet helps your immune system stay strong. Avoid very salty, spicy, or acidic foods (like citrus) when you have a cold sore – they can sting. Regular exercise is good for overall health and stress management.

Mental health and emotional wellbeing

Cold sores can make teenagers feel self‑conscious or embarrassed. It is normal to feel upset about the way they look. Remember, cold sores are very common and not your fault. If you feel worried or down about them, talk to a trusted adult, friend, or doctor.

Prevention

You cannot always prevent cold sores, but you can reduce how often they happen. Avoid your known triggers (like too much sun, stress, or not enough sleep). Use a lip balm with SPF every day. Avoid sharing personal items when someone has an active cold sore.

Vaccines

There is no vaccine for cold sores.

Screening programmes

There is no routine screening for the herpes simplex virus.

Complications

If left untreated

• Most cold sores heal without problems, but rarely the virus can spread to other areas, such as the eyes (herpes keratitis) which can affect vision.
• In people with weak immune systems, the infection can spread more widely and cause more serious illness.
• If a cold sore becomes infected with bacteria, it may get redder, swollen, and painful – this is rare.

Long-term outlook

For most teenagers, cold sores are a temporary nuisance. They usually heal without scars and become less frequent as you get older. With the right care and avoiding triggers, you can keep outbreaks under control. If you have concerns, your doctor can help you manage them easily.

Find support

Local organisations

• NHS – Cold Sores ↗ · UK

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