Signs and symptoms vary, depending on whether this is your first outbreak or a recurrence. The first time you have a cold sore, symptoms may not start for up to 20 days after you were first exposed to the virus. The sores can last several days, and the blisters can take two to three weeks to heal completely.
In a first-time outbreak, you might experience the following symptoms:
- A burning sensation in the mouth, followed by painful mouth sores, which can form on the tongue, gums, lips, or throat
- Sore throat
- Pain when swallowing
- Swollen lymph nodes (glands)
- Fever
- Aches and pains
- Headache
- Nausea
- Fever
- Burning and pain inside your mouth
- Painful gums
- Muscle aches
Children under 5 years old may have cold sores inside their mouths and the lesions are commonly mistaken for canker sores. Canker sores involve only the mucous membrane and aren’t caused by the herpes simplex virus.
Recurring cold sores
If you get cold sores from time to time, the signs and symptoms may also differ. Recurrences typically appear at the same spot each time and tend to be less severe than the first outbreak. If you get cold sores, you’ll usually have the following signs and symptoms:
1. Warnings symptoms begin. A day or two before you get a cold sore, you may feel one or more of the following on your skin where a cold sore will appear.
- Burning
ItchingStingingTingling and the skin feels a little numbThrobbing
Some people who have these warning symptoms never get cold sores.
2. Cold sores appear. One or more painful, fluid-filled blisters appear. These usually form on your lips or around your mouth. They can also appear elsewhere on your face. If you have a sore near an eye, you should see an eye doctor immediately. The virus can spread to the eyes. Warning signs that this has happened include your eyes becoming sensitive to light or feeling painful. Your eyes may also feel gritty or runny.
If any of these symptoms develop, you need immediate medical treatment. Without treatment, your eyesight could be affected. Sometimes, blisters appear elsewhere. They can appear on a hand or in the genital area. This can happen when you spread the virus from your mouth to other areas by touching a cold sore and then touching another part of your body. You can avoid spreading the virus to other parts of your body by always washing your hands after touching your cold sores.
3. Sores crust over. Within 48 hours of the warning symptoms, cold sores usually break open. They will ooze fluid and then crust over (form scabs).
In healthy people, most cold sores disappear within 5 to 15 days. They often heal without leaving a scar. If you have cold sores for longer than 15 days, you should see your primary care doctor or dermatologist. Some people need treatment to get rid of cold sores.