Cold Sores/Mouth Ulcers: Causes, Tips to manage it

Cold sores are these tiny, blisters on or around the lips that usually contains fluid and are usually very painful. They also known as fever blisters, as they are commonly seen during a fever. They are a common manifestation of viral or bacterial infections. There’s no cure for cold sores, but antiviral pills or creams can help in making the mouth ulcer heal faster.

Most people can get infected by the virus even before they are 10 years old., after which the virus would remain inactive for years, waiting for the perfect time to strike. There are some conditions that can lead to an outbreak of cold sores. Examples are stress (both mental and emotional stress), dental treatment, illness, injury to the lips or even sun exposure.

In this write-up, we would be talking about what these mouth ulcers are, the common causes as well as tips to manage them.

What are Cold Sores/Mouth Ulcers?

Cold Sores are form of wounds or ulcers that appear as blisters on the lips. Mouth ulcers can also appear around the side or edge of the mouth, where it would seem like the mouth is tearing. They are a common complication of infections due to Herpes Simplex virus (HSV-1) or Syphilis. They are also seen in some cases of Vitamin deficiencies. These cold sores are:

  • Tingling and itchy: Some persons have this feeling about a day or two before the small, painful blisters appears.
  • Blisters: commonly found around the lips, nose or cheeks. Sometimes, you might notice them inside the mouth.
cold sores, mouth ulcers
Cold sores due to Herpes Simplex Virus seen on the lips. Image credits: Sun News

Causes of cold Sores/Mouth Ulcers

There are a number of medical conditions that can cause you to develop these cold sores or mouth ulcers. Common ones in our environment are:

  • Herpes: This is a viral infection caused by the Herpes Simplex virus (HSV-1). There are two types of the virus, the HSV-1 and the HSV 2. They are responsible for the Oral herpes and genital herpes respectively. They can cause cold sores that are identical to that of syphilis.
  • Syphilis: This is a type of bacteria infection that is caused by an organism known as Treponema Pallidum. It is commonly sexually transmitted, but can also be transmitted through other means as well. It is a common cause of cold sores in sexually active adults. Read more about Syphilis here.
  • Candida: This is an infection caused by candida albicans. Mouth ulcers are usually seen in some persons with this infection, especially in persons with some form of immunosuppression, such as in cases of Diabetes, people on steroids or on treatment for cancer.
  • Malnutrition: mouth ulcers can also be seen in malnourished children, with forms of vitamin and iron deficiencies. Read more about malnutrition here.
  • Medication: Some drugs, example, carbimazole have been identified with mouth ulcers.

Other uncommon causes of mouth ulcers are: some cancers (e.g: squamous cell carcinoma), bacterial infection like vincent’s angina, some problems of the blood (haematological disorders), some skin diseases (e.g: lichen planus), SLE, etc.

Risk factors for Mouth Ulcers

These are the things that can put you at risk of developing these cold sores. A number of people, especially adults carry these infections that can causes the mouth ulcers, even if they’ve not shown any sign of it. Conditions such as the following can put you at a greater risk of complications from the virus:

  • Medication Abuse
  • Diabetes
  • Atopic dermatitis (eczema)
  • undergoing Treatment for Cancer
  • Undergoing preparation for organ transplants

Symptoms of Cold Sores/Mouth Ulcers

A cold sore itself is actually a sign of an underlying disease or infection, but other symptoms that may be associated with these mouth ulcers include:

  • Fever
  • Headache
  • Painful gums
  • Muscle aches
  • Sore throat
  • Sores in the genital region.
  • Muscle wasting

Treatment for mouth Ulcers/Cold Sores

Most times, the ulcers would go away on their own without any treatment, but, you should see a doctor if:

  • the ulcers do not go away after two weeks.
  • You have any of diabetes, steroid abuse or malnutrition, which can weakened your immune system.
  • You have frequent recurrences of these mouth ulcers

Some antiviral medications can help the sores to heal faster. Examples are acyclovir (Zovirax), famciclovir (Famvir), etc. These drugs cannot get rid of the virus. They relieve pain and discomfort.

Tips to Manage Cold Sores/Mouth Ulcers

It is usually best to avoid the virus, by protecting yourself. However, If you have already contracted the virus, you can practice the following to keep yourself comfortable:

  1. If the ulcers are very painful, you can make use of Pain relievers such as paracetamol or ibuprofen. Ensure to see a doctor for the appropriate dosage of Ibuprofen that would be enough for you. Taking this drug without a doctors guidance can cause you to develop stomach Ulcers.
  2. Ice cubes can be used to ease the pain and keep mouth ulcers cool.
  3. Avoid consumption of foods with high acidic contents (like oranges, tomatoes, and lemonade) as well as spicy or salty foods, which can cause irritation.
  4. Do not touch the ulcers while you are waiting for them to heal. This may cause bleeding, or even lead to it being infected. Remember, sores are open wounds and bacterial or viral infections can slowly enter from it.

Complications of Cold Sores

These are other medical conditions that could arise as a result of this mouth ulcer. Some times, they are much worse than the ulcer. They include:

  • Whitlow: This is an infection of the spaces in the finger. It can arise due to infection by HSV-1 or HSV-2. It is commonly referred to as herpes whitlow. It is commonly seen in children, who have these sores and who suck their thumbs.
  • Eyes Problems: Transfer of the virus to the eyes can result in repeated infections of the eye, which can lead to injury of the eye from scars due to these injuries. These may in turn lead to visual problems or loss of vision.
  • Spread of Sores to the skin: This is commonly noticed in persons who have another condition known as allergic dermatitis (popularly called eczema in our environment). In these people, these ulcers can spread to other parts of their bodies. This is a serious problem.

Prevention of Cold Sores

In order to prevent the sores from getting to other parts of your body, or to other people, You should:

  • Avoid skin contact or kissing with individuals who have blisters, especially in children.
  • Avoid sharing items like lip balm, towels and other personal items.
  • Keep your hands clean: Ensure that your hands are properly washed before touching any part of your body or even other people, especially babies.

Facts about cold sores

•  They are tiny blisters that appear on the lips or around the mouth.

• It is commonly caused by the herpes simplex virus HSV-1 which is a highly contagious virus, and is spread through close contact.

• Cold sores usually clear up within 7 to 10 days, and most times requires no treatment.

• After infection, the virus can remain inactive for a long time, till activated by triggers like stress or injury.

Feel free to ask any questions below


  • Obasi Chinedu

    Obasi Chinedu David attended the College of Medicine, University of Nigeria Teaching Hospital, in ituku-ozalla, Enugu state, Nigeria.

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