Let's Bust Some Cold Sore Myths


Here’s a statistic for you: the World Health Organization estimates that around 67-percent of people globally (that’s 3.7 billion people, BTW) get cold sores. Maybe you’re one of those 3.7 billion! It does sound pretty likely. But although cold sores are super common, there’s a lot of misinformation out there on them. Namely what they are, how to treat them, and how to prevent them from getting worse. When it comes to cold sores, swapping rumors is just about as effective as swapping spit. Which is why we reached out to three doctors to bust six of the biggest cold sore myths. Whether you’ve had a cold sore before or not, here’s everything you have to know.

Myth: This thing next to my lip? Oh, that’s just a pimple.
Fact: Sometimes it can be really hard to tell whether what you’re dealing with is actually a cold sore, or just a zit that’s cropped up near your lip. “Cold sores look like one or more blisters, pus bumps, or erosions, and they often tingle,” says board-certified dermatologist at Laser & Skin Surgery Center of New York Dr. Roy Seidenberg. “They’re usually clumped together in patches,” added board-certified dermatopathologist Dr. Gretchen Frieling, “and appear on the lips, chin, cheeks, inside the nostrils, and less frequently on the gums or the roof of the mouth.” Plus, Dr. Frieling notes that while pimples go away on their own rather quickly, cold sores may persist for two weeks or longer. If you really can’t tell, it’s best to treat the spot like a cold sore anyway to prevent spreading, just in case. Avoid touching your face, wash your hands frequently, and don’t share food or makeup. If you’re really unsure if it’s a zit or a cold sore, Dr. Seidenberg advises visiting your doctor for a culture swab.

Myth: Sure, I get cold sores, but I don’t have herpes.
Fact: It’s a complicated answer, but this isn’t quite true—if you get cold sores, it does mean that you have oral herpes. Here’s why: cold sores can be caused by two different viruses, herpes simplex type one and herpes simplex type two. Notice that both have the word ‘herpes’ in the name? When we talk about herpes, what we usually mean is HSV-2, the virus historically responsible for genital sores. However, there isn’t much difference between HSV-1 and HSV-2. “Genital herpes used to be pretty much HSV-2, but now it’s almost 50-percent HSV-1 in recent studies,” says Dr. Seidenberg. While he recognizes that oral cold sores are almost always HSV-1, both HSV-1 and 2 can spread either upstairs or downstairs through contact. Dr. Sapna Palep, board-certified dermatologist at Spring Street Dermatology, echoes this statement, noting that while the viruses are slightly different genetically, “herpes are not defined by where you get them.” Because of that, you may as well think of cold sores and herpes as the same thing—both cause sores, may flare up or lie dormant, and are treatable but not curable. But don’t freak out! It’s estimated that 50 to 80-percent of adults in the US have oral herpes, too.

Myth:I can tell I’m not infected with the herpes simplex virus because I’ve never had a cold sore.
Fact: The herpes simplex infection can lie dormant in your body for a long time—and it’s contagious even when sores are not visible. It’s quite possible that even though you’ve never had a cold sore, you’re still a carrier. “Many people actually get the infection during childhood,” says Dr. Seidenberg, “and it stays dormant until you’re a stressed-out adult.” Dr. Palep adds, “Regardless of having symptoms or not, an infected person can still transmit the virus.” That’s why it’s so difficult, and often impossible, to pinpoint exactly when you were infected.

While Dr. Frieling notes that only 40-percent of the US adult population get repeated cold sores, it’s likely that you’ll get at least one in your lifetime. If you’ve managed to escape them thus far, it’s probable that one’s still coming your way eventually.

Myth: Cold sores can only happen on the mouth or the genitals.
Fact: While it sounds like an urban legend, it’s wholly possible for the herpes virus to spread to anywhere on the body where there’s been contact. If you have a cold sore, be particularly careful about avoiding contact with any open wounds on your body. Wash your hands often, and don’t rub your eyes. (Yes, the sores can spread there, too.)

Additionally, refrain from scheduling facials when you have an active cold sore. Not only is it possible your aesthetician may turn you away (the virus is extremely contagious, and by touching your face the aesthetician is at high risk of infection), but facial treatments are likely to exacerbate your outbreak or spread the sores across your face.

Myth: You can only get the herpes simplex virus from sex.
Fact: You can get HSV from a whole host of sources. The most common form of transmission is person-to-person contact—sex is just one of the many ways we interact with others. “You can get the herpes simplex virus from kissing, sharing cosmetics, sharing food, and of course oral sex,” says Dr. Frieling.

But what about non person-to-person infection? Can you get the virus from contact with shared surfaces, too? “The virus can survive on dry surfaces for anywhere between a few hours to eight weeks,” shares Dr. Palep, adding that the virus survives longest at lower humidity. In 2017, Sephora faced a lawsuit claiming that one woman contracted HSV from Sephora makeup samples. And the New York Department of Health suggests sharing a cell phone may also spread the virus. Still, Dr. Seidenberg insists, “non person-to-person transmission is the exception, not the norm.” Probable? No. But possible? Absolutely.

Myth: I can use [insert home remedy here] to get rid of a cold sore.
Fact: The only way to treat cold sores is with an antiviral—and all three doctors emphasize not endorsing natural, at-home remedies. “Vanilla, ear wax, licorice, acetone, and toothpaste are not effective treatments for cold sores,” insists Dr. Frieling. To that list, Dr. Palep adds baking soda and castor oil, and Dr. Seidenberg essential oils, including tea tree.

So, let’s say you’re dealing with a flare up—potentially triggered by a cold with a fever, menstruation, stress, and even sun exposure according to Dr. Frieling. To treat it, head to your doctor for a prescription antiviral—Acyclovir, Famvir, and Valtrex are the most popular. “The next best treatment is using an over-the-counter topical antiviral like Abreva,” says Dr. Palep. Or you could wait it out! After a couple weeks, the cold sore will go away on its own.

Photo via ITG