8 Critical Cold Sore Stages

Nidhi Nangia
By Nidhi Nangia. Updated: June 17, 2020
8 Critical Cold Sore Stages

Cold sores, also known as fever blisters, herpes labialis or oral herpes, are a kind of infection which affect lips or the area around the mouth. They are caused by HSV-1 (herpes simplex virus 1). Cold sores may take as long as 2-3 weeks to heal completely, but the virus causing them will still be laying dormant in your body. In order to have a clearer understanding of cold sores, you need to have a look at the 8 critical cold sore stages. Reading this oneHOWTO article will detail these stages as well as providing some information on treating the symptoms of cold sores.

You may also be interested in: What are the Stages of a Cold Sore?


  1. Symptoms of cold sores
  2. Stages of Cold Sores
  3. Treatment and management of cold sores

Symptoms of cold sores

At the start of our 8 critical stages of a cold sore, you may start experiencing a little burning or tingling sensation in your lips. This usually happens even several days before you actually see a cold sore on your skin. The tingling will increase until the cold sore is pulsating. Once the sores form, you may see raised red blisters filled with fluid. They are usually tender and painful to touch. If you are seeing only one blister, there may be many more coming soon. The cold sores remain for about 2 weeks and are contagious until the crust has gone.

You should see your first blister around 20 days after contracting the herpes virus. In addition to the blisters, you may also experience fever, muscle ache and swollen lymph nodes during the outbreak. It is advisable to seek medical help immediately if you develop an eye symptom during the infection. If left untreated, you may end up having permanent vision loss due to the infection caused by the herpes virus.

Stages of Cold Sores

There are 8 critical stages of cold sores, depending on their severity and action:

  1. Latent stage: This is the first stage of developing cold sores. At this stage, the virus responsible for causing the infection is present in the ganglia nerve which is present at the back of your jaw. It is usually on the same side where you are going to develop blisters. This virus can lie in this place for several years without making any blisters appear. This depends on the capability of your body’s defense system which should keep the virus under control and disallow it from spreading. However, it can escape its boundaries as soon as you become ill or infected and your body’s immunity starts concentrating on that area. Once it escapes, it can start spreading and reproducing, leading to the beginning of further cold sore stages.
  2. Prodrome stage: This is the stage at which herpes simplex virus 1 starts its reproductive cycle. When the virus senses favorable conditions for its reproduction, it escapes the latent stage, passes through the nerve fibers and comes out in the open to the skin surface. Due to this movement of the virus, you can actually feel a little itchy and tingling in the area. Sometimes, you may also experience a minor dryness and a pulsating or burning sensation. This stage can continue for a few hours, even a few days, before it progresses to the next stage. This is the best stage to get the treatment in order to avoid further complication. The first thing you can do is to apply some ice on the area as soon as you start feeling these first warning signs. Controlling the virus at this stage may not prevent the appearance of a cold sore, but it can reduce severity and duration.
  3. Inflammation stage: At this stage, the virus has begun its reproductive cycle and has started entering your skin cells at the end of your nerves. Now you are going to experience a considerable amount of redness and swelling as your skin cells react against the herpes simplex virus invading them.
  4. Pre-Sore stage: During this cold sore stage, the cold sore vesicles start appearing on the skin, and you encounter extreme redness, swelling and itching. Cold sore blisters or vesicles are small, hard, pimple-like, blisters which appear alone or in groups (clusters). Most of the time you will see them as group of many small blisters. They are extremely delicate and painful to touch. In addition, you may also start experiencing other symptoms of the infection, including swollen glands, fever and headache.
  5. Open Sore stage: This is the most painful and infectious stage of cold sores. At this stage, all the blisters open up and merge together to create a single, large, weeping cold sore. You may also develop swollen lymph glands below your jaw and fever as an additional discomfort. When newly born viruses come in contact with the cold sore weeping stage fluids, they can easily spread to other parts of your body when touched. If you are suffering from cold sores, keep your towels, bedding and other private objects separate, as you may end up spreading the infection to other members in your family as well. Whenever you need to touch your cold sores, never touch them with fingers. Instead use a tissue soaked in alcohol. Don’t kiss anyone as long as you have cold sores on or near your lips.
  6. Crusting stage: Once the open sore stage is over, your cold sores will finally begin their healing process and develop a honey yellow scab or crust over them. However, the sores are still painful because of the constant bleeding and cracking of the scabs as you stretch or move your lips while speaking or smiling.
  7. Healing stage: The cold sores will continue weeping or seeping contagious fluid as well as providing pain, itching and discomfort. These persist during the healing stage as new skin cells form under the scabs. During this process, the scabs may fall off and then re-form several times before they completely heal. Once this stage is over, the virus will go back to the latent stage and wait for the next opportunity to break out. Try not to disturb the scabs, if possible as this should help encourage healing.
  8. Post scab stage: By this stage, your skin has completely healed and you can no longer see any visible scabs or sores. But healing is still going on under the new skin you have received. Millions of destroyed cells are being regenerated to bring your skin back to its healthy state. Your skin has recently gone through a major trauma and it will take some time to recover completely. The healing process can vary from 2 to 15 days, depending on your individual immune system. You will still remain contagious until this healing period is over, even if you can’t see any redness in the area.
8 Critical Cold Sore Stages - Stages of Cold Sores

Treatment and management of cold sores

Bothersome cold sores can be controlled with an antiviral ointment like penciclovir or aciclovir (the latter was previously known as Zovirax). It would be best if you start applying it as soon as you notice the first signs of blisters. Docosanol is another medicine that can shorten the duration of your infection. Oral antiviral medicines like famiciclovir and valacyclovir can also be prescribed to treat cold sores and promote the healing process.

There are certain home remedies too that you can use to treat cold sores:

  • Apply a washcloth soaked in cold water or some ice on your sores
  • Apply a lip balm that has lemon extract as one of its ingredients
  • If you frequently have cold sore outbreaks, you may take lysine supplement to decrease the frequency
  • Aloe vera gel is very cooling and provides significant relief to cold sores. Apply this gel or a lip balm containing this gel several times a day
  • Petroleum jelly may not treat the sore, but it may ease the discomfort by preventing cracking. It will also act as a barrier from foreign irritants
  • Witch hazel has natural astringent properties that can help in drying out and healing cold sores

Whenever you use a gel, cream or ointment on your cold sores, use a cotton ball or cotton swab instead of using your finger. This will help prevent further infection. Even when you think these 8 critical stages of cold sores are finished, remember that the healing process can take a while after the visible cold sore is gone, so be careful.

This article is merely informative, oneHOWTO does not have the authority to prescribe any medical treatments or create a diagnosis. We invite you to visit your doctor if you have any type of condition or pain.

If you want to read similar articles to 8 Critical Cold Sore Stages, we recommend you visit our Diseases & secondary effects category.

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