1. Adult Skin Problems Slideshow Pictures
2. Quiz: Can You Identify These Skin Conditions?
3. Gallery of Skin Problems and Images Collection

Medical Author:

Mohamad El Mortada, MD

Medical Author:

MaryAnn Tran, MD

Medical Author:

Corrine Young, PharmD

Medical Author:

Mary Nettleman, MD, MS, MACP

Mary Nettleman, MD, MS, MACP

Mary D. Nettleman, MD, MS, MACP is the Chair of the Department of Medicine at Michigan State University. She is a graduate of Vanderbilt Medical School, and completed her residency in Internal Medicine and a fellowship in Infectious Diseases at Indiana University.

View Full Profile

Medical Editor:

Melissa Conrad Stöppler, MD, Chief Medical Editor

Melissa Conrad Stöppler, MD, Chief Medical Editor

Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

View Full Profile

The virus that causes cold sores is known as the herpes simplex virus (HSV). There are two types of HSV, type I and type II. Cold sores are usually caused by type I.

Herpes simplex is caused by a contagious oral virus. The virus is spread from person to person by kissing or other close contact with sores or even from contact with apparently normal skin that is shedding the virus. Infected saliva is also a means of spreading the virus. The most contagious period is when a person has active blister-like sores. Once the blisters have dried and crusted over (within a few days), the risk of contagion is significantly lessened. However, a person infected with HSV can pass it on to another person even when a cold sore is not present. This is because the virus is sometimes shed in saliva even when sores are not present. Despite popular myth, it is almost impossible to catch herpes (cold sores) from contaminated surfaces, towels, or washcloths.

After the first infection, the virus enters the nerve cells and travels up the nerve until it comes to a place called a ganglion, which is a collection of nerve cells. There, it resides quietly in a stage that is called a "dormant" or "latent" period. In more active stages, the virus starts multiplying again and travels down the nerve to the skin, causing blisters on the lips known as cold sores. The exact way this happens is not clear, but it is known that some conditions seem to be associated with recurrences, including

• fever, colds, or the flu (this is why some people call them "fever blisters");



• ultraviolet radiation (exposure to the sun);



• stress;
  
  
• changes in the immune system;
  
  
• hormonal changes, such as menstruation; and
  
  
• trauma to the skin.

Sometimes there is no apparent cause of the recurrence.

Colds sores have a tendency to recur in more or less the same place each time. Such recurrences may happen often (for example, once a month) or only occasionally (for example, once or twice a year).

Must Read Articles Related to Cold Sores

Colds The cold is the most commonly occurring illness in the entire world, with more than 1 billion colds per year reported in the United States alone. Symptoms and s...learn more >>

Stress Everyone is familiar with stress. We experience it in varying forms and degrees every day. In small doses, stress can actually be beneficial to us. Stress sympt...learn more >>

Sunburn Sunburn is a burn on the skin caused by UV radiation. Mild sunburn symptoms include skin redness and pain. Severe cases of sunburn (sun poisoning) are complicat...learn more >>

See the Entire Cold Sores Topic Guide »