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Cold Sores

Childhood Infections


Updated May 28, 2014

Child with a Cold Sore

Child with a Cold Sore

Photo (c) Rebecca Ellis
Cold sores or fever blisters are common in children.

Surprisingly to parents, cold sores are caused by the herpes simplex virus (HSV), but when it occurs in younger children with a cold sore on their lips or around their mouth, it is not necessarily the same as a genital herpes infection that a teen or adult might have.

Oral herpes is usually caused by HSV-1, while genital herpes is usually an HSV-2 infection, although either virus can occur in other parts of the body.

It is best to think of cold sores as a common childhood infection. In fact, when it occurs for the first time and the cold sores or ulcers are located throughout a child's mouth, it is typically referred to as gingivostomatitis, which some parents are more familiar with.

Unfortunately, some children get cold sores repeatedly, often on the same spot on their face or lip.

Symptoms of Cold Sores

For kids who get cold sores over and over again, they will often feel some pain, burning, or itching at the site of the cold sore before it appears.

Other symptoms of cold sores include:

  • a group of vesicles (small, fluid filled blisters) appearing on a red area of skin
  • vesicles that quickly develop crust on them

Diagnosis of Cold Sores

It is possible to do blood tests and viral cultures on cold sores, but they are usually diagnosed on the typical appearance of the cold sore. It is sometimes easy to confuse a cold sore with impetigo though, especially if they are in the crusty phase and your child doesn't often get cold sores.

Cold Sore Treatments

Although there are several medicines available to treat cold sores in children, the main one that is available for children is acyclovir. This cold sore medicine must be used 4 to 5 times a day though and must be started as early as possible once the cold sore develops to be effective though. And not all experts agree that acyclovir is effective to treat cold sores in children...

Untreated, cold sores usually go away in 7 to 10 days.

Topical creams, such as acyclovir cream and Abreva are also sometimes used to treat cold sores, but are not thought to be as effective as oral medicines.

Preventing Cold Sores

The main way to prevent recurrent cold sores is to prevent the herpes virus from becoming reactivated, which can happen if your child's skin becomes irritated or if he has a fever, etc.

Although it can be hard to avoid getting a fever, you can help your child avoid chapped lips and sunburn, which may help prevent his getting more cold sores.

A daily, preventative dose of acyclovir is also sometimes used for children who get very frequent or severe cold sores.

Washing your hands frequently while you have a cold sore can help prevent other people from getting a cold sore from you...

What You Need To Know

  • Cold sores are caused by the herpes simplex virus.

  • Herpes skin infections in high school wrestlers is called herpes gladiatorum.

  • Cold sores can be especially serious if they are located near the eye.

  • Cold sores are very contagious, especially in the first 2 or 3 days after an outbreak. Since the herpes virus can cause serious infections in newborns, be sure to keep your newborn baby away from anyone with a cold sore.

  • In addition to fever and sun exposure, stress is thought to trigger cold sores in some children.

1Habif: Clinical Dermatology, 4th ed., Copyright © 2004 Mosby, Inc.
2Long: Principles and Practice of Pediatric Infectious Diseases, 2nd ed., Copyright © 2003 Churchill Livingstone, An Imprint of Elsevier
3 Herpes simplex virus infections in neonates and early childhood. Kimberlin DW - Semin Pediatr Infect Dis - 01-OCT-2005; 16(4): 271-81

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