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Medical News Today: What causes recurrent cold sores?

Cold sores can occur when a person contracts the herpes simplex virus, which causes small, fluid-filled blisters around the lips and in the mouth. Many people get cold sores repeatedly throughout their lifetime, as the virus lies dormant in the body between outbreaks.

The blisters usually break and form a sore that crusts over. They will generally heal without treatment within a few weeks.

This article explores why some people get cold sores frequently, as well as how to treat and prevent them.

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Why do cold sores keep coming back?

close up of lip with scabbed over cold sore
Once contracted, the cold sore virus remains in a person’s body for life.

Once a person contracts the herpes simplex virus (HSV-1), it usually causes an initial outbreak of cold sores.

Then, the virus remains in the person’s body for the rest of their life, causing new cold sores to form randomly when it reactivates.

If a person keeps getting cold sores, there may be an underlying cause. Many factors can trigger reactivation and subsequent cold sore outbreaks, including:

  • hormonal changes, such as those associated with pregnancy or menopause
  • another viral infection or illness
  • exposure to sunlight, wind, or cold
  • stress
  • fatigue
  • immune system changes

The virus that causes cold sores is extremely contagious, even when a person does not have cold sores.

A person can contract or spread HSV-1 through sharing utensils, food, and beverages. Kissing and engaging in oral sex can also spread the virus. Oral sex may also spread HSV-2, which usually causes genital herpes.

Risk factors

Anyone who has HSV-1 or HSV-2 is at risk of developing cold sores.

According to the World Health Organization (WHO), 67 percent of the global population under age 50 has HSV-1.

Not everyone who has the virus will have recurrent cold sores. People at most risk of developing recurrent cold sores or other complications from the virus may have a weakened immune system. These individuals include:

  • people with HIV
  • people undergoing chemotherapy
  • people with severe burns
  • organ recipients

Having conditions such as eczema or psoriasis may also increase a person’s risk of developing frequent cold sores.


woman holding tables and glass of water
A person can take over-the-counter pain medication to reduce any cold sore-related pain.

Cold sores generally clear up on their own within a few weeks. However, most people wish to speed up the healing process to ease their discomfort sooner.

There is no cure for cold sores, but some treatments may speed up the healing process, ease bothersome symptoms, and reduce their recurrence.

Taking antiviral medications may speed up healing time and reduce recurrence rates. A doctor can prescribe either oral and topical antiviral medications.

Oral antiviral medications tend to be more effective than topical treatments. Examples of antiviral medications that a doctor may prescribe for cold sores include:

  • acyclovir (Zovirax)
  • famciclovir (Famvir)
  • valacyclovir (Valtrex)

While antiviral medications focus on healing the cold sores, other treatments can help ease the discomfort they cause. These treatments include:

  • applying a cold compress to the area for pain relief
  • taking over-the-counter (OTC) pain relievers, such as ibuprofen
  • using aloe vera
  • using lysine
  • applying analgesic creams
  • applying OTC cold sore creams with drying agents


meditation group
Stress management may help reduce the frequency of cold sores.

If a person has cold sores that occur frequently, they should talk to their doctor about antiviral medications. They can prescribe antiviral medications for regular use to keep cold sores at bay.

Other actions a person with HSV-1 can do to reduce the frequency of cold sores include:

  • avoiding triggers, such as sun exposure or eczema flares
  • managing stress
  • washing the hands frequently
  • avoiding people who are sick


Cold sores can be irritating and painful. Once a person has HSV-1, it can lie dormant between outbreaks, which can recur throughout a person’s life.

If a person keeps getting cold sores, they may wish to speak to a doctor about taking antiviral medications to lessen their recurrence.

Other management techniques for cold sores include avoiding triggers such as stress and sun exposure.

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