Why do I keep getting cold sores?
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Cold sores have a habit of returning at the worst possible time like before a big event, during exam season or right as you're getting over a cold. That's not a coincidence. It's how the herpes simplex virus (HSV) works.
HSV is a common virus that spreads through skin-to-skin contact and most cold sores are caused by the HSV-1 strain.1 Once it's in your body, it stays there for life, however it lies dormant in the nerve cells and can reactivate periodically, which is what triggers a new cold sore.
Understanding what wakes the virus up can help you manage flare-ups and in some cases, reduce how often they happen.
Why does HSV reactivate?
After your first infection, HSV travels along nerve pathways and settles into a dormant state. It can reactivate when your body is under physical or emotional stress.1,2 Common triggers may include:
- Illness, fever or a weakened immune system
- Physical or emotional stress
- Fatigue or lack of sleep
- Sun exposure or windburn on the lips
- Hormonal changes, including menstruation
- Local skin trauma, such as dental work or lip injury
Triggers vary from person to person and some people never identify a clear pattern.
Does everyone with HSV get recurring cold sores?
No. Around 90% of adults carry HSV, but only about a third ever develop symptoms and how often outbreaks occur varies widely.2 Some people have a single episode and never again, while others experience several outbreaks a year, often in the same spot.
Can I reduce how often I get cold sores?
While there's no way to clear HSV from the body, being aware of your personal triggers can help you reduce how often cold sores appear.1 This might include:
- Using a broad-spectrum SPF lip balm if sun exposure is a trigger
- Prioritising sleep and managing stress where possible
- Looking after your general health and immune system
- Avoiding known personal triggers where you can
If you notice a pattern for example, outbreaks around your period, or after time in the sun this can be a useful thing to mention to your doctor.
How can I avoid spreading cold sores?
HSV is most contagious when a cold sore is visible, but it can still spread even without visible symptoms.¹ To help reduce the risk of passing it on:
- Avoid kissing or close contact while a cold sore is present
- Don't share items like toothbrushes, towels, cups or lip balm
- Wash your hands after touching a cold sore and avoid touching your eyes
- Avoid oral sex during an outbreak, as HSV can spread to the genital area
These steps help protect the people around you and can also lower your chances of spreading the virus to another part of your own body.
When should I speak to a doctor?
It's worth checking in with a doctor if your outbreaks are frequent or severe, if a cold sore is taking longer than usual to heal, or if you have a weakened immune system and develop a cold sore. Symptoms appearing near your eyes should also be checked promptly, as should any sore you're not confident is actually a cold sore.
Cold sores can be frustrating, especially when they keep coming back, but recurrence is common and doesn't reflect your overall health. Getting to know your triggers and knowing when to seek advice can make outbreaks easier to manage over time.
References
1. Cold sores — causes, symptoms and treatment. Healthdirect Australia.
2. Herpes simplex (cold sores): Causes and Treatment — DermNet NZ
Disclaimer: This information is not intended to be used as medical advice or a substitute for your own practitioner's advice, nor is it intended to be used for diagnosis or treatment for any illness/disease.
