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What Are the Stages of a Cold Sore?

By Meshell Powell
Updated Mar 03, 2024
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A cold sore, also commonly referred to as a fever blister, is caused by a type of virus known as the herpes simplex virus. There are several different stages of a cold sore, and it may be particularly helpful for those who suffer from recurring outbreaks to understand these stages. The cold sore begins before the blister actually appears on the skin and ends a few days later with the healing stage. Questions or concerns about the various stages of a cold sore or the most appropriate treatment methods for an individual situation should be discussed with a doctor or other medical professional.

The earliest of the stages of a cold sore is often referred to as the tingle stage. At this stage, a slight itching, burning, or tingling sensation may be noticed, although there is not yet a visible sore on the skin. This can last for a few hours or up to a day before the blister begins to appear. Shortly afterward, the site begins to turn red and slight swelling may appear. Many people prefer to start treatment at this point.

The next stages of a cold sore are the blister and ulcer stages. A small group of painful bumps begin to appear, forming a blister on the surface of the skin. As white blood cells travel to the surface in order to fight the infection, the blister fills with fluid. Within a couple of days or so, the blister turns into an ulcer, the most painful stage of this virus. During this stage, the blisters rupture, often causing increased redness and pain.

The scabbing phase is the next of the stages of a cold sore. The fever blister begins to dry out and a scab starts to form over the affected area. Pain and cracked, bleeding skin may occur at this stage. Itching or burning sensations may become quite severe at this point in the healing process.

The scab begins to fall off during the final stage of healing. Dry, flaky skin and some degree of swelling may still be present at this point. There may also be a slight pink or red color to the affected area of skin. Treatment for the fever blister should continue until all symptoms have disappeared. Fortunately, the entire life cycle of a cold sore is almost always less than two weeks, and medical attention is rarely required since over the counter medications are typically very successful at treating any uncomfortable symptoms.

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Discussion Comments
By fify — On Oct 26, 2013

@ddljohn-- You can skip the ulceration stage with the use of antiviral creams, medications or some cold sore cures and remedies. If you kill the virus, the cold sore won't be able to turn into an ulcer. I accomplished this once with the use of salt. I applied salt several times a day for as long as I could hold it when my lip became swollen (second stage). It never formed a blister. It just scabbed over.

I think medications like valacyclovir and supplements like l-lysine can do this too. I haven't tried them though, so I can't say for sure.

Why don't you ask your doctor? I'm sure that he would have some recommendations, especially if you get cold sores frequently.

By ddljohn — On Oct 25, 2013

I'm familiar with cold sore stages because I've been getting them since I was in middle school. What I'm wondering is, is it possible to skip the ulceration stage?

This is the stage I hate the most because it's the most painful and infectious time of the blister. If it just scabbed over instead of becoming an ulcer, that would be great.

By SarahGen — On Oct 25, 2013

I don't seem to experience the first stage of a cold sore at all. I've never had tingling or itching. By the time I realize that something is happening to my lip, it's already red and swollen and quickly goes into the painful blister stage. And then it takes at least two weeks for it to scab over. It's horrible.

People tell me to use antivirals and take supplements when I feel a cold sore coming on. I would if I could actually feel it!

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