Is It Common To Get Cold Sores (Fever Blisters) During Pregnancy?

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Cold sores or fever blisters erupt inside the lips or cheeks, around the mouth, or near the nose and chin. These itchy and tingly sores might sometimes be painful too. Usually, cold sores are likely to disappear in a couple of weeks. But what happens when they occur during pregnancy? What should you do about them?

We tell you about it in this MomJunction post. Keep reading to know more about cold sores during pregnancy.

Are Cold Sores Common In Pregnancy?

Cold sores are usually caused by herpes simplex virusⁱXA type of virus that affects the genital, anal area, or mouth (HSV), especially type 1 of the virus (1). Therefore, they are likely to be common in women who have experienced them in the past (2).

What Are The Causes Of Cold Sores During Pregnancy?

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Cold sores are caused by the herpes simplex viruses named HSV1 and HSV2. The virus transmits from one person to another through skin to skin contact during touching, sexual intimacy, kissing, or sharing contaminated items (3).

Once a woman has contracted the virus, the following risk factors could trigger the cold sore virus.

• Hormonal changes that frequently rise and fall could make the body susceptible to viral infection, including a cold sore outbreak (4).
• Psychological concerns, such as stress and fear could trigger the virus (5).
• Certain foods (acidic, spicy, or salty), citrus fruits, exposure to the sun, and hot water could trigger the virus and cause cold sores (6).

Signs And Symptoms Of Cold Sores In Pregnancy

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The common signs and symptoms that could indicate cold sores during pregnancy include:

• Swelling of the lips
• Small, painful blisters
• Redness
• Tiny bumps over your lips
• Fever
• Pains and aches
• Sore throat

There are five stages of a cold sore where you might experience the above symptoms. Understanding the changes in each of these stages might help you take the right steps to prevent them from spreading to other parts of the body.

Stages Of Cold Sores

The cold sores last for seven to 12 days, and during this time, they might progress in different stages (7).

Stage 1: The tingling stage

You may experience a tingling sensation for about a couple of days. The skin (inside your lips, on your lips, or inside the cheeks) might turn sore and red and might even swell and become itchy.

Stage 2: The blister stage

This stage lasts for about two days. During this stage, new blisters may form and spread to other parts in the absence of proper prenatal care.

Stage 3: The weeping stage

At this stage, the blisters may burst, and you might experience pain. The cold sores might scab over at this point.

Stage 4: The scabbing stage

The scabsⁱXCrusty, dark red or brown layers that keep bacteria out of the wound while allowing the skin cells to recover may crack and even bleed. They could be itchy, but make sure you are not poking them.

Stage 5: The healing stage

In this stage, all the scabs flake off and disappear soon after. Even the scars slowly vanish.
Observe the progress of cold sores and treat them in time to prevent the infection from spreading.

Are Cold Sores Contagious?

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According to the World Health Organization (WHO), herpes infections are highly contagious when symptoms such as ‘cold sores’ are present (8). The virus may be passed from one person to another. If the bump ruptures, the active virus could spread via lipstick, cups, utensils, kissing, or through oral sex (9).

According to the UT Southwestern Medical Center, HSV 1 or the cold sore infection could pass from the infected person to the baby. This usually happens when the person kisses the baby or when the baby is touched after the cold sore is touched (10).

Therefore, it is important to treat the cold sore in pregnancy to prevent the virus from spreading to the baby after it is born. Herpes infection is mild for the mother but can be life-threatening for the baby.

Point to consider

Pregnant women contracting herpes infection for the first time (primary infection) have a higher infection transmission rate. A newly infected mother doesn’t have the antibodies to provide natural protection to the baby (2).

How To Treat Cold Sores In Pregnancy?

Home care measures for the sores might alleviate pain and discomfort. In some cases, medication may be necessary.

1. Home treatment

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• You may try some home remedies to ease the cold sore-related pain and discomfort
• Placing a cold compress (wet, cool cloth, or towel) on the sores may help reduce the redness and pain.
• A mouthwash containing baking soda may also reduce the soreness.
• Apply sunscreen before going outside.

You may apply aloe vera gel or lip balm containing soothing ingredients on the sores.

2. Clinical medicine

Before you take any medication for cold sores in pregnancy, talk to your doctor. Ideally, antiviral medications are prescribed to treat cold sores. According to the American Academy of Family Physicians, the common options include valacyclovir, famciclovir, and acyclovir (11). These fall under pregnancy category B medications of the US Food and Drug Administration.
If the cold sores get severe, the doctor may change the dose or prescribe other treatment.

Are Cold Sores An Early Sign Of Pregnancy?

Cold sores are common, and it is not uncommon for expecting women to experience them. But they may not be an early sign of pregnancy. A woman may get cold sores at any point during the gestationⁱXThe period between conception and delivery of the baby period.

Are Cold Sores During Pregnancy Harmful To The Baby?

According to the Royal Hospital for Women, Australia, cold sores may not affect newborn babies. But they are infectious and should be treated in time, so they don’t spread to the infant (1). However, if you have genital herpes, then there are chances of the virus transmitting to the baby during the process of childbirth (known as acquired herpes). This can be very dangerous for the baby. Hence, a cesarean section is indicated to avoid contact of the baby with the cold sores.

Did you know?

Neonatal herpes infection may result in viral meningitisⁱXA swelling of the linings that protect the brain and spinal cord . However, it occurs in less than 1% of births, and the development of meningitis from HSV-1 infection is quite rare (10).

Infographic: Precautions For Cold Sores When Pregnant And Postpartum

For most women who have experienced cold sores before, developing them while pregnant or after having a baby is not uncommon. If you are concerned that cold sores could impact your pregnancy or baby, the safety tips in this infographic could ease your worry and help you prevent them while pregnant, and protect your newborn from acquiring the infection.

Illustration: Momjunction Design Team

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Dr. Ben Abbes Taarji HichamMD

Dr. Ben Abbes Taarji Hicham is a practicing obstetrician and gynecologist with around 20 years of experience in the field. Having worked in various Moroccan hospitals, he currently runs a private practice. Dr. Hicham specializes in rejuvenation and cosmetic gynecology, medically assisted reproduction, breast and gynecological cancers, HPV diseases, hysteroscopy and laparoscopy, and hormonal disorders.more

• Dr. Alan LindemannMD, MS

  Dr. Alan Lindemann is an obstetrician and maternal mortality expert, who worked as a clinical associate professor at the University of ND. An alumnus of the University of ND and the University of Minnesota, he is a member of the American College of Obstetricians and Gynecologists and the American Medical Association.
  
  Dr. Alan Lindemann is an obstetrician and maternal mortality expert, who worked as a clinical associate professor at the University of ND. An alumnus of the University of ND and the University of Minnesota, he is a member of the American College of Obstetricians and Gynecologists and the American Medical Association.

Rebecca MalachiBSc

Rebecca is a pregnancy writer and editor with a passion for delivering research-based and engaging content in areas of fertility, pregnancy, birth, and post-pregnancy. She did her graduation in Biotechnology and Genetics from Loyola Academy, Osmania University and obtained a certification in ‘Nutrition and Lifestyle in Pregnancy’ from Ludwig Maximilian University of Munich (LMU). She has been into health and...more

Dr. Ritika ShahBDS, CLC

Dr. Ritika Shah is a certified lactation counsellor (CLC) from iNational Health Care Academy, Singapore and a dental surgeon with more than seven years of clinical experience across various cities in India. She did her graduation in Dentistry from KM Shah Dental College. During her clinical practice, pediatric dentistry was her particular area of interest, and she constantly thrived to...more

Reshmi DasMSc

Reshmi Das has over four years of experience as a clinical coordinator, medical content writer and medical conference coordinator. Her continuous interest in medical journals and writing makes her write well-researched articles for MomJunction. She writes health and wellness articles for children and pregnant and lactating women. Reshmi has completed her post graduation in Biotechnology from MITS School of Biotechnology,...more