Cold Sores In Children: Causes, Symptoms and Treatment

Cold sores in children

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Children can be highly vulnerable to skin infections and allergies. Besides a breakout, bacterial infections could also cause rashes, blisters, or sores on a child’s skin.

One such cause of sores and blisters in children is a condition we refer to as cold sores, which is due to a viral infection. This infection mostly occurs during childhood and remains dormant through the rest of the life.

In this MomJunction post, we talk about cold sores in children, its causes and symptoms, and the preventive measures you should take.

What Is Cold Sore In Children?

Cold sores, also known as fever blisters, are the small, pus-filled blisters that are formed in and around the mouth, on the cheek, chin, and nose (1) (2). They are caused by a contagious virus called Herpes Simplex Virus Type-I (HSV-1). A child can first contract this infection between the age of one and five, which also gives it the name primary HSV.

How Do Cold Sores Spread?

Cold sores can spread from one person to another through the virus, which can be transmitted within 24-48 hours before the sores appear on the skin (3). The modes of transfer are:

  • Skin-to-skin contact
  • Saliva
  • Touching or sharing utensils and clothes of an infected person

Usually, the blisters ooze after a few days, leaving the crust behind. It takes around a week or two for the crust to cure completely. Children who stay close to the infected people are at risk of contracting cold sores.

[ Read: Canker Sores In Children ]

What Triggers The Cold Sores?

When a child gets infected by HSV-1, the virus remains inside the body forever, but in a dormant state. However, the infection can return when the virus is activated by the following stressors (2):

  • Stress and fatigue
  • Heat, cold, dryness
  • Intense sunlight
  • Cracks on or injuries to the skin
  • Poor diet
  • Dehydration
  • Cold or fever
  • Hormonal fluctuations during menstruation

But sores could appear on the skin due to other reasons as well. So how can you know for sure if the child has cold sores? Read on, and we’ll tell you.

Symptoms Of Cold Sores In Children

Children with cold sores may show different symptoms, some of which could be so mild and negligible that you may not notice. The common symptoms are ( (4), (3), (5)):

  • Soreness around the lips and mouth that lasts for 3 to 7 days
  • Irritability and drooling
  • Blisters that appear on the lips and inside the mouth may discharge pus and leave a crust
  • Fever
  • Sore throat
  • Itching and tingling sensations where the blisters are
  • Swollen and tender lymph glands
  • Swelling of gums

Some of these symptoms can cause discomfort and may need medical intervention. Read the next section to know when you need to seek medical advice.

When To Seek Medical Attention?

Take your child to a pediatrician for cold sores if ( (6), (1), (2)):

  • The child has cold sores along with fever, headache, seizures, or confusion. This could indicate brain infections, including encephalitis and meningitis caused by the virus.
  • The child has a chronic skin condition like eczema.
  • The sores do not start to heal within 7 to 10 days. In such a case, the doctor might want to check for any secondary infection or medical condition.
  • The blisters appear near the eyes. Cold sores that spread into the eyes may lead to corneal infection.
  • The child has a weakened immunity, as it can cause the spread of the infection to other parts of the body.
  • There is redness and swelling around the sore that feels hot to touch. It could be an indication of a secondary bacterial infection that may spread through the bloodstream and could be a cause of concern in children with weak immunity.
  • If the outbreak of cold sores is frequent in the child.

Based on the symptoms and other procedures, the doctor will be able to diagnose the condition.

How Is Cold Sore Diagnosed?

The diagnosis involves a physical examination by the doctor. They will check for and ask about the symptoms and might suggest you get the skin scraping test and a blood test done.

A skin scraping test involves retrieval of a sample by scraping the sore gently, which is then tested to identify the virus. A blood test may be advised to check the presence of the virus in the bloodstream (7).

Once the diagnosis is confirmed, the doctor will suggest the treatment.

[ Read: Bronchitis In Children ]

What Is The Treatment For Cold Sores In Children?

Once the herpes simplex virus enters the body, it remains inside for the rest of the child’s life. Though the virus cannot be entirely removed, treatment can be provided to soothe the pain caused by the sores. Usually, the sores start to heal on their own in a few days.

Otherwise, the treatment includes the use of prescription antiviral medicines for cold sores, and skin ointments or cold sore creams (4), which can be effective if used at the first signs of the infection. Tylenol and Motrin are effective in managing painful sores (8).

In addition to the treatment, a few home care tips can help ease the pain and the discomfort that the child has to deal with.

How To Ease Discomfort Of Cold Sores In Children?

Here are some tips to ease the discomfort or the pain caused by the cold sores.

  • Cold or warm compress: Apply ice directly on the cold sore or use a warm compress.
  • Melissa leaves extracts: Lemon leaves are known for their antiviral properties. The dried extracts of Melissa may help reduce the herpes simplex infections. These extracts can be used to make a balm that can be applied to the affected areas (9). This treatment could be most effective if initiated early on.
  • Avoid acidic food: Citrus fruits are acidic and can irritate the sores. So, avoid such foods in the child’s diet.
  • Icy treats: Chilled food items like smoothies can have a soothing effect on the sores and may also help keep the lips hydrated.
  • Aloe vera gel: According to a study, aloe vera gel could have inhibitory effects on the herpes simplex virus (10).

These measures alleviate the pain and the discomfort caused by the cold sores. The infection cannot be treated entirely, but it can be prevented if you take the necessary precautions.

How To Prevent Cold Sores In A Child?

Here are the steps you can take to prevent your child from contracting the infection:

  • Avoid contact with children or adults who have the infection.
  • Prevent your child from scratching the sore as it may cause the pus to leak and spread to other parts of the body like the fingers and eyes.
  • Do not let the child share clothes or utensils with someone who is infected by the virus. Also, clean the utensils and clothes used by the child separately, using hot water.
  • Do not send the child to school if there is an outbreak of cold sores.
  • Prevent skin to skin contact with a person with sores.
  • Apply some balm, cream, or sunscreen on the child’s skin before they step out into the sun. This will prevent any skin irritation, which can trigger cold sores.
  • Ensure that they remain physically active, get enough sleep, and eat well-balanced meals.

[ Read: Viral Infection In Children ]

If you suspect that your child has cold sores, take the necessary precautionary measures to prevent the infection from spreading. Take them to a doctor. The infection may not lead to any complications if the treatment is done at the right time.

Did your child ever have cold sores? How did you deal with it? Let us know in the comment section below.


1. Cold Sores in Children; Boys Town Pediatrics
2. Cold Sores in Children: About the Herpes Simplex Virus; American Academy of Pediatrics
3. Herpes Simplex Virus (Cold Sores) in Children; University of Rochester Medical Center
4. Cold Sores; Regents of the University of Michigan
5. Cold Sores; The Nemours Foundation
6. Cold Sores; Raising Children Network
7. Herpes Simplex Virus (Cold Sores) in Children; University Hospitals
8. How To Treat Your Child’s Cold Sore; University Of Utah
9. Local therapy of herpes simplex with dried extract from Melissa officinalis; ScienceDirect
10. Assessment of Anti HSV-1 Activity of Aloe Vera Gel Extract: an In Vitro Study; NCBI


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