Cold Sores (Fever Blisters) In Kids: Causes And Treatment

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Small, pus-filled blisters characterize cold sores. Also known as fever blisters, they are found more commonly on the outside of the mouth, on or around the lips, and rarely inside the mouth, on the gums, or the roof of the mouth (1) (2). Cold sores in children, also termed primary HSV, are more common between ages one and five. For most children, cold sores do not lead to any serious complications. However, children with weak immune systems or skin conditions such as eczema may experience complications. Read this post to learn more about the causes, symptoms, and preventive measures for cold sores in kids.

What Causes Cold Sores In Children?

Cold sores can be due to a primary cause, such as a virus, or a secondary cause that triggers the dormant virus.

1. Cold sores due to primary infection

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They are caused by a contagious virus called herpes simplex virus type-I (HSV-1), which remains contagious for six to eight days.

2. Cold sores due to secondary infection (cold sore triggers)

Viral infections in children are among the most common reasons for cold sores. Once the child is infected with the herpes virus, the virus remains dormant in the body even after the symptoms disappear.

Some of the triggers which can cause flare-ups are (2):

• Infections
• Cold weather
• Fever
• Menstrual period
• Sunlight
• Emotional stress
• Weak immune system

This could be a reason why some children might get cold sores repeatedly.

Quick fact

Fatigue, dehydration, poor diet, fluctuating hormones, skin injuries, and some illnesses may also worsen the cold sores symptoms in children (14) (15).

What Does A Cold Sore Look Like?

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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). It gets transferred through:

• 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 heal completely. Children who stay close to the infected people are at risk of contracting cold sores.

Unlike canker sores or mouth ulcers, these are usually found outside the mouth and can be contagious. 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

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

• Soreness around the lips and mouth that lasts for three to seven 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?

Usually, these fever blisters heal away after seven to eight days. But if you find any of the following symptoms, then take your child to the pediatrician (5).

• If the sores do not start healing after ten days
• You doubt that it might not be a cold sore.
• Your child has swollen, painful gums with multiple sores inside the mouth.
• Your child has a weakened immune system.
• If your child has repeated cold sores.
• If the cold sore shows up on the eye (6).

Based on the symptoms, the doctor will be able to diagnose the condition in the following ways.

Caution

Herpes simplex virus may lead to brain inflammation (encephalitis) or other long-term brain problems (14).

How Are Cold Sores Diagnosed?

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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.

What Is The Treatment For Cold Sores In Children?

Cold sores usually go away on their own after seven-eight days. 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. Also, your child’s doctor might prescribe a suppressive therapy based on the frequency of recurrences.

Otherwise, the treatment includes the use of prescription antiviral medicines for cold sores, and skin ointments or cold sore creams, which can be effective if used at the first signs of the infection (4) (8). Tylenol and Motrin are effective in managing painful sores, says pediatrician Dr. Gellner (7).

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

Home Care Tips To Ease Discomfort Of Cold Sores

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Here are some tips to ease the discomfort and 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 balm 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).

• Avoid the triggers which can flare up the cold sores.

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.

Can You Prevent Cold Sores?

As it is difficult to remove the virus from the body, you can always take precautions that might prevent your child from contracting the infection (4) (7):

• 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 who has 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 to boost the child’s immunity.

Infographic: Home Care Tips To Ease Discomfort Of Cold Sores

Cold sores are often self-resolving and may not need medical treatment in children. If your child is experiencing mild sores, you may try relieving their discomfort by following some simple home care measures discussed in this infographic.

Illustration: Momjunction Design Team

Illustration: Cold Sores (Fever Blisters) In Kids: Causes And Treatment

Image: Dalle E/MomJunction Design Team

In this informative video, discover practical tips and remedies to assist your toddler in dealing with a cold sore and promoting their comfort and recovery.

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Reviewer Author Editor Fact Checker

Dr. K. Harish KumarMD

Dr. Harish Kumar comes with a decade-long experience in medical and cosmetic dermatology. He is an accredited member of the Indian Association of Dermatologists, Venereologists and Leprologists (IADVL), and Cosmetic Surgeons of India.

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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.

Read full bio of Dr. Ritika Shah

Swati PatwalM.Sc. (Food & Nutrition), MBA

Swati Patwal is a clinical nutritionist, a Certified Diabetes Educator (CDE) and a toddler mom with more than a decade of experience in diverse fields of nutrition. She started her career as a CSR project coordinator for a healthy eating and active lifestyle project catering to school children.

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Ghazia ShahMSc, MA, BEd

Ghazia is a scientist-turned-writer with three years of research experience in Cancer Biology. She did her masters degree in Biotechnology at the University of Kashmir and bachelors in Education at the same university. Ghazia then delved deeper into the science of language with a masters in English.

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