Understanding Cold Sores
What are they? Cold sores are small lesions on the lips that are caused by viruses, most often the Herpes Simplex Virus Type 1 (HSV1)
Common Types
- Cold Sores/Herpetic Gingivostomatitis:
- Most children are infected between 1-5 years of age, by adulthood over 50% of the population has had HSV1 whether they show symptoms or not.
- Herpetic Gingivostomatitis: the first time your child shows symptoms of HSV1 with lesions on the lips and inside the mouth.
- Most common in ages 6 months - 5 years
- Cold sores
- Subsequent break outs after herpetic gingivostomatitis of cold sores on the lips and sometimes in the mouth (usually less severe than Herpetic Gingivostomatitis)
- HSV 1 Is highly contagious, it can spread by skin to skin contact, saliva or contact with an item that someone touched (i.e. drinking glass of someone who has HSV 1)
- Herpangina
- Caused by a virus called Coxsackie, also known as ‘hand foot and mouth”, sometimes this virus can cause oral lesions and a sore throat only without the hand and foot rash.
- Most common in ages 3-10 years
- Canker Sores
- Unknown etiology
- More common in adolescent age, seems to run in families
- Painful oral lesions that appear sometimes appear more whitish / grey
When to Manage at Home
✅ You can manage your child's cold sores at home when:
- They are still drinking enough to stay hydrated (shown by urinating every 6-8 hours, have saliva in their mouth, and tears when they cry)
- They do not have any lesions by their eyes (especially if younger than 6 months of age)
How to Treat at Home
🏠 Home remedies for Cold Sores:
- Encourage cool fluids and cold foods - which may be soothing
- Avoid citrus & spicy foods as they can hurt more against the open sores
🛑 Stop the spread!
- Your child is less contagious and can return to daycare if they are old enough to have control of their oral secretions/saliva. If not, then it is best to return when they have had no fever and no new oral lesions appear for 24 hours
- Avoid kissing or sharing utensils or items with family members who do not have symptoms, especially newborns and infants under 6 months of age
Safe Medications
- Ibuprofen every 6 hours if no other contraindications or Acetaminophen every 6 hours, weight based for your child
- You can make a ‘magic mouthwash’ with equal parts Benadryl & Maalox (50:50), mix them together and dab a q-tip in the mixture and dab on the inner mouth sores, or if your child is able to swish and spit (don’t swallow) that works as well! This doesn’t help much for lesions on the lip, only the inner mouth
- Talk to Poppins or your pediatric provider about an antiviral medication that can sometimes be prescribed and whether it is right for your child’s situation
When to Visit Your Pediatrician
🩺 Go to an in-person appointment when:
- You have lesions around the eye, your child is dehydrated or has a fever and other symptoms that may not just be cold sores.
If your gut tells you something is wrong, don't hesitate to reach out. Need help? Reconnect with our on-demand team of medical staff available 24/7.
