Possible rewritten title: “The Reasons Behind Your Persistent Cold Sore Lasting for Months”

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Herpes simplex virus (HSV) causes cold sores or fever blisters that are highly contagious. If you have an oral HSV infection and kiss someone, the other person may catch the virus. Rarely, you can spread it through aerosol transmission. HSV can survive for short periods outside the body, meaning it’s possible to transmit HSV and cold sores through contaminated surfaces and objects. While cold sores typically clear up within 7–15 days, sometimes they can last longer. The more time that goes by without treatment, the longer the cold sore will take to heal.

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What Causes Cold Sores?

The highly contagious herpes simplex virus causes cold sores. This virus has two types: HSV-1 and HSV-2. Once you have the virus, it stays in your body for life. It can reactivate spontaneously, and scientists believe multiple flare-up triggers exist, including:

• Fever
• Stress
• Menstruation
• Exposure to sunlight
• Illness or injury

A cold sore can last up to 15 days, but many things can cause complications and lead to healing taking longer than expected. For example, the healing process may take longer than usual if you have another type of infection or an allergic reaction. If you take medication that suppresses your immune system, this can also affect healing time. It’s important to know what complications may arise when managing treatment for cold sores so you can respond accordingly to ensure quick, complete healing.

How Do You Know It’s a Cold Sore?

After initial HSV exposure, most people experience their first cold sore outbreak within 2–12 days. While HSV-1 typically causes oral lesions, symptoms vary with age. A child may experience herpetic gingivostomatitis, which is a very painful condition causing blisters on the lips and canker sores (ulcers) in the mouth. On the other hand, an adult may have a sore throat (herpetic pharyngitis) on infection with the herpes virus. This is most common in young adults. If you have recurrent cold sores, the first indication of a flare-up is usually tingling, itching, or pain around your mouth. Small red bumps form on your lips before breaking open to form painful ulcers.

What Other Issues Can Cause Similar Symptoms?

While the herpes simplex virus causes cold sores, people confuse them with other conditions:

• Angular cheilitis – inflammation of the corners of the mouth, causing them to swell and crack. They may need treatment with antibiotics or antifungal medication.
• Canker sores
• Cracked lips – a common condition that mimics a cold sore. Healing may take longer than expected because of irritation around the mouth. Frequent application of lip balm or petroleum jelly can relieve symptoms.

How Do Angular Cheilitis and Cold Sores Differ?

Cold sores are a virus symptom, while angular cheilitis is inflammation with several possible causes. People may confuse these two conditions because they share symptoms, but they are different. Angular cheilitis causes dryness and painful cracks at the corners of your mouth, usually due to a bacterial or fungal infection. Cold sores typically look like blisters that break open and ooze.

What to Do When Your Cold Sore Lasts for Months

Cold sores can lead to complications. A complication is a secondary disease or condition aggravating an already existing one. In the case of cold sores, complications can stem from:

• Secondary infection
• Immunosuppression
• Herpetic whitlow – a herpes infection of the fingers
• Encephalitis – inflammation of the brain

If you have a secondary infection, the healing process will take longer. Contact your physician for the best treatment plan. Doctors typically don’t recommend topical ointments, such as acyclovir or valacyclovir cream, as they offer minimal benefits. Your doctor will prescribe oral antivirals as appropriate