Cold Sore Won’t Go Away for Months? Here’s What to Do

 

Cold sores are aggravating, but in most cases they’re not dangerous. However, a cold sore that lingers for months on end is enough to make anyone a little nervous!

If you have a persistent cold sore that just won’t seem to heal, the first step is to make sure it’s really a cold sore you're dealing with. Once you’re sure of this, you have some options.

In this post, we’ll look at what to do when your cold sore won’t go away for months.

Make Sure It’s a Cold Sore

If you’ve had a cold sore before, especially in the same spot, you can be fairly certain this one is a cold sore, too. But if you’ve never had a cold sore before and you’re not experiencing other symptoms like fever, chills, swollen lymph nodes, sore throat, or feeling run down, then what looks like a cold sore might actually be something else.

Angular Cheilitis

Angular cheilitis is an inflammatory disorder commonly mistaken for a cold sore. Starting at the corners of the mouth, angular cheilitis forms red, swollen patches and painful fissures that may resolve after a few days or become a continuous problem.

The symptoms of angular cheilitis and cold sores may look similar, but angular cheilitis is not contagious and can be treated with antibiotic or antifungal ointments. To differentiate a cold sore from angular cheilitis, watch the progress of the lesion for a few days. A cold sore will fill with fluid and burst within a week, while angular cheilitis will remain raw and red.

Cold sores can also form anywhere on or around the mouth, while angular cheilitis remains at the corners of your mouth.

Canker Sore

Canker sores are shallow lesions with white or yellow centers and bright pink or red borders. Also known as aphthous ulcers, canker sores occur inside the mouth and can cause quite a bit of pain.

Location is the main factor that differentiates canker sores from cold sores. Canker sores never develop outside the mouth, so if you have a blister on the outside of your mouth, it’s definitely not a canker sore.

Cracked Lips

Chapped, cracking lips result from dryness and irritation from factors like intense sun exposure, dry air, cold weather, or repeatedly licking your lips. Symptoms include dryness, flaking, and scales on the surface of both lips, often accompanied by discomfort and occasionally light bleeding from new cracks.

Cracked lips don’t involve blisters of any kind, so they should be relatively easy to distinguish from cold sores.

Ingrown Hair

Ingrown hairs happen when hairs grow back down into the skin instead of growing out through the skin. They’re not dangerous, but they can cause plenty of pain while they last. Ingrown hairs usually look like tiny pimples surrounded by a red border. You might be at risk for ingrown hairs around your mouth if you shave, wax, or have thick hair in the area.

Ingrown hairs will not follow the same progression of filling, bursting, weeping, and crusting as cold sores. If they fill with anything, it will be white pus rather than clear fluid.

Next Steps When Your Cold Sore Won’t Go Away for Months

Now that you’re thoroughly convinced you’re dealing with a cold sore, you can move forward in the right direction.

Cold sore healing time varies, but in general, your cold sore should be well on its way to healing within a week to 10 days. If your suspected cold sore hasn’t formed a blister by this time, you’re likely dealing with angular cheilitis or another one of the common misdiagnoses above. If it has and it just won’t resolve, it’s time to contact a doctor to find out what’s keeping your cold sore from healing.

When Healing Takes Longer Than Expected

If your cold sore is taking longer than expected to heal, underlying complications could be involved. This is why it’s important to speak with a doctor, especially if you’ve had a cold sore that won’t heal for several months.

Another possibility is a succession of frequent cold sores, rather than a single cold sore that won’t go away for months. If cold sores develop one right after the other in the same place, it can be difficult to tell them apart. The best course in this case would be to talk with your doctor, use proven cold sore treatments, and avoid common cold sore triggers as much as possible.

Suppressed Immune System

A suppressed immune system could be responsible for a lingering cold sore. Cold sores are caused by herpes simplex virus, type 1 (HSV-1), a virus which lives dormant in nerve endings until a trigger reactivates it to cause blisters on the skin’s surface. If an illness or autoimmune disease compromises your immune system, your body may not be able to keep the virus dormant, resulting in lingering cold sores.

Hormonal Changes

Some women find that cold sores tend to flare during certain times of their menstrual cycle, particularly during their period or just before it begins. Pregnancy is a more lengthy hormonal change, so it’s more likely to account for a cold sore that won’t heal or that keeps reappearing.

Poor Diet

A poor diet can contribute to a weak immune system, so make every effort to eat a well-balanced diet that’s low in simple carbohydrates, sugar, and heavily processed foods to keep your immune system strong. You may also want to limit your arginine intake if you have a succession of cold sores that won't go away for months, or supplement with extra lysine to block the absorption of arginine.

Some important elements to be sure to include in your diet are:

• Alkaline foods
• Lean protein
• Lysine
• Omega-3 fatty acids
• Vitamins C
• Vitamin E
• Zinc

Injury to the Skin

Consistent pressure to the mouth or lips can result in cold sore formation and irritate an existing cold sore. If you’ve had lots of dental work completed in recent weeks, this could account for more frequent cold sore formation.

Stress and Fatigue

Believe it or not, stress and fatigue can trigger cold sore outbreaks as well. Stress suppresses the immune system and allows the cold sore virus to run wild. If you’ve been stressed for many months, take time to relax, get more exercise, and try to set aside time for deep breathing and meditation.

Viral Infection and Fever

In healthy people, the immune system works to fight off invaders like viruses and bacteria. If your immune system is working overtime to fight off a cold, the flu, or another bug, it may be less able to suppress the herpes virus in your system. Arm yourself against illness by washing your hands frequently, staying hydrated, and give your body plenty of time to rest.

Talk With Your Doctor

If you’ve already had your cold sore for more than 10 days, it's important to call your doctor. Only a medical professional can evaluate whether something more serious, like an autoimmune issue, is causing your lingering cold sore.

So if your cold sore won’t heal for months, don’t wait any longer. A doctor can suggest which cold sore remedies might work best for your situation and whether you need to have any further testing done.