Distinguishing Cold Sores and Canker Sores

Cold sores and canker sores share some physical characteristics so many of you might be confused resulting you to use inappropriate treatments or remedies which may reflect on its outcome. So it is necessary to differentiate between these two conditions. In this article we have tried to summarize some features of each so you can distinguish between these two conditions.

Distinguishing Cold Sores and Canker Sores

Location: Cold sores are primarily located outside the mouth (may also be seen inside mouth in immuno-compromised people), while canker sores are usually located inside the mouth, usually inner lining of the cheeks, tongue, lips and the base of the gums.

Frequency: Cold sores occur as multiple blisters, while canker sores may occur as a single or in small groups. Both have tendency to recur.

Appearance: Cold sores have fluid filled blisters surrounded by a red halo, while canker sore have large sallow round ulcer without blistering and surrounded by erythematosus halos.

Halitosis: Cold sores are associated with bad breath, while canker sores are not usually associated with bad breath (in case of canker sores due to bacterial or fungal infection, bad breath may be present).

Fever: Cold sores may be associated with fever, while canker sores are not generally associated with fever until it’s due to some systemic infection.

Association: Cold sores may be associated with swollen neck glands, while canker sores are generally not associated with swollen neck glands.

Note: The symptoms like fever and swollen glands are less likely to present in every individuals. However absence of these symptoms doesn’t exclude the disease.

Contagious: Cold sores are exclusively caused by herpes simplex virus type-1 and 2 and are highly contagious, while canker sore may be caused by either bacterial or may be due to the result of underlying hematological abnormalities or gastrointestinal disorders. Canker sores are not contagious.

Pain: In both of the cases of cold sores and canker sore, lesions may be painful.

Here are few home remedies for cold sores and canker sores

Home Remedies for Cold Sores

Home Remedies for Canker Sores

Home Remedies for Cold Sores

Cold sores, also called as fever blisters are small painful fluid-filled blisters that appear most frequently on the lips mouth or inside the nose. In rare circumstances like in case of immuno-compromised patients they may also occur inside the mouth. Cold sores are not same as canker sores.

What causes cold sores?
Cold sores are caused by herpes simplex virus (HSV). Two types of herpes simplex virus causes cold sores namely HSV-1 and HSV-2. Although in most cases HSV-1 is responsible for cold sore and HSV-2 is responsible for genital herpes, they may both cause cold sore on the lips or mouth.

Once herpes simplex attacks you there is no cure, it stays in your body throughout your life. But the good thing is that after primary infection herpes simplex stays inactive without causing any symptoms or any serious complications and you may live a normal healthy life. It may later reactivate to certain triggering factors like excessive stress or other factors that decrease your immune system. If you are struggling with recurrent herpes and looking for some cold sore home remedies, here we go:

Some home remedies for cold sores

  • Do not pick, pinch, squeeze or bite the blisters.
  • Avoid licking the lips area.
  • Avoid acidic foods or other salty foods if they irritate your skin.
  • Rinse your mouth with available mouthwash or mix one teaspoonful of salt in 500 ml water and rinse, it will help soother cold sore and reduce irritation.
  • If you see yellow pus around the cold sore, it may be due to bacterial infection. Coat the lesion with some antibacterial ointment. If infection persists see your doctor.
  • Wash the lesion area gently with mild soap free liquid cleansers and pat dry with paper towel, but remember to keep the lesion moist afterwards to prevent further drying and fissuring.
  • Avoid sharing day to day applications like razors, toothbrush, and towels.
  • Clean your hands after touching the lesion. Try not to touch your eyes or genitals before washing the hands.
  • Don’t apply reusable applications like lip balms, lipsticks etc directly to the cold sore lesion. Apply with hands or cotton swabs and wash hands after application.
  • If you have pain you may take some analgesics to relive the pain. Do not take analgesics like aspirin or ibuprofen if you have peptic ulcers, gastritis. Aspirin is contraindicated in blood disorder and child below 12 years.
  • Over the counter topical medications like topical analgesics and skin protectants are available which will soothe the skin and relief pain. Apply the products directly to the lesion; do not spread to adjacent skin or non involved areas.
  • If you have difficulty in eating due to cold sores apply above mentioned products before eating. This will ease the pain and facilitate eating.
  • As cold sore are very contagious. Strictly avoid contact with other person during the blister formation periods. If you practice oral sex avoid it during this period.
  • Avoid excessive sunlight to your lips. Always apply broad spectrum sunscreen on your lips and over the area of your face where cold sore develops. Ultra violet radiation also is thought as one of the aggravating factor for cold sore.
  • Cold sore may persist for 10-14 days there is no cure for it, all available topical or medications will not help cure lesion but may shorten the duration of lesion if used early.
  • It is estimated that almost 80%-90% of the world population will have cold core at any time during their lifetime. Remember, herpes virus can be transmitted to another person even when a person is asymptomatic and no blisters are present.
  • If you have diabetes or recurrent herpes infection, above mentioned home remedies for cold sore treatment may not work for you all the time, you may need oral prescription drugs. Talk to your dermatologist for prescription products.
  • Avoid stress and other factors that you think has link to your recurrent cold sores.

1.Paterson J, Kwong M: Recurrent herpes labialis. Assessment and non-prescription treatment. GlaxoSmithKline Continuing Education in Pharmacy CCCEP#268-0405 1-21, 2005

Canker Sore – Causes and Remedies

What is Canker Sore?

Canker sore or aphthous stomatitis is a painful recurrent disease of oral mucous membrane. They are usually seen on the inner lining of the cheeks, tongue, lips and the base of the gums.

What Causes Canker Sores?

The true cause of canker sores is not clear. Genetic studies show that it is inherited in about one third of the patients. About 10-20% of the cases are due to underlying hematological abnormality such as low serum iron or ferritin, or deficiency of folate or vitamin B12. About 3% of the cases are due to gastrointestinal malabsorption and coeliac disease.

Other triggering factors include trauma (toothbrush injury, self biting, and dental procedures), sodium lauryl sulfate containing toothpaste, stress, spicy foods, citrus, medications allergy, hormonal changes in women, and sometimes cessation of smoking.

Canker sores may also be the oral manifestation of a number of systemic diseases including acute HIV infection, Behçet disease, sweet’s syndrome, cyclic neutropenia, Systemic lupus erythematosus and other immunodeficiencies.

Unlike cold sores which are caused due to herpes simplex virus, canker sores are not associated with herpes simplex virus infection.

Three clinical presentations are usually observed which are as listed below:

Minor sores: They accounts for almost 90-95% of the total canker sores and cause minimal symptoms. They present as few (1-6), small (2-4 mm in diameter) sallow ulcers. They resolve within 7-10 days without scarring and recur at variable interval

Major sores: They accounts for 5-10 % of all the sores and are painful. They present as few, large (1-3 cm) deep ulcers. They usually resolve within 2-6 weeks and may result in scarring.

Herpetiform ulcers: They accounts for 1-5% of all the canker sores and are extremely painful and recur very frequently. They present as cluster of multiple (1-100) small (1-3 mm diameter) shallow ulcers. They usually resolve within 7-10 days.

Are Canker Sores Contagious?
Unlike cold sores which are highly contagious, canker sores are not contagious, but they tend to run in families.

canker sore

canker sore

Canker Sore Treatment

Treatment is usually not required as ulcer heals by themselves. For recurrent ulcers there is no permanent cure. The initial step in canker sores treatment is to correct the triggering factors. If it is due to spicy food or food allergy it should be excluded from the diet. If it is due to zinc, folate or vitamin B12 deficiency it should be corrected. Good oral hygiene should be maintained. Mouth wash containing chlorhexidine or triclosan can be bought at any stores, this will help maintain oral hygiene and reduce the duration of ulcer.

Canker Sore Remedies

  • Rinse your mouth with normal salt water or baking soda.
  • Mix equal parts of Milk of Magnesia and Benadryl and hold the mixture in your mouth for 5 minutes and split it out, it will soothe your pain.
  • Mix equal part of hydrogen peroxide and water. Apply the mixture directly to the canker sore using cotton swap.
  • Apply small amount of Milk of Magnesia on the canker sore for 3 to 4 times a day. This will help soothe the pain and quicker healing.
  • Applying ice to your canker sores may also help soothing the pain.
  • If pain is severe one teaspoonful of Lidocaine 2% solution can be kept in the mouth for several minutes. Other topical anesthetics like dyclonine hydrochloride 0.5% can also be applied to the lesion.
  • If your condition is severe, you may consult your doctor. He may prescribe you some anti-inflammatory medicines like mild to moderate topical corticosteroid accordingly.