Start with pharmacy advice.
A pharmacist can advise on antiviral creams, cold sore patches and suitable pain relief. Antiviral cream works best from the first tingling and may not work once blisters have appeared.
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Cold sores · GP care
Cold sore starting? Act early. Protect others.
Cold sores are common and usually settle, but the first tingle is the best time to consider pharmacy treatment. Learn how to ease discomfort, limit the spread and recognise when a GP should help.
This page offers general guidance rather than a diagnosis. Any medicine or prescription depends on an individual clinical assessment.
Choose a suitable route
What kind of help do you need?
Most cold sores can be managed with self-care and pharmacy support. The size, severity, frequency and location of the outbreak determine when a GP review is more appropriate.
For severe or recurring outbreaks.
Ask for a GP review if the sore has not started healing within 10 days, is very large or painful, keeps returning, or comes with painful swollen gums or sores inside the mouth.
Explore GP appointmentsFor eye symptoms or an unwell baby.
Eye pain, a worsening red eye, light sensitivity or vision change needs urgent advice. A young baby who may have been exposed and becomes unwell also needs prompt medical help.
Get help from NHS 111Speak to a GP if you have a weakened immune system. If you are pregnant, ask a pharmacist, GP or maternity professional before using a medicine when you are unsure whether it is suitable.
What you may notice
A familiar sequence.
Cold sores are caused by the herpes simplex virus. After the first infection, the virus remains in the skin and can reactivate later.
Tingling or burning
Itching, tingling or a burning feeling often starts before the sore is visible.
Small blisters
Fluid-filled blisters usually develop on or around the lip over the next 48 hours.
Crusting and healing
The blisters can burst and crust over before the skin gradually heals.
Atypical or severe changes
Very large painful sores, widespread mouth symptoms or lesions near an eye need more careful assessment.
Not every sore around the mouth is a cold sore. Mouth ulcers are usually inside the mouth and are not contagious; impetigo and other conditions can look different but still need the right diagnosis. Ask a pharmacist or clinician if you are unsure.
A focused GP assessment
Understand the pattern. Choose the next step.
A GP can review the appearance and timing of the outbreak, whether it is new or recurrent, and any factors that make complications more likely.
Explore GP appointments01
Review the outbreak.
Where it started, how it has changed, how long it has been present and whether similar episodes have happened before.
02
Check for added risk.
Eye symptoms, pregnancy, reduced immunity, severe mouth involvement and contact with a newborn all affect the safest plan.
03
Agree appropriate care.
The plan may be self-care, pharmacy treatment, antiviral tablets when clinically indicated or referral for urgent specialist assessment.
Practical care
Treat early. Reduce the spread.
Simple precautions can ease discomfort and help protect the people around you while the skin heals.
01
Start early
Ask a pharmacist about an antiviral cream at the first tingling. Cold sore patches may protect the skin while it heals, but follow the label carefully.
02
Ease discomfort
Suitable pain relief, plenty of fluids and avoiding acidic or salty foods if they sting may help. Ask a pharmacist if you are unsure what is safe for you.
03
Prevent spread
Wash your hands after touching the area, avoid kissing and do not have oral sex until the sore has healed completely. Do not share products that touch the lips.
Dab cream onto the sore rather than rubbing it in. Cold sores are contagious from the first tingling until they have completely healed. A GP may consider antiviral tablets for a very large, painful or recurrent outbreak, but treatment is not automatic.
Extra care around babies
Protect newborn babies.
Neonatal herpes can be serious, and babies are particularly vulnerable during their first 6 weeks. If you have a current or recent cold sore, wash your hands before handling a baby and do not kiss them.
Call a GP or NHS 111 straight away if a baby is irritable, feeding less, has a temperature of 38°C or higher, or develops a rash or sores on the skin, eyes or inside the mouth. Call 999 for breathing difficulty, a seizure, blue skin or tongue, unusual floppiness, unresponsiveness or difficulty waking.
Read NHS neonatal herpes guidance ↗Good to know
Questions about cold sores.
Clear answers for managing an outbreak and knowing when to ask for help.
How long does a cold sore last?
A cold sore should usually begin to heal within 10 days. Ask for a GP review if it has not started healing by then, is unusually large or painful, or you are unsure it is a cold sore.
When is a cold sore contagious?
From the first tingling until it has healed completely. During that time, wash your hands after touching it, avoid kissing and do not have oral sex.
Is it a cold sore or a mouth ulcer?
Cold sores usually appear on or around the lips and often begin with tingling. Mouth ulcers are usually inside the mouth and are not contagious. A pharmacist or clinician can help if the appearance is unclear.
Will I need antiviral tablets?
Not necessarily. Many outbreaks settle with self-care or pharmacy treatment. A GP may consider antiviral tablets when a cold sore is very large, painful or keeps returning, depending on your assessment.
Can a video or telephone appointment help?
A remote appointment may be suitable for an initial history and visual review, especially for a familiar outbreak. Eye pain, redness, light sensitivity or vision change needs urgent assessment and may require same-day specialist eye care. Explore remote GP formats.
What should I do if a baby has been exposed?
Do not kiss a baby while you have a current or recent cold sore, and wash your hands before contact. If a young baby becomes unwell, feeds less, develops a fever, rash or sores, call a GP or NHS 111 straight away; call 999 for the emergency signs described above.
Clinical information: NHS cold soresNHS herpes simplex eye infectionsNHS neonatal herpesNHS mouth ulcers. This information is general and does not replace individual medical advice.