Children Cold Sore Information

Children cold sore information includes information and photos on the usual cold sore children get on the lip as well as the initial infection that involves the whole mouth - gingivostomatitis.

Children with eczema may get a severe infection with herpes called eczema herpeticum - this requires urgent medical attention.


What is a cold sore?

Children cold sore information also applies to adults with a cold sore on the lip.

cold sore lipTypical lip sore

A cold sore is an infection caused by the herpes simplex virus (type 1). It starts as a small swelling that may look a little red and then becomes a blister (vesicle) and is usually on the lip.

Initially it is very itchy and then the blister appears and then over a few days it scabs over. It is usually gone within a week to 10 days.

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Can a cold sore occur in the mouth?


The first time children get the cold sore virus, they get a reaction within the mouth with lots of blisters and ulcers (an ulcer is a blister without the top) on the gums, tongue and inside the cheeks as well as the lips. This is called gingivostomatitis.

Children are often feverish with gingivostomatitis and find it hard to eat and drink. They can have enlarged lymph glands in the neck. The infection lasts 7 to 10 days.

Children's cold sores in the mouth can also look like hand, foot and mouth disease although the ulcers in hand foot and mouth disease are usually less severe than gingivostomatitis.

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What is the treatment for gingivostomatitis?

  • The important thing is to make sure your child continues to drink. She may not feel like eating much. Give non-acid fluids as acid fluids will sting, so avoid juice. Give milk or water instead.
  • A mouthwash with anti-inflammatory and pain-relieving properties can sometimes help - you can try a Diphenhydramine (Benadryl) mouthwash or a Benzydamine (Difflam) mouthwash.
  • Occasionally, children will get dehydrated and need to have an iv or nasogastric (ng) line placed to maintain their fluid intake until the viral infection settles itself.
  • Paracetamol (Acetaminophen) may help keep your child comfortable if she is very miserable.
  • There is no specific treatment required for most children. Cold sore treatments are reserved for children with underlying problems. So, in children with a reduced immune system or recurrent attacks, specific anti-viral agents like acyclovir / aciclovir or valacyclovir / valaciclovir can be used.

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What is the treatment for a cold sore on the lip?

If your child is able to tell you when the itch first starts, using a topical cream like Acyclovir / Aciclovir (Zovirax) can prevent the cold sore appearing.

This is one of the best cold sore remedy treatments available if you act early enough. Once the cold sore is present, there is not much use putting cream on it.

The important thing is to try and stop your child touching it as it will spread easily as herpes infection is contagious. You can also try and dry up the blister by dabbing it with tea tree oil or an alcohol swab.

Another adult and children cold sore treatment that has been shown to be as effective as aciclovir cream is the invisible patch, such as Compeed.

Children cold sore information - when the cold sore becomes scabbed over it can look a bit like impetigo. However, you can usually distinguish impetigo from children cold sore by the location. Cold sores will usually be on the lips where the pink of the lips meet the pink of the skin and cold sores are usually discrete.

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Can toddlers get cold sores anywhere else?

Occasionally, the herpes virus can cause an infection around the eye, involving the cornea. This will affect the vision so if your child has a red eye that is weepy or is complaining of poor vision, see your doctor.

Children with eczema can get a widespread herpes infection that needs treatment, so if this is the case with your child, you will need to see your doctor. Read more

The herpes simplex virus can cause infections in the brain as well - this is called encephalitis and symptoms would include confusion and fever and can cause seizures, often only on one side of the body. You don't usually see a cold sore on the mouth.

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What is eczema herpeticum?

cold sore eyeEczema herpeticum

If your child has eczema, there can be a severe reaction if she gets a cold sore and it spreads. This is called eczema herpeticum and will require treatment with an anti-viral drug like acyclovir so see your doctor.

You may initially notice little blisters appearing in areas where the skin is broken down with eczema - these will eventually scab over and there may be a "punched out" appearance on the skin.

In the picture on the right, you can see herpes infecting skin around the eye area in a child with eczema - this required intravenous treatment.

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Is a cold sore caused by the same virus as genital herpes?

No. Children cold sores are caused by Herpes simplex virus type 1 while genital herpes is usually caused by the type 2 virus.

Children cold sore information: It would be very unusual for a toddler to get a herpes infection involving the genital area unless they had been interfered with.

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How can I prevent cold sores in my child?

If your child gets cold sores as a response to sunlight, wearing sunblock on the lips may help. Hand washing and not touching a cold sore that is already there will prevent further spreading 

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Last reviewed 22 September 2011

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Dr Maud MD

Dr Maud MD (MBChB, FRACP, FRCPCH), a specialist pediatrician, provides health information and medical advice for parents of babies and toddlers. Read more about Dr Maud.

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