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How Common Are Cold Sores (Fever Blisters) During Pregnancy?

You may contract the virus again while pregnant if it was contracted before.

Research-backed

MomJunction believes in providing reliable, research-backed information to you. As per our strong editorial policy requirements, we base our health articles on references (citations) taken from authority sites, international journals, and research studies. However, if you find any incongruencies, feel free to write to us.

Image: Shutterstock

Cold sores or fever blisters erupt inside the lips or cheeks, around the mouth, or near the nose and chin. These itchy and tingly sores might sometimes be painful too. Usually, cold sores are likely to disappear in a couple of weeks. But what happens when they occur during pregnancy? What should you do about them?

We tell you about it in this MomJunction post. Keep reading to know more about cold sores during pregnancy.

Are Cold Sores Common In Pregnancy?

Cold sores are usually caused by herpes simplex virus (HSV), especially type 1 of the virus (1). Therefore, they are likely to be common in women who have experienced them in the past (2).

What Are The Causes Of Cold Sores During Pregnancy?

Image: iStock

Cold sores are caused by the herpes simplex viruses named HSV1 and HSV2. The virus transmits from one person to another through skin to skin contact during touching, sexual intimacy, kissing, or sharing contaminated items (3).

Once a woman has contracted the virus, the following risk factors could trigger the cold sore virus.

• Hormonal changes that frequently rise and fall could make the body susceptible to viral infection, including a cold sore outbreak (4).
• Psychological concerns, such as stress and fear could trigger the virus (5).
• Certain foods (acidic, spicy, or salty), citrus fruits, exposure to the sun, and hot water could trigger the virus and cause cold sores (6).

Related: Reasons For Postpartum Hormonal Imbalance And Ways To Deal

Signs And Symptoms Of Cold Sores In Pregnancy

Image: Shutterstock

The common signs and symptoms that could indicate cold sores during pregnancy include:

• Swelling of the lips
• Small, painful blisters
• Redness
• Tiny bumps over your lips
• Fever
• Pains and aches
• Sore throat

Cold sores develop gradually, in five different stages, when you might experience the above symptoms. Understanding the changes in each of these stages might help you take the right steps to prevent them from spreading to other parts of the body.

Stages Of Cold Sores

The cold sores last for seven to 12 days, and during this time, they might progress in different stages (7).

Stage 1: The tingling stage

You may experience a tingling sensation for about a couple of days. The skin (inside your lips, on your lips, or inside the cheeks) might turn sore and red and might even swell and become itchy.

Stage 2: The blister stage

This stage lasts for about two days. During this stage, new blisters may form and spread to other parts in the absence of proper care.

Stage 3: The weeping stage

At this stage, the blisters may burst, and you might experience pain. The cold sores might scab over at this point.

Stage 4: The scabbing stage

The scabs may crack and even bleed. They could be itchy, but make sure you are not poking them.

Stage 5: The healing stage

In this stage, all the scabs flake off and disappear soon after. Even the scars slowly vanish.
Observe the progress of cold sores and treat them in time to prevent the infection from spreading.

Related: C-Section Scar Wound Infection

Are Cold Sores Contagious?

Image: Shutterstock

According to the World Health Organization (WHO), herpes infections are highly contagious when symptoms such as ‘cold sores’ are present (8). The virus may be passed from one person to another. If the bump ruptures, the active virus could spread via lipstick, cups, utensils, kissing, or through oral sex (9).

According to the UT Southwestern Medical Center, HSV 1 or the cold sore infection could pass from the infected person to the baby. This usually happens when the person kisses the baby or when the baby is touched after the cold sore is touched (10).

Therefore, it is important to treat the cold sore in pregnancy to prevent the virus from spreading to the baby after it is born. Herpes infection is mild for the mother but can be life-threatening for the baby.

Point to consider

Pregnant women contracting herpes infection for the first time (primary infection) have a higher infection transmission rate. A newly infected mother doesn’t have the antibodies to provide natural protection to the baby (2).

Related: Threatened Miscarriage: Causes, Symptoms And Risk Factors

How To Treat Cold Sores In Pregnancy?

Home care measures for the sores might alleviate pain and discomfort. In some cases, medication may be necessary.

1. Home treatment

Image: iStock

• You may try some home remedies to ease the cold sore-related pain and discomfort
• Placing a cold compress (wet, cool cloth, or towel) on the sores may help reduce the redness and pain.
• A mouthwash containing baking soda may also reduce the soreness.
• Apply sunscreen before going outside.

You may apply aloe vera gel or lip balm containing soothing ingredients on the sores.

2. Clinical medicine

Before you take any medication for cold sores in pregnancy, talk to your doctor. Ideally, antiviral medications are prescribed to treat cold sores. According to the American Academy of Family Physicians, the common options include valacyclovir, famciclovir, and acyclovir (11). These fall under pregnancy category B medications of the US Food and Drug Administration.
If the cold sores get severe, the doctor may change the dose or prescribe other treatment.

Are Cold Sores An Early Sign Of Pregnancy?

Cold sores are common, and most pregnant women may experience them. But they may not be an early sign of pregnancy. A woman may get cold sores at any point during the gestation period.

Are Cold Sores During Pregnancy Harmful To The Baby?

According to the Royal Hospital for Women, Australia, cold sores may not affect newborn babies. But they are infectious and should be treated in time, so they don’t spread to the infant (1). However, if you have genital herpes, then there are chances of the virus transmitting to the baby during the process of childbirth (known as acquired herpes). This can be very dangerous for the baby. Hence, a cesarean section is indicated to avoid contact of the baby with the cold sores.

Did you know?

Neonatal herpes infection may result in viral meningitis. However, it occurs in less than 1% of births, and the development of meningitis from HSV-1 infection is quite rare (10).

1. Can pregnancy flare-up cold sores?

Pregnancy modulates the immune system, and women who have herpes may have an increased risk of outbreaks of cold sores during pregnancy (12) (13).

2. Can pregnancy hormones cause cold sores?

Cold sores may be triggered due to hormonal changes during pregnancy or menstruation in women already exposed to the herpes simplex virus type 1 (HSV-1) (14).

3. Can I use Abreva for cold sores while pregnant?

The manufacturer’s instruction states that Abreva is not recommended for treating cold sores in pregnant or lactating women unless advised by a doctor (15).

4. Can I use cold sores cream when pregnant?

A doctor may prescribe cold sores creams containing aciclovir, an antiviral medication, for treating cold sores during pregnancy (2).

HSV1 and HSV2 can produce cold sores during pregnancy that can emerge inside the lips or cheeks, near the nose and chin, or around the mouth. The advancement and healing may occur in stages over seven to twelve days. It is advised to avoid touching the sores when they erupt, follow a well-balanced diet, and get plenty of rest to avoid cold sores during pregnancy. Also, stay away from spicy meals and wash your hands frequently. Though cold sores are not a cause for concern during pregnancy, you should visit your doctor and have them treated as soon as possible.

Key Pointers

• Cold sores are blisters inside the mouth or near the nose, caused by the herpes simplex virus and commonly seen in women with past exposure.
• The virus is contagious, and factors such as hormonal or psychological changes can trigger its occurrence in pregnant women.
• It is not an alarming concern. You may try some effective home remedies or consult your ob/gyn for pregnancy-safe medications.

References:

MomJunction's articles are written after analyzing the research works of expert authors and institutions. Our references consist of resources established by authorities in their respective fields. You can learn more about the authenticity of the information we present in our editorial policy.

1. Cold sores (herpes simplex type 1) – including symptoms, treatment and prevention; Government Of South Australia (2019)
2. Cold sores in Pregnancy and Breastfeeding; The Royal Hospital For Women (2016)
3. Cold sores in pregnancy; Pregnancy, Birth and Baby; Healthdirect Australia (2019
4. Cold sores; University of Wisconsin-Madison
5. D. B. Donahue; Diagnosis and Treatment of Herpes Simplex Infection During Pregnancy; Journal of Obstetric, Gynecologic & Neonatal Nursing (2002)
6. Herpes simplex; Mount Sinai
7. Cold Sores; San Diego State University
8. Herpes simplex virus; World Health Organization (2017)
9. D. Shipp; How contagious are cold sores?; The Ohio State University (2019)
10. R. Horsager-Boehrer and J. Kahn; How to protect your baby from herpes infection; UT Southwestern Medical Center (2017)
11. ACOG Releases Guidelines on Managing Herpes in Pregnancy; American Academy of Family Physician (2008)
12. Gil Mor and Ingrid Cardenas; The Immune System in Pregnancy: A Unique Complexity; American Journal of Reproductive Immunology (2010)
13. Cold sores in pregnancy; Pregnancy Birth & Baby
14. Cold Sores; Cleveland Clinic
15. Understanding cold sores; Abreva Canada

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Rebecca is a pregnancy writer and editor with a passion for delivering research-based and engaging content in areas of fertility, pregnancy, birth, and post-pregnancy. She did her graduation in Biotechnology and Genetics from Loyola Academy, Osmania University and obtained a certification in ‘Nutrition and Lifestyle in Pregnancy’ from Ludwig Maximilian University of Munich (LMU). She has been into health and...
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Dr. Ben Abbes Taarji Hicham is a practicing obstetrician and gynecologist with over 20 years of experience. Having worked in various Moroccan hospitals, he currently runs a private practice. Dr. Hicham specializes in rejuvenation and cosmetic gynecology, medically assisted reproduction, breast and gynecological cancers, HPV diseases, hysteroscopy and laparoscopy, and hormonal disorders.

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Early pregnancy | Shchelkovsky perinatal center

Pregnancy is a wonderful period! However, the changes taking place in the body at this time can greatly frighten you. The phenomena characteristic of pregnancy are different for all women, and will not necessarily be repeated during each subsequent gestation. Let's analyze the most common symptoms, their causes and possible methods of correction.

1. Frequent urination.

Frequent, painless (!) urge to urinate is one of the signs of pregnancy. This is due to increased secretion of progesterone (pregnancy hormone), changes in metabolism and pressure from the growing uterus on the bladder. nine0005

Be sure to see a doctor if:

• painful urination (this may be a sign of an infection)
• urine of strange color (stained with blood, brown)
• the amount of urine excreted per day is much less than the liquid drunk per day

Life hack! Under no circumstances should fluid intake be restricted! To alleviate the condition and reduce the frequent urge to urinate, it is necessary to exclude products that have a diuretic effect: tea, coffee, zucchini, watermelon; as well as salty, spicy and fried foods. It is better to drink water or juice. Wear comfortable cotton underwear that does not squeeze the lower abdomen. nine0005

2. Nausea, vomiting, heartburn, increased susceptibility to smells.

Nausea is one of the common symptoms of early pregnancy. The range of issues related to nausea and vomiting during pregnancy is quite wide. From "it's good, I don't even feel sick" (with relief), "I don't feel sick, what's wrong with me?" (with anxiety) to "when will this nausea pass" (with hope). Indeed, these symptoms are not at all a mandatory accompaniment of gestation, they can manifest at 7-8 weeks and last up to 12-14 weeks. The duration of this condition can sometimes be delayed, but rarely persists throughout pregnancy. nine0005

Life hack! For nausea, eat before feeling hungry. Solid, non-hot food and drinks at a cool temperature are best. With heartburn, you should eat small portions of food and often, and most importantly, sit, stand or walk for at least 30 minutes after eating, but do not lie down.

You should definitely consult a doctor if:

• vomiting occurs even after drinking water
• vomiting is exhausting, accompanied by dizziness, weakness
• dryness, jaundice and flaking of the skin appear
• Nausea and vomiting interfere with proper nutrition, accompanied by weight loss

To reduce nausea and vomiting in the morning, try eating something before you get out of bed. It can be a cracker, a cookie, a piece of hard cheese. And salty food is preferable to sweet. You can have a snack in the same way at night when you get up to go to the toilet. Do not lie down immediately after eating, this will only increase nausea. Vitamins for pregnant women with nausea should be taken in the evening after meals. Cool water with lemon, ginger, mint tea, or ginger or mint candies can alleviate the condition. It is necessary to exclude those foods, drinks and smells that are unpleasant to you. Brushing your teeth and rinsing your mouth often can also reduce nausea. nine0005

3. Pain or cramps in the lower abdomen, constipation, pain in the lumbar region.

The simplest and most easily controlled cause of pain is delayed and incomplete bowel movements. An increase in the concentration of progesterone relaxes the smooth muscles, which are located not only in the uterus, but also in other hollow organs. In this case, the correction of the diet and the restoration of the passage of feces will help. If the measures are ineffective, the doctor may prescribe safe drugs for you. A special type of pain that occurs during exclusivity in pregnant women is pain in the round ligament of the uterus. This acute, rather intense pain occurs, as a rule, on the one hand with a sharp change in body position (for example, when getting up from a chair or leaving a car). This pain occurs due to stretching, and then a sharp contraction, like a spring, of the round uterine ligaments. The pain quickly passes if you immediately take a comfortable position and does not require special treatment. nine0005

You should definitely consult a doctor if:

• pain is accompanied by spotting bloody discharge from the external genitalia
• increasing duration and intensity of pain
• abdominal pain accompanied by dizziness, fever, loss of consciousness

Life hack! To normalize bowel movements, eat more vegetables and fruits, drink water and move more during the day. Try to eat often and in small portions. nine0005

4. Enlargement and soreness of the mammary glands.

Hormonal restructuring of the body during gestation is accompanied, among other things, by an increase in the size of the mammary glands and an increase in their sensitivity. By the end of the first trimester, the soreness usually disappears, no additional methods of treatment are needed.

Life hack! Choose comfortable supportive underwear (it should not leave marks on the skin at the end of the day). You may need a larger size or a sports bra. Pain in the mammary glands is relieved by a warm shower at the end of the day. nine0005

You should definitely see a doctor if:

• the pain is intense
• mammary glands are very dense with redness and body temperature is increased
• discharge from the nipples appears (purulent, bloody)

5. Increased body temperature.

In early pregnancy, an increase in body temperature to 37.5 ° C is not necessary, but is possible due to the peculiarities of the action of progesterone. Because of this, it is difficult for pregnant women to endure stuffy, hot rooms. Self-medication is dangerous: an attempt to bring down the temperature even with a seemingly harmless folk method - tea with raspberries - can mask the true cause of hyperthermia and delay the diagnosis. Due to the increased body temperature, pregnant women should dress in layers and avoid stuffy and hot rooms and spaces so that they can always “adjust” their temperature on their own. nine0005

• temperature above 37.5 °C
• along with fever, any pain occurs
• runny nose, cough, body aches appear

6. Nasal congestion, difficulty breathing, nosebleeds.

These symptoms can be explained by the individual reaction of the vascular system to the increase in blood volume that occurs during pregnancy. Another possible reason is dry air in the room, the operation of central heating batteries. nine0005

Life hack! The easiest way to deal with nasal congestion is to use a humidifier. If you don't have one, you can put a damp towel on the battery - less effective, but better than nothing. It is possible to use sprays with sea salt, but you need to carefully read the instructions and especially the "Indications" section, it should contain information about the safety of the product during pregnancy.

You should definitely see a doctor if:

• symptoms of a cold occur
• nasal congestion accompanied by ear congestion
• These symptoms appeared after exposure to the allergen known to you

7. Blood pressure fluctuations.

An ideal option for the course of any pregnancy is the stability of the blood pressure throughout the gestation. However, this is extremely rare. A small (up to 10 units) increase in pressure from the usual reference may be due to an increase in the load on the cardiovascular system as a result of changes in body weight, hormonal changes, and uterine pressure on the vessels. Normal pressure: systolic below 130 mm Hg, diastolic no more than 85 mm Hg. Blood pressure in the range of 130–139/ 85–89 mm Hg considered high to be normal. High numbers are often observed in patients of older reproductive age, suffering from diabetes mellitus and kidney disease, obesity, etc. However, it is imperative to tell the doctor about all these concomitant pathological conditions at the first appointment and, if necessary, consult a neurologist, cardiologist, endocrinologist and other related specialists . Reasonable physical activity, adherence to sleep and wakefulness, a balanced diet, and the rejection of coffee and strong tea allow you to keep pressure within limits. Of the completely exotic for our days, but no less significant - the prevention of stress. nine0005

Life hack! If you first discovered that you have high normal pressure, repeat the measurement after 15 minutes. If the pressure remains elevated, see a doctor.

Be sure to see a doctor if:

• your blood pressure is above 140/90 mmHg.
• pressure increased by more than 10 mm Hg. relative to your regular
• an increase in the pressure indicator is accompanied by edema, the appearance of "flies" before the eyes

NB! You should also pay attention to lowering blood pressure. Numbers less than 90/60 mmHg - an excuse to see a doctor.

Life hack! Keep a blood pressure diary, especially if you are prone to hypertension. Show your diary to your doctor at every appointment.

8. Heaviness and pain in the legs.

Heaviness and pain in the legs, especially in the evening, are frequent companions of pregnancy. There is an explanation for the occurrence of symptoms: an increase in load due to growing weight and a shift in the center of gravity of the body. nine0005

Life hack! Ask your partner/husband to give you a foot massage, relax with your limbs elevated (not too much!) A therapeutic pedicure, dousing the legs with cool water, a contrast shower, a cream or gel for legs with cooling components (menthol, essential oils), as well as compression stockings or stockings of the lightest degree of compression will help.

You should always see a doctor if:

• one or both legs are very swollen or discolored
• previously diagnosed varicose veins, family history of thrombosis

9. Skin changes.

During pregnancy, you may notice dark spots on your skin. Especially often such darkening (hyperpigmentation) is observed in the nipple area, along the white line of the abdomen. Stretch marks (stretch marks) may appear on the skin of the abdomen and thighs. These are normal signs and do not require any treatment. In most cases, skin color will return to normal after breastfeeding ends, and stretch marks will shrink and fade. Itching can be associated with stretching of the skin, especially in the abdomen and mammary glands. This symptom occurs infrequently and is usually successfully stopped by the use of special products to moisturize and soften the skin. By the way, these same remedies usually help in the fight against stretch marks. nine0005

Life hack! Oils and moisturizing creams to increase skin elasticity, contrast showers, massage with a hard brush will help reduce the likelihood of skin changes.

You should definitely consult a doctor if:

• along with itching there are areas of redness, spots, peeling
• itching increases

10. Bleeding gums.

Changes in the characteristics of blood circulation in the body of a pregnant woman can cause bleeding gums. The appearance of minor blood impurities during brushing your teeth, when eating solid foods (for example, an apple) is acceptable. However, the key provision is "insignificant". If you find it difficult to assess your own condition, consult a specialist. nine0005

You should definitely consult a doctor if:

• you have loose teeth, sore gums, bad breath
• bleeding in the gum area increases

11. Fatigue, mood instability.

Tearfulness, lack of strength, forgetfulness, distraction, the whole palette of feelings "here and now"... The list can be continued, and there is only one explanation for this - pregnancy. The most common early symptom is severe fatigue. There is no universal recipe, just as there is no single picture of these states. The main recommendation for all pregnant women is to rest often, relax and even sleep during the day. Most importantly, you need to remember: pregnancy is not a disease, but a great time to prepare for motherhood. nine0005

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