Cold sores have painful symptoms. Facial nerve pain after the herpes simplex virus (HSV-1) has been activated is less common, but it can occur. Other medical conditions affect the nerves in the face, so a self-diagnosis can be difficult.
Responsible for most of your facial sensations, the trigeminal nerve is adversely affected by HSV-1. This is where the virus resides before traveling down the nerve to the area of the lips and mouth (the position where you got your first cold sore). This same nerve can also be compromised during more common illnesses, such as cold and flu.
While nerve issues in the face can be long-term in some cases, most forms of facial pain will go away when they’re given sufficient time. When HSV-1 returns to a dormant state, the trigeminal nerve should return to its natural state as well. The pain should go away on its own.
We will provide more information about facial pain, trigeminal neuralgia, and how it can be effectively treated. We’ll also look at an ailment known as post-herpetic neuralgia and how it can sometimes be connected to shingles.
Can Cold Sores Cause Face Pain?
Cold sores can introduce many uncomfortable symptoms, and some can affect the face and eyes. Because HSV-1 is a virus, many of the signs are similar to a cold or flu. In the same way that a body that aches and experiences joint pain are signs of influenza, the same applies to severe cold sores.
Stimulation of the trigeminal nerve is the issue. Forming the largest and most detailed section of the 12 cranial nerves, the trigeminal nerve controls virtually every sensation in the face. This also includes the mucous membranes as well as most of the head.
Because the trigeminal nerve is responsible for virtually every facial sensation, a viral attack can result in some harsh symptoms. The issue is described as “shock waves” throughout the face.
- Example: Have you ever experienced a sinus infection where your entire face hurt and was sensitive to the touch? The same issue can take place during a bad case of cold sores. Another example would be a particular tooth that is sensitive to extreme cold. The sensation caused by ice can lead to a quick burst of pain throughout the facial area.
Although face and eye pain are uncommon, they can occur. If you are in the midst of a primary cold sore infection, your symptoms could include extreme facial discomfort.
- Facial and eye can pain can be a symptom of a severe outbreak. Intense flaring of the trigeminal nerve is responsible for this discomfort.
- Many of the symptoms are similar to the flu. Facial pain and general body aching regularly occurs. The discomfort tends to be worse during a primary infection because your immune system has yet to figure out how to fight back against the virus.
Medical Conditions that Affect the Trigeminal Nerve
While cold sores can trigger the trigeminal nerve for a brief period, there is also a condition known as trigeminal neuralgia. Issues that stimulate the trigeminal nerve and trigeminal neuralgia are NOT always the same.
Trigeminal neuralgia causes damage to the myelin sheath that protects various nerves in the face. Trigeminal neuralgia can be caused by a host of issues that have directly compromised the trigeminal nerve more permanently.
Some medical conditions that can directly impact the trigeminal nerve are as follows:
- Multiple sclerosis
- Tumor (pressing the trigeminal nerve)
- Brain lesions
- Spinal injuries
- Facial surgery
- Facial trauma (Hitting your face, getting punched, car accident, etc.)
Ailments that impact the trigeminal nerve do not define the condition. Just as not all coughs are linked to the flu, the onset of every cycle of facial pain is not always trigeminal neuralgia. Many cases are the result of the trigeminal nerve being damaged to some degree.
Noted below are a few known actions that can cause trigeminal neuralgia:
- Harsh rubbing/touching of the face
- Brushing teeth
- Putting on makeup
- Prolonged smiling
- Aggressive washing of the face
Can You Get Trigeminal Neuralgia from a Cold Sore?
It is highly unlikely that an aggressive cold sore outbreak will leave you with trigeminal neuralgia. While fever blisters can aggravate the trigeminal nerve, the “shock wave” sensations will usually vanish once the virus has run its course.
If you develop long-term trigeminal neuralgia, there is a chance that something else is to blame. Trigeminal neuralgia primarily involves some form of nerve damage. This is why it is unlikely that a cold sore outbreak would damage it. For example purposes, this would be similar to a case of the flu leading to long-term facial nerve issues. It’s unlikely to happen.
If you are experiencing extreme facial sensitivity following an outbreak, you should consult your physician. Facial pain (of any type) following cold sores is not typically a symptom. It’s even rarer if several weeks have passed since the cold sore healing stage concluded.
- The likelihood of HSV-1 causing trigeminal neuralgia is low. While herpes simplex one can negatively stimulate the trigeminal nerve, any issues should vanish once your outbreak has concluded.
- If you are experiencing long-lasting facial pain and general discomfort you should contact your physician. While fever blisters can trigger a variety of symptoms, long-term facial pain is not one of them.
Do I Have Shingles or Trigeminal Neuralgia?
There is also a controversial school of thought on a condition known as post-herpetic neuralgia and how it could be related to shingles.
Shingles, also known as herpes zoster, is a reactivation of chicken pox which causes a very painful rash. It also introduces a sensory disorder which leads to a “pins and needles” sensation across the coverage area. Most commonly the “trunk” of the body.
This same sensation is what most trigeminal neuralgia sufferers report. Post-herpetic neuralgia is the concept that shingles, once healed, can introduce long-standing neuralgia.
While nothing is conclusive, shingles can leave behind severe nerve damage in severe cases. If you have had shingles and are experiencing nerve pain, we encourage you to consult your physician. It is not out of the realm of possibility that your ailment is the result of shingles that have compromised your nerves in some way.
- Shingles (herpes zoster) is an awakening of chickenpox in adults. In addition to an extensive rash, it is also common for nerves to flare and promote extreme sensations. These sensations are similar to that of trigeminal neuralgia.
- While shingles most commonly form on the sides and back (trunk) of the body, the nerve pain is regarded by some in the medical community as a “post-herpes” influence.
What Can I Do to Reduce the Pain Quickly?
If you are experiencing facial nerve pain, there are a host of medications and treatments available. This goes for standard nerve pain in addition to a definite diagnosis of trigeminal neuralgia.
Here are some of your treatment options:
- The introduction of drugs known as anticonvulsants is common. These medications are designed to keep facial nerves from reacting to irritation. This will allow you to get through your day and complete normal tasks without concern.
- Muscle relaxants, either singular or in combination with anticonvulsants, can also be taken. Because common pain relievers often do not work when attempting to stop nerve pain, relaxants are often introduced.
- Additional treatments such as acupuncture, aromatherapy, meditation, and yoga can also help to calm facial and head nerves. Anything (within reason and safety) that can relax the face and head may be beneficial.
Facial pain, ear pain, headache, fatigue, etc. can all occur. If your facial pain has continued weeks after your cold sore has healed, then you should seek the guidance of a medical professional. It’s very unlikely to be caused by cold sores at this stage.