The most effective way to put a stop intense cold sore pain is to take action as soon as you notice the symptoms. If you treat your fever blisters with an FDA-approved medication, they will hurt far less and the site of the lesion will heal that much faster.

Because cold sores follow a lifecycle,[1] the level of discomfort is directly tied to each stage of progression. The blister and ulceration stages are the two most painful ones. Act fast during the prodromal stage and your suffering will likely be vastly reduced.

The use of a treatment that’s approved by the FDA, such as the Virulite Electronic Cold Sore Device, during the prodromal stage can accelerate healing and help with pain avoidance.[2] It can, of course, be of assistance at any stage, but early treatment is highly recommended.

We’ll now look at why cold sores hurt and provide quick ways to minimize the painful symptoms. It’s entirely normal for fever blisters to hurt, but you can make life more comfortable.

Are Cold Sores Supposed to Hurt Like Hell?

Born from the herpes virus, fever blisters can hurt a lot. Because your immune system is unfamiliar with the virus, your initial outbreak (primary infection) can be accompanied by unpleasant flu-like symptoms.

Cold sore blisters appear in clusters and this creates tension on your lip. Because the blisters fill with fluid, the area becomes swollen and painful. That’s why taking action at an early stage is vital. You can prevent the virus from reaching that stage of development.

What Are the Most Common Symptoms?

The symptoms typically just affect blister region itself. These localized symptoms typically occur during fever blister recurrences. After several recurrences, the appearance of a cold sore may be the only symptom that you experience. Unfortunately, not everyone is that fortunate.

Common cold sore symptoms include:

  • Tingling and itching at the original site of transmission (lip or mouth area).
  • Fluid-filled blisters. These blisters are quite painful in their own right, but the surrounding areas can also become red and swollen.
  • The oozing and crusting over the blisters with yellow scabs comes next. This process can lead to clear liquid drainage and even bleeding. Many people are concerned that they have an infection when they notice that their scab has turned black, but it’s just dried blood.

The initial symptoms of cold sores may include the following:

  • Fever
  • Pain along the gum line
  • A sore throat
  • An intense headache
  • Muscle aching and fatigue
  • Swollen lymph nodes

Which Stage is the Most Painful?

The ulceration stage causes the most discomfort. This is when the fluid-filled blisters burst and leave a tiny hole (ulcer) in the damaged skin.

The intense pain is not only caused by the bursting of the blisters but the ulcers that are left behind. Left exposed to open air, it’s possible that your ulcers could become infected if not treated properly. Viral spreading to other areas can also take place during this stage.

Because the fluid is contaminated with the herpes simplex virus, it can potentially enter other areas of the skin. The appearance of cold sores on the nose (nostrils) and cheeks, for example, can be the result of viral spreading. That’s why you always need to be really careful.

Primary vs. Recurrent Outbreaks

By definition, a primary outbreak is a reference to your first HSV-1 outbreak. This outbreak will often be the most intense and longest lasting. Any outbreak that takes place subsequently is known as a recurrent outbreak. It usually occurs in the same region that was originally infected.

How many and how often varies from person to person. With every recurrence, your overall symptoms should lessen. This will occur naturally if you have a robust immune system. Once your body can recognize HSV-1, it will handle recurrent cold sores so much better.

Do Cold Sores Hurt Before They Appear?

Although “hurting” can be subjective, the general answer is no. While the prodromal/tingling stage will lead to a tingling and itching sensation, perhaps even slight burning, it is not typically that painful. Although noticeable, the prodromal stage is not a source of pain. Also, the visual clues are normally minor.

What the prodromal stage can offer you is a valuable warning. Usually taking place a full 24-48 hours before blister formation, the prodromal stage is when you need to be proactive. The best time to use an over-the-counter cold sore medication is before the appearance of a fever blister.

Why Do Cold Sores Hurt More at Night?

Cold sores hurt more at night for the same reasons that a bad cold or flu makes you feel much worse.

When your body is tired, your energy levels become depleted. Fatigue at night can also compromise your immune system. When you’re on full alert during the day, the pain associated with your fever blister can be minimal. However at night, when your immune system is weakened, your body can find it hard to fight off HSV-1 symptoms.

Remember that your blister is a product of a highly infectious virus. While it looks like a blister that could occur anywhere on the body, that is not the case. If you think of your blister as having a type of sickness, you will understand better why it becomes more painful when you’re exhausted.

Are Cold Sores Painful to Touch?

If you touch a cold sore, it will probably hurt. It’s no different to any type of wound in that respect. Many people mistake cold sores for pimples.

Although cold sores can be painful to touch, the greater concern is what can happen subsequently. In fact, it could cause contamination which could lead to infection and delayed healing. You should never pick and poke at your blisters, ulcers or scabs.

Unless you are actively applying a treatment, you should never touch or rub your fever blisters. Allow them to go away naturally.

Can Cold Sores Not Hurt?

If you have endured multiple cold sore outbreaks, it will often be an uncomfortable experience. Blisters, tightly formed and packed with fluid, will lead to tension and tightness around your lip line. With the addition of swelling around the area, most cold sores do hurt like hell.

Another consideration is the location of your cold sores. If you have blisters in one corner of your mouth, they will logically be more painful. If you are a male and have an outbreak that’s above your lip (where facial hair grows) your sores will also hurt more.

What to do when your cold sores hurt too much

How Long Do Cold Sores Hurt?

Significant discomfort can occur from the start of the blister stage right throughout to the completion of the scabbing stage.

Noted below is a brief explanation of various pain stages and the reasons for discomfort:

  • The blister stage can be painful because of the pressure from each sore. Because fever blisters are filled with fluid, they can cause the compromised area to become tight. This tightness can introduce a burning sensation that coincides with swelling along the areas of the sore. The general feeling is similar to the sensation caused by a busted lip that could come from severe trauma.
  • The ulcer stage is the most painful stage, but the general “hurt” can occur for many reasons. The ulcer can introduce a painful stinging sensation. Once the damaged skin becomes an open sore, it can now be taken over by outside influences. This includes adverse weather, debris, touch, etc. Anything that enters this area is like pouring salt into an open wound. It will inevitably cause a degree of discomfort.
  • Pain can take place during the scab stage. Because scabs are meant to flake away naturally, the cracking of a scab can be an agony. Not only does it leave tender skin exposed to the open air but it can also cause bleeding. Although the scab stage is good news because it means that you’re really close to a full recovery, it’s not always a pleasant experience.

Can I Make Eating & Drinking Less Painful?

If you have HSV-1, the best way to avoid an outbreak is to steer clear of trigger foods and beverages. This includes spicy foods as well as choices that are high in arginine. Beverages that have a high acidity content are also frowned upon. This includes citrus drinks, sodas, and most alcoholic beverages.

Listed below are ways to make eating and drinking easier:

  • The use of a straw could be beneficial as a liquid is less likely to remain on your lips. Active treatment is also less likely to be disrupted as the beverage can bypass your lips entirely.
  • Place food in your mouth rather than on your lips. This can keep your blister unharmed and free of any food particles.

What Are the Quickest Ways to Numb Pain?

The quickest way to numb your cold sore pain is with an OTC selection such as HERP-B-GONE Cream or an anti-inflammatory option such as Ibuprofen.

The application of aloe vera gel to your sores can also serve to soothe the area.[3] This approach has become more and more common in recent years.

Cold Compress

What makes the cold compress valuable is that it is safer than ice upon application.

The use of ice, even when wrapped, can burn your skin. If you were to burn a cold sore with ice, it would add to the problem. A cold compress can prevent skin burning. Compression treatments do not produce liquid, so you never have to worry about a messy cleanup.

Use small gel packs. This will provide you with just the right about of coverage without the hassle of bulky and extra material.

How to reduce the pain from cold sores

Pain Killers (Ibuprofen)

Following the guidelines is important. The last thing you want to do is abuse any medication.

  • Important: For cold sore relief, you should take 200 or 400 mg every 4 to 6 hours. This will help with moderate pain.

Ibuprofen should be taken with a meal. This is important as this pain reliever can cause an upset stomach if consumed without food. Take Ibuprofen while eating your largest meal of the day.

While most most of the cold sores last just over one week, some can last longer. Perhaps 14 days or more. Per recommendation, you should not take Ibuprofen for more than ten consecutive days unless permitted by your physician. While useful, Ibuprofen can lead to abdominal pain and diarrhea.

If you have concerns about Ibuprofen, especially if you are currently taking other medications, we encourage you to consult your physician.

Can a Doctor Reduce My Discomfort?

If your cold sore discomfort has reached an unmanageable level, your primary care physician may prescribe treatments and numbing agents.[4]

Many times an anesthetic gel will be given to calm your pain in addition to oral medication. Issued as an antiviral, these methods of treatment will not only reduce your pain but also speed up the natural healing process.

The three primary antiviral pain reduction and healing treatments include:[5]

Although these medications are best when used within 48 hours of your initial symptoms, they will work at any stage.

If you are dealing with extreme pain, your physician will likely check for signs of infection. Although cold sores can be painful, they should never lead to intense pain. Depending on your fever blister stage, it is possible that your pain is being caused by infection by an external factor.

During a severe outbreak and extreme pain, a cortisone injection can be introduced. Unlike a gel or prescription medication, a cortisone injection aggressively tackles the problem head-on. This is what sets it apart from more generic types of treatment.

Regarded as a steroid shot, cortisone injected directly can reduce the lifespan of the sore and drastically reduce pain. Results can be seen and felt in as little as 24 hours.

While the injection itself can be quite painful, it is often worth the trouble in some cases. It is important to remember that corticosteroids cannot be used without antiviral medication, because they will weaken the immunity system and cause even more problems.[6]

Can Painful Cold Sores Be Prevented?

Although there is no foolproof way to keep cold sores away there are steps you can take that may reduce the number of outbreaks that you experience each year. Your primary focus should always be to keep your immune health at peak efficiency.

The stronger your body is, the more likely you’ll be able to fight off the herpes simplex virus. The only thing keeping HSV-1 in a dormant state is a robust immune system. While specific work and lifestyle factors can trigger the herpes virus, many of those triggers depend on immune weakness. If you take care of your body (less stress, more sleep, etc.), it will be better placed to keep you cold sore free.

If you are searching for ways to avoid a painful cold sore outbreak, we encourage you to lean on a product that’s medically proven to work. The FDA approved Virulite Electronic Cold Sore Machine, using invisible light technology, will minimize the period of recovery when used during the prodromal stage. It is possible to reduce your entire outbreak to a mere 72 hours with Virulite. That means that less pain will be experienced by you.


  1. Everett RD.2014. HSV-1 biology and life cycle. Methods in Molecular Biology, 1144: 1-17.
  2. Ablon G. Phototherapy with Light Emitting Diodes: Treating a Broad Range of Medical and Aesthetic Conditions in Dermatology. The Journal of Clinical and Aesthetic Dermatology. 2018;11(2):21-27.
  3. Khan AW, Kotta S, Ansari SH, Sharma RK, Kumar A, Ali J. Formulation development, optimization and evaluation of aloe vera gel for wound healing. Pharmacognosy Magazine. 2013;9(Suppl 1):S6-S10. doi:10.4103/0973-1296.117849.
  4. Vadlapudi AD, Vadlapatla RK, Mitra AK. Update On Emerging Antivirals For The Management Of Herpes Simplex Virus Infections: A Patenting Perspective. Recent patents on anti-infective drug discovery. 2013;8(1):55-67.
  5. Cunningham A, Griffiths P, Leone P, et al. Current management and recommendations for access to antiviral therapy of herpes labialis. Journal of clinical virology : the official publication of the Pan American Society for Clinical Virology. 2012;53(1):6-11. doi:10.1016/j.jcv.2011.08.003.
  6. Arain N, Paravastu SC, Arain MA. Effectiveness of topical corticosteroids in addition to antiviral therapy in the management of recurrent herpes labialis: a systematic review and meta-analysis. BMC Infectious Diseases. 2015;15:82. doi:10.1186/s12879-015-0824-0.