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Acold soreis a type ofherpesinfectioncaused by theherpes simplex virusthat affects primarily thelip.Symptoms typically include a burning pain followed by smallblistersorsores.The first attack may also be accompanied by fever, sore throat, andenlarged lymph nodes.The rash usually heals within ten days, but the virus remainsdormantin thetrigeminal ganglion.The virus may periodically reactivate to create another outbreak of sores in the mouth or lip. The cause is usually herpes simplex virus type 1 (HSV-1) and occasionally herpes simplex virus type 2 (HSV-2).The infection is typically spread between people by direct non-sexual contact.Attacks can be triggered bysunlight,fever,psychological stress, or amenstrual period.Direct contact with thegenitalscan result ingenital herpes.Diagnosis is usually based on symptoms but can be confirmed with specific testing. Prevention includes avoiding kissing or using the personal items of a person who is infected.Azinc oxide,anesthetic, orantiviral creamappears to decrease the duration of symptoms by a small amount.Antiviral medications may also decrease the frequency of outbreaks. About 2.5 per 1000 people are affected with outbreaks in any given year.After one episode about 33% of people develop subsequent episodes.Onset often occurs in those less than 20 years old and 80% developantibodiesfor the virus by this age.In those with recurrent outbreaks, these typically happen less than three times a year.The frequency of outbreaks generally decreases over time.