A Complete Medical Guide to Cold Sores on the Nose (with Pictures)

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How do you prevent nasal cold sores from spreading and coming back?

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• Treating Cold Sores in Your Nose
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• Preventing Cold Sores from Recurring
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• Video
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• Tips
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• Warnings

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Cold sores, which are sometimes called fever blisters, are a viral infection experienced by many people. They are caused by the herpes simplex virus (HSV-1) and are contagious even if you can’t see them. Although cold sores usually present on the mouth or other areas of the face, in some rare cases they may appear inside your nose. There is no cure for the virus that causes cold sores, but you can treat lesions in your nose and manage the virus by taking medications and preventing outbreaks.

Things You Should Know

• Give the cold sore 1-2 weeks to heal on its own or treat it directly with prescription antivirals like acyclovir, famciclovir, and valacyclovir.
• Treat the cold sore with a medicated topical cream (like penciclovir or docosanol) to ease your symptoms and shorten the length of the outbreak.
• Apply medicated ointment to help ease any irritation, and take OTC painkillers to help manage any pain.
• Wash your hands frequently to prevent passing the cold sore virus to other people (or spreading it on your own skin).

Steps

Part 1

Part 1 of 2:

Treating Cold Sores in Your Nose

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1. 
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   Look around your nose to see if you have cold sores. Because it is difficult to see inside of your nose, you may need to figure out if you have cold sore instead of another condition such as an ingrown hair or pimple. Checking the areas in and around your nose can help you figure out if you have cold sores in your nose.

   • Use a mirror to check the visible surfaces of your nasal cavity. You may not be able to see much, but even detecting a cold sore can help.
   • Recognize symptoms of cold sores in your nose including tingling and itching, burning, feeling painful bumps, and oozing from small blisters.
   • You may also have a fever or headache if you have cold sores.
   • See if there is an inflamed area either on the inside or outside of your nose that might indicate cold sores.
   • Avoid sticking your fingers or other objects deep inside your nose. Things like cotton swabs can lodge themselves in your nose, which may cause severe harm.
   • See your doctor or leave the sore alone if you can’t locate the source of the pain.
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   Allow the sore to heal on its own. If the cold sores in your nose aren’t too severe, allow them to heal without treatment. In many cases, the sores may heal within 1-2 weeks without treatment.

   • Use this treatment option only if you feel well and may not come into contact with anyone. Remember that even a cold sore in your nose is contagious to others.
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   Place a cool, damp rag over the sore throughout the day. If the sore is at the base of your nose, set a cool towel on top of it for up to 10 minutes during the day. This can help the sore feel a little less irritated and look a little less red.
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   Take prescription antiviral medications. Ask your doctor for prescription antiviral medication and take it. This can help treat outbreaks sooner, lessen the severity of recurrences, and minimize the chance of transmitting the virus.

   • Common medications for cold sores are Acyclovir (Zovirax), Famciclovir (Famvir), and Valacyclovir (Valtrex).
   • Follow dosing instructions given by your doctor for maximum efficacy.
   • Your doctor may advise an antiviral infection if your outbreak is severe.
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   Apply a medicated topical cream. Because the sores are in your nose, this may not be the easiest treatment to apply. Consider using topical creams (like Orajel) if you want to shorten the time of your outbreak, relieve discomfort, or minimize the risk of infecting someone else. Ask your doctor about the best way to apply some of the following creams:

   • Penciclovir (Denavir)
   • Acyclovir cream (the antiviral treatment in topical form — may be more effective than other topical treatments)
   • Docosanol 10% (Abreva), which you can purchase over the counter.
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   Reduce itching and irritation with numbing ointment. You may experience itching and irritation with your cold sores. Scratching can make them worse and potentially cause an infection, so to reduce the itchiness, consider applying a gel or cream with lidocaine or benzocaine. Apply these remedies with a clean finger or cotton swab only if the cold sores are not deep inside your nasal cavity.

   • Buy these treatments at most pharmacies and some grocery stores or large retailers. You could also order them online. Be aware, though, that these remedies may only offer minimal or short-term relief.
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   Relieve the pain of cold sores with painkillers and cool compresses. Blisters or cold sores associated with the herpes simplex virus can be painful. In addition to topical ointments, there are several ways to minimize the pain and discomfort.

   • Take an over the counter pain reliever such as acetaminophen or ibuprofen to minimize pain.
   • Apply ice or a cool washcloth to the outside of your nose may also help.
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   Consider alternative therapies. Studies have produced mixed results for treating cold sores with alternative therapies. Consider using these treatments if you want to avoid chemicals or in conjunction with medical treatment, but speak with your doctor first. Some alternative therapies that may work are:

   • Lysine supplements or creams
   • Propolis, an ointment also known as synthetic beeswax
   • Stress reduction through breathing exercises and meditation.
   • A sage or rhubarb cream, or a combined sage-rhubarb cream.
   • Lip balm containing lemon extract for lesions not too deep in your nose.
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Part 2

Part 2 of 2:

Preventing Cold Sores from Recurring

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1. 
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   Limit or avoid skin-to-skin contact with someone who has cold sores. The liquid that oozes from cold sores contains the virus and can infect others. Limiting or avoiding skin-to-skin contact can prevent cold sores from transmitting or making yours worse.

   • Abstain from oral sex and kissing, even if the blisters are only in your nose.
   • Keep your fingers and hands away from your eyes.
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   Wash your hands with soap and water often. Any time you have a cold sore, even if it is in your nose, wash your hands before touching yourself or someone else. Washing with soap and water is an effective way to reduce any virus present on your hands, which will help keep it from spreading on your own skin or to other people.

   • Wash with any type of soap, which can kill bacteria.
   • Lather the soap on your hands for at least 20 seconds.
   • Dry your hands completely with a clean or disposable towel.
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   Avoid using other people’s items. Whenever you have blisters present, avoid sharing items with other people. This can minimize the risk of spreading the virus to others and to other areas of your skin.

   • Keep a separate set of utensils, towels, and other linens when you have an outbreak.
   • Avoid using lip balms and personal items from other people.
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   Manage stress, illness, and fatigue. Stress, illness, fatigue may make you more prone to having an outbreak of cold sores. Manage stressful situations as much as you are able and make sure you are getting enough rest, especially when you are sick.

   • Organize your day with a flexible schedule that incorporates time to relax can reduce your stress.
   • Avoid stressful situations if possible.
   • Take deep breaths or try breathing exercises to help you relax.
   • Get regular exercise, which can also help reduce stress.
   • Aim for seven to nine hours of sleep per night.
   • Don't push yourself if you feel like you're getting sick. Make sure you get adequate rest and take time off work or school if you need to.
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   Watch for outbreak symptoms. If you begin seeing the symptoms of an outbreak, treat them promptly. This can reduce the amount of time your outbreak lasts and reduce its severity. If you begin to experience the telltale tingling or itching sensation that is often present before an outbreak, you may wish to begin treatment immediately.

   • Call your doctor and ask for a prescription to minimize and treat your outbreak.
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Tips

• If you have an outbreak of cold sores on your nose, try your best not to touch your face so you don’t spread it to your eyes or mouth.
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• Wash your hands with soap and water frequently to prevent the spread of the virus that causes your cold sores.
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Warnings

• If you have cold sores and a high fever or severe headache, see your doctor to make sure there aren’t any underlying medical issues.
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