What is the difference between cold sores and mouth ulcers?

January 24, 2021

What is the difference between cold sores and mouth ulcers?
Cold sores are caused by Herpes Simplex Virus (HSV). Cold sores are filled with fluids which develop as blisters
Mouth ulcers are also known as canker sores. They are not contagious and appear on the oral mucosa within the mouth - the inside of the lips or cheeks
Cold sore is a viral infection which appears as a cluster of small blisters around the mouth and the chin. Cold sores are always extraoral - not on the inside of the cheeks and lips

Cold sores and mouth ulcers represent some of the most discomforting sensations that you can get in the orofacial region. These can be extremely painful and take at least a week to completely heal. The presentation of these two types of oral lesions may be similar, but there are stark differences seen between the reason behind the lesions, the area of their occurrence, treatment plan, etc.


Cold sores are usually seen in the area surrounding the lips. They are often seen at the junction of the lips and the facial skin, and might also occur inside the mouth. Cold sores are a result of viral infections, specifically the Herpes Simplex Virus (HSV). A person who contracts this virus can suffer from headaches, nausea, body aches, sore throat and itching or burning sensation in the area around the lips. Cold sores are filled with fluids which develop as blisters. When the sores break open, it results in a crusted appearance of the blister. The fluid released from the cold sores is contagious.


A person suffering from cold sores can aggravate his or her condition by acts of kissing, sharing routine equipment, being frequently exposed to sunlight, irritation near the cold sore area while visiting a dentist or cosmetologist and hormonal changes. The diagnosis of cold sores can be confirmed by taking a sample of the same and getting it tested for HSV. Cold sores are treated by application of benzocaine and lidocaine creams or gels which ease the sensation of pain. The spread of the cold sores can be restricted by docasanol containing creams. Additionally, antiviral drugs like acyclovir and valacyclovir can be prescribed to counter HSV.


Home remedies for cold sores include application of lip balms, ice, aloe vera and sunscreen. Analgesics like ibuprofen or acetaminophen can help in relieving the pain caused due to cold sores.


Mouth ulcers are also known as canker sores or aphthous ulcers. These ulcers are formed only inside the mouth. They can occur on the gums, inner linings of the cheeks and lips, floor of the mouth, palate, etc. There are various ways in which mouth ulcers appear in the oral cavity. They can circular or ovoid, big or small, white or yellow and in some cases reddish pinpoint structures. Mouth ulcers can occur because of multiple reasons. Some of them are vitamin deficiency,  consumption of spicy foods, traumatic injury, toothpastes or mouthwashes that are irritant to the mouth, mental stress, wearing of braces, tobacco consumption, hormonal changes and diseases that target the immune system. These ulcers are not contagious.


Frequent occurrence of canker sores can make the doctor ponder about nutritional deficiencies, allergies or underlying medical conditions for which certain tests may be required. Mouth ulcers often resolve by themselves, but painful ones can be healed with a quicker rate by the application of certain creams that contain benzocaine or hydrogen peroxide. Mouthwashes containing dexomethasone can also be helpful. Larger canker sores can be surgically excised if needed. If the cause behind the canker sores is a nutritional deficiency or allergy, then the doctor will give you an advise on your dietary intake.


There are various in-home remedies for mouth ulcers. To begin with, rinsing the mouth with salt water or baking soda can help in neutralizing the acid level inside the mouth. Alum powder and milk of magnesia can be directly applied over the mouth ulcer to decrease pain and irritation. Coconut oil, curd and honey can also be consumed in order to reduce the amount of acid produced in the stomach. The high acidic level due to gastric juices can be one of the reasons for frequent occurrence of mouth ulcers. Herbal extracts of chamomile and echinacea are said to reduce the occurrence of mouth ulcers. However, these extracts need to be applied multiple times in a day. Finally, Vitamin B complex supplements and lozenges containing zinc can help in the treatment of mouth ulcers.


Cold sores and mouth ulcers should not be ignored if they occur too frequently. The underlying reason can be a potential threat if the cause is contagious in nature. Moreover, these lesions should be resolved the moment they first appear in the mouth. It is wise to consult a dentist or physician in order to heal your sore condition as soon as possible.



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