Can Telemedicine Treat Cold Sores (Herpes Labialis)?

Audience: pediatric

Cold sores, also called herpes labialis, are common small blisters that usually appear on or around the lips. They are caused by the herpes simplex virus and often come back in the same spot. In children, cold sores can be uncomfortable but usually heal on their own within 1 to 2 weeks. Telemedicine can help by allowing a healthcare provider to look at the sores through a video call, answer questions, and suggest ways to ease symptoms. They can also advise when medicine might be needed or if a visit to a clinic is important. However, telemedicine cannot perform physical tests or treat serious complications. Parents and caregivers should watch for warning signs like fever, spreading sores, or severe pain that need urgent care. This guide helps families understand what telemedicine can do for cold sores and when to seek in-person help.

Red flags — go in person / ER

• High fever above 38.5°C (101.3°F) lasting more than 2 days
• Sores spreading to the eyes or inside the mouth causing pain or vision changes
• Difficulty swallowing, breathing, or signs of dehydration such as very little urine output or extreme sleepiness

What telemedicine can do

• Visual assessment of cold sores via video
• Providing advice on symptom relief and home care
• Discussing when antiviral medications may be appropriate
• Answering questions about cold sore prevention and contagiousness

What telemedicine cannot do

• Performing laboratory tests or swabs
• Treating severe or spreading infections
• Managing dehydration or difficulty eating/drinking
• Providing emergency care for complications

What Are Cold Sores?

Cold sores are small, fluid-filled blisters that usually appear on the lips or around the mouth. They are caused by the herpes simplex virus (HSV-1). After the first infection, the virus stays in the body and can cause outbreaks later, often triggered by stress, illness, or sun exposure. In children, cold sores may cause pain, itching, or burning before the blisters appear.

How Telemedicine Can Help

Through a video or phone visit, a healthcare provider can look at the child's cold sores and ask about symptoms. They can offer advice on how to care for the sores at home, such as keeping the area clean, avoiding touching the blisters, and using over-the-counter creams or pain relief. Providers can also discuss when antiviral medicines might be helpful, especially if the sores are severe or frequent.

When Telemedicine Is Not Enough

Telemedicine cannot perform physical tests like swabs or blood tests to confirm the infection. It also cannot treat serious problems such as widespread infection, dehydration, or severe pain that prevents eating or drinking. In these cases, an in-person visit to a healthcare facility is important for proper care.

Preventing Spread and Care Tips

Cold sores are contagious, especially when blisters are present. To reduce spread, avoid sharing utensils, towels, or lip products. Encourage children to wash hands often and avoid touching their face. Applying sunscreen on the lips during sun exposure may help prevent outbreaks.

When to Seek Urgent Care

If your child has a high fever, difficulty swallowing or breathing, sores spreading to the eyes, or signs of dehydration (such as not urinating or being very sleepy), seek emergency care immediately. These signs mean the infection may be more serious and needs prompt treatment.

How to prepare for your tele-visit

• Ensure a stable internet connection for video call
• Have good lighting to clearly show the affected area
• Prepare a list of symptoms and questions
• Have a thermometer to check for fever if possible
• Avoid applying creams or ointments before the visit to allow clear viewing

After your tele-visit

• Follow the healthcare provider’s advice on home care and medications
• Keep the affected area clean and avoid touching sores
• Monitor for any worsening symptoms or new warning signs
• Keep the child hydrated and rested
• Schedule an in-person visit if symptoms worsen or new red flags appear

FAQs

What causes cold sores in children?

Cold sores are caused by the herpes simplex virus type 1 (HSV-1). Children can get infected through close contact with someone who has an active cold sore, such as kissing or sharing utensils.

Are cold sores contagious?

Yes, cold sores are contagious, especially when blisters are present. The virus spreads through direct contact with the sores or the fluid inside them.

Can telemedicine prescribe medicine for cold sores?

A healthcare provider may suggest antiviral medicines during a telemedicine visit if the cold sores are severe or frequent. However, the ability to prescribe depends on local regulations and the provider’s assessment.

How long do cold sores usually last?

Cold sores typically heal within 7 to 14 days without leaving scars. Pain and itching usually improve as the sores dry up.

When should I take my child to see a doctor in person?

If your child has a high fever, spreading sores, difficulty swallowing or breathing, or signs of dehydration, seek in-person medical care promptly.

Sources

1. Cold Sores — MedlinePlus, U.S. National Library of Medicine.
2. Herpes Simplex Virus Infections — Centers for Disease Control and Prevention (CDC).
3. Cold Sores (Herpes Simplex) — Mayo Clinic.
4. Herpes Simplex Virus — National Library of Medicine, NIH.

This telemedicine guidance is for educational purposes only and is not a substitute for in-person medical care. If your child has severe symptoms or warning signs, seek immediate medical attention.