Oral Herpes (Cold Sore) Symptoms

A first outbreak, if it causes noticeable symptoms at all (many childhood infections don't), often starts with tingling or itching around the lips, followed by small blisters that break open, ooze, and crust over within a week or two — commonly called a cold sore or fever blister. Some first outbreaks are accompanied by more general symptoms like fever and swollen glands, which subsequent outbreaks typically don't include.

Once someone has HSV-1, the virus stays in the body permanently and can reactivate periodically, triggered by factors like stress, illness, sun exposure, or hormonal changes. Recurring outbreaks tend to be milder and shorter than the first, often limited to the tingling-and-blister cycle without the broader flu-like symptoms.