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I remember waking up the morning of my first wedding, aged 26, and immediately knowing it was there. A warm throbbing sensation on the corner of my lip, a pulse of physical pressure, and that signature tingling that every cold sore sufferer fears. As the sun shone over the beautiful Italian hotel room I had slept in alone, I searched my mouth in an antique mirror for any visible traces.
As blurry as it was, I could see the inflammation growing around what was at the time a small blister. After all the planning, trying on the clothes, the lace umbrellas, the rustic, yet timeless floral arrangements, the thing I had no control over had reared its ugly head. It was my worst nightmare come true.
Now 42, I had my first outbreak of cold sores before I was two years old, brought on by my father who had suffered from them all his life. Worldwide, 3.8 billion people under the age of 50 – about 64 percent of the world’s population – are carriers of the herpes simplex virus type 1 (HSV-1), which causes cold sores.
After the initial infection, usually caused by an infected, but not necessarily symptomatic, adult kissing a child, the virus hibernates in a cluster of sensory nerve cells at the base of your brain. Once you are infected, you will never be able to cure or get rid of the virus. Unlike my first, short-lived marriage, my relationship with my cold sores is truly ’till death do us part.
For the unlucky like me, HSV-1 will – usually at the most uncomfortable and devastating time – reactivate and explode in sores somewhere on the lips or around the mouth.
Only about a third of people who carry the virus will ever develop these blister-like lesions, with about one in five experiencing recurrent outbreaks. To put it in context, this is about 12 percent of all people under the age of 50 worldwide. We’re not talking about a niche problem here.
Outbreaks of ulcers can be caused by stress, fatigue, illness, hormonal changes, or strong sunlight, which temporarily weakens your immune system.
Katherine last month during a bout of cold sores. She had her first outbreak of cold sores before she was two years old, after contracting the cold sore from her father, who had suffered from it all his life
From my experience over the past 40 years, HSV-1 usually hits you at the lowest point: when your friend leaves or when you get fired. Or when you need to look your best to feel confident or sexy – think about the biggest presentation of your life or a date with someone you’ve been fantasizing about kissing for ten years. An oozing cut begins to weep on your face, almost as if the virus knows it and is out to exact maximum misery.
To anyone new to cold sores, this may all sound like an exaggeration. It’s just a minor inconvenience, right? After all, they are usually no bigger than a fingernail. But that totally belies what cold sores feel like in your body.
First of all, they are – as the name suggests – very painful. As they progress from a tingling sensation to multiple small blisters that burst and reform, with a ginger-colored scab on top, often peeling away to reveal the angry, inflamed skin underneath, you’re always hyper-aware of them.
Second, it can be impossible to change them, and even when the worst is behind you, it can seem like the pain is coming back to life and coming back from the grave. My last outbreak was active for 12 days, but on day 14 I felt it starting to flare up again. Mayday!
Third, they actually make you feel unwell, with almost flu-like symptoms. As your immune system sends white blood cells to fight the virus, you often experience systemic fatigue, body aches, and fever. There’s also the very obvious vanity problem.
As a fashion content creator and author who often speaks in public or on camera, a crusty scab on my face is not the kind of accessory I’m looking for.
But the biggest element, the part that bizarrely still feels so taboo, is the way other people treat you. When I recently posted a photo of myself in active pain on Instagram to my 92,000 followers – something I had never done in my 13 years of working in social media – the outpouring of solidarity and stories was enormous.
I heard stories from women whose partners made them sleep in different rooms when there was an outbreak, from a friend who regularly had his HSV-1-carrying significant other undergo checkups before engaging in any form of sexual activity. There were stories of bullying at school: one girl was constantly asked why she had a cornflake on her face.
I heard from mothers of teenagers who didn’t want to leave the house with an active ulcer, from parents who were devastated that they had passed an ulcer to their young children even though they had taken precautions. In this age of oversharing you would never think that a condition that affects more than a fifth of the world’s population could be so stigmatized, but many said they found their cold sores humiliating and debilitating.
Personally, my sores have always made me feel sick and dirty.
The fact that some people believe oral cold sores are sexually transmitted is probably where a lot of the shame begins. Although genital herpes is spread through sexual contact, it is a separate virus variant: HSV-2. However, it is important to note that most people do not spread or contract any form of herpes because they are careless.
No matter where the outbreak occurs or what strain of virus you carry, no one deserves to be judged as some kind of degenerate simply because they caught a bug. Flu, Covid and the common cold are all viruses that almost everyone will encounter at some point in their lives.
Now that I’m older, I can rationalize that it’s probably something that doesn’t deserve the level of emotional energy I give it. To everyone who is in the same boat, I feel for you with such deep solidarity, but it is high time that we stop hiding like lepers.
Finding an effective treatment helps with that, of course – and while I will say it’s hard to dodge a bad attack, there are many options to try (see above).
While this may not be the classiest topic I’ve ever broached in print, and I still feel a lingering shame, the only way we can overcome this is by being honest. This virus is so widespread and most of us were infected before we turned five – no one deserves to be ashamed of something they have no control over. To all my HSV-1 sisters and brothers: It’s time to load up on your antivirals and give yourself some grace.
Cold sores are not your fault; you’re not disgusting. HSV-1, like mosquitoes, slow WiFi and never a £1 piece for the supermarket trolley, is just one of life’s kickers. Don’t let them stop you from smelling the roses.
