If you've ever had a sore on or near your mouth, you've likely thought to yourself: Is this a canker sore or a cold sore, and what's the difference? Here are three significant differences of a canker sore vs. cold sore to help you determine your next steps for treatment. Show
1. AppearanceThe first way to differentiate a canker sore vs. cold sore is by appearance. As the Mayo Clinic explains, canker sores — also called aphthous ulcers — appear inside the mouth. They develop in soft tissues, such as in the cheeks, gums, under the tongue or on the tongue. Canker sores look like small white or yellow circles surrounded by a red border and may cause discomfort when you eat or drink. Cold sores, on the other hand, usually appear on or around the lip, as the Mayo Clinic explains. A cold sore often looks like a cluster of blisters, and they can eventually burst, causing oozing and crusting. 2. CausesCanker sores and cold sores have different underlying causes. According to the American Dental Association, the exact cause of canker sores is unknown. Experts speculate that they may happen as a result of immune issues, mouth trauma, bacteria or viruses. Cold sores result directly from the herpes simplex virus (HSV-1), according to the Mayo Clinic. This virus is dormant until triggered, which is when you might experience a tingling or burning sensation in your mouth and the development of a sore. Several factors can trigger the recurrence of a cold sore:
3. TreatmentsBoth canker sores and cold sores usually heal on their own. Minor canker sores typically take a week or two to heal, according to the Mayo Clinic, while cold sores may take two to four weeks. Cold sores usually do not leave scars; however, major canker sores have the potential to cause scarring. If your symptoms last longer than you'd like, you can also discuss treatment options with a medical or dental professional. For canker sores, if they are unusually large, clustered or painful, your doctor or dentist may suggest mouthrinses, topical ointments or oral medication. Because cold sores are caused by HSV-1, the American Academy of Dermatology (AAD) suggests treating them with antiviral topical or oral medications. If you are experiencing discomfort, your doctor or dentist may also prescribe a pain-relief medication. In addition, the AAD strongly encourages the use of sunscreen during an outbreak, as sun exposure can affect the healing of the sore. Another important note: Unlike canker sores, cold sores are contagious, according to the Mayo Clinic. Therefore, to prevent spreading the virus, you should not share utensils or any other items that touch the mouth. The easiest way to tell the difference between a canker sore and a cold sore is by its location. If the sore is in your mouth, it's likely a canker sore. If it's outside the mouth, it's probably a cold sore. If you aren't sure — don't worry. See your doctor or dentist so that they can determine what it is and recommend the proper treatment. Key takeaways:
A mouth sore can make it hard to eat, drink, brush your teeth, and sometimes even talk. They can also be embarrassing, especially when they show up on the outside of your lips. But are they really a serious problem? Most mouth sores are either cold sores or canker sores. While these names might sound pretty similar, the distinction between them is important. Keep reading to learn the difference between cold sores and canker sores, and what to do if you think you have one. 1. Oral herpes causes cold sores but not canker soresUnderstanding the difference between canker sores and cold sores begins with knowing a bit about what causes them. The herpes simplex virus (oral herpes) causes cold soresThis might be alarming, after all, genital herpes is a well-known sexually transmitted disease (STD). But oral herpes is different from genital herpes, and having a cold sore doesn’t mean you have an STD. Cold sores and genital herpes are caused by different strains of the herpes simplex virus (HSV) — HSV-1 and HSV-2. Both HSV-1 or HSV-2 can cause genital herpes, but HSV-1 almost always causes cold sores around the mouth. And HSV-1 is common: Research suggests that over half of U.S. adults have been infected with it. Canker sores have many causesUnlike cold sores, canker sores have a long list of possible causes, including:
With so many different causes, it’s likely that everyone gets canker sores at some point — and most of the time we never know what causes them. A single canker sore, or a single group of canker sores, that comes and goes within 1 to 2 weeks usually isn’t a big deal. 2. Cold sores and canker sores look different and show up in different placesYou can often tell the difference between cold sores and canker sores based on what they look like and where they show up. A cold sore (oral herpes) is usually a large blister or crust on the lipA typical cold sore starts as a blister on the pink outside surface of your lip. Over a couple of days the blister grows larger, breaks, and turns into an open sore. Then it crusts over and heals. The whole process takes a couple of weeks. But there’s one important note: If you’ve never had HSV-1, you might have a different experience when you catch it for the first time. A new infection with HSV-1 can sometimes cause herpes gingivostomatitis. This is a condition that comes with a fever and dozens of painful sores inside the mouth, across the tongue, and on the gums. Canker sores can happen inside the mouth or noseCanker sores aren’t as predictable as cold sores. They can show up anywhere on your mucous membranes — that is, anywhere on the moist, pink skin inside your mouth or nose. Canker sores often start out as a single small ulcer, although this depends on the cause. Over a few hours or days they can grow larger and more painful, and more ulcers can appear nearby. 3. Cold sores and canker sores follow different patterns over timeAnother important piece in understanding mouth sores is when they occur. Cold sores tend to come back during times of stress.If you’re a person who gets cold sores, you’ll find they pop up during times of stress — and not just psychological stress. Anything that stresses your body, from illness to ultraviolet (UV) sunlight exposure, can trigger a cold sore. This happens because HSV never goes away completely. Instead, it hides deep inside your nerve cells, where it can stay for years without causing problems. It reemerges when you’re most vulnerable. Many canker sores are isolated, but they can return in a patternAnyone can get a one-off canker sore or even a group of canker sores that appears and then fades over time. This is the case for most people. But some people tend to get recurring canker sores, over and over again. This is typical with certain medical conditions, like:
In these cases, canker sores also tend to come on during times of stress. But unlike cold sores, recurring canker sores often come with other symptoms, like fevers, joint pain, or rashes. If you tend to get mouth sores over and over again, it’s worth talking to a healthcare provider. Sometimes blood work or other tests are needed to figure out what’s going on. 4. Cold sores (oral herpes) are contagious — canker sores are notWhen you have a mouth sore, the last thing you want to do is spread it to others — especially if it can cause problems. Cold sores are very contagious, and HSV can be dangerousHSV, the virus that causes cold sores, can spread between people very easily. It spreads fastest when you have an open sore — that is, after the blister has broken open and before a crust has formed over it. But it can spread any time you have symptoms. Although HSV is not usually dangerous for healthy adults, it can be a major problem for some people. In particular, HSV can cause life-threatening infections in:
Anyone with a cold sore should stay away from vulnerable individuals, including people who are pregnant and near to term. Canker sores can be painful, but usually they are not dangerousMost of the time canker sores aren’t contagious. Even when they are linked to an infection, they don’t tend to be a major source of germ spreading. That isn’t to say canker sores aren’t a big deal. They can be very painful. And sometimes they can be a sign that something else is going on, especially when they keep coming back. 5. The treatment for cold sores and canker sores is completely differentAlthough both types of mouth sores might call for pain control, the way you’ll want to handle them is quite different. You can treat cold sores with antiviral medication if you catch them quicklyPeople who get cold sores often know when they’re about to get one. That’s because they experience a tingling feeling on their lip right before the cold sore appears. That warning sign is helpful, because if you start treatment quickly, you can stop the cold sore in its tracks. In fact, if you start the medication really quickly, you might even be able to keep the cold sore from fully appearing. Docosanol (Abreva) is an over-the-counter (OTC) antiviral cream that can be helpful against HSV. It works best when you start it at the first hint of a cold sore. To be effective, you need to use it five times per day. Prescription oral antiviral medications are very effective against HSV. Again, they work best if you start treatment right away. You take these by mouth several times per day:
If you are someone who gets frequent cold sores, you’ll want to talk with your healthcare provider about having a prescription for an oral antiviral ready to go quickly in case your symptoms return. Another possible option is to take antivirals every day to prevent cold sores. There’s no specific treatment for canker sores — but there are things you can do to helpCanker sores are more difficult to treat than cold sores. Since the cause of canker sores is often a mystery, their treatment often has to do with fighting the pain until they go away on their own. OTC options for treating the pain of canker sores include:
Natural remedies for the pain of canker sores include:
In severe situations, prescription options, such as steroids, can also help with the pain of canker sores. The bottom lineBoth canker sores and cold sores are common, and they can be easy to confuse. But understanding the difference between them is important. The cause of cold sores is an oral herpes virus (HSV-1), and it can spread easily to others. But you can treat a cold sore with medication if you catch it quickly. On the other hand, canker sores are usually more of a nuisance and don’t have a specific treatment. GoodRx Health has strict sourcing policies and relies on primary sources such as medical organizations, governmental agencies, academic institutions, and peer-reviewed scientific journals. Learn more about how we ensure our content is accurate, thorough, and unbiased by reading our editorial guidelines. Was this page helpful?Subscribe and save.Get prescription saving tips and more from GoodRx Health. Enter your email to sign up. By signing up, I agree to GoodRx's Terms and Privacy Policy, and to receive marketing messages from GoodRx. Do canker sores mean you're getting sick?Several studies have found that people tend to have outbreaks of canker sores when they experience stress, which can take a toll on the immune system. “A lot of people get canker sores if they have had a cold, been sick or really stressed at work, haven't been eating properly or haven't been getting enough sleep,” Dr.
Do I have a canker sore or a cold?Ever notice how you have canker sores more often when you have a cold? That's because your immune system is weakened. The common cold, flu, and other viruses and infections lower your immunity, making you and your family more prone to canker sores.
|