Winter Storm Watch

Why are cold sores more likely to manifest in the winter?

By Jennifer Fabiano, AccuWeather staff writer

Due to trigger factors related to colder weather, cold sores are more likely to manifest in the winter, according to Dr. Erick Eiting, the director of emergency medicine for Mount Sinai Downtown.

“It’s something that I don’t often think about, but it’s true it definitely happens more around this season,” Eiting said.

Cold sores are fluid-filled blisters that appear on or around the lips that are caused by a herpes simplex virus (HSV-1). The virus is highly contagious and is spread easily from person to person through contact.

The cold sores will heal without scarring in two to four weeks, but those infected will remain infected and can be contagious even without the occurrence of a cold sore.

As there is no cure for the HSV infection, cold sores often return under certain conditions. While the main concern is a compromised immune system, winter weather conditions also contribute to the flux in cold sore appearance. Below are five conditions that are more common in the winter that often result in the recurrence of cold sores and how to reduce that risk.

Cold air cover mouth

A woman shields her face as she departs from Union Station with wind chills nearing minus 30 Fahrenheit on Tuesday, Jan. 7, 2014, in downtown Chicago. (AP Photo/Andrew A. Nelles)

Exposure to dry, cold air

Not only does dry air strip moisture from your skin, but exposure to dry, cold air is one of the main cold sore triggers.

Dehydration during the winter is also another stressor that most people don’t think about. Dry air in the winter makes dehydration an even larger risk to those exposed. An important part of fighting cold sore outbreaks is drinking plenty of water and staying hydrated, according to Eiting.

Eiting also stresses that using appropriate hydrating lip balms and facial moisturizers is also important in preventing cold sore outbreaks.

“The air in winter is colder and drier, and that’s why we get chapped lips and drier skin,” Eiting said. “All of those just make it easier for stress responses to get triggered.”

Exposure to wind

Skin is more frequently exposed to dry wind in the winter season.

“Wind dries out the lips which makes them more hospitable to the virus,” Eiting said.

Eiting recommends staying out of harsh wind when possible. When exposed to wind and cold air, scarves or other winter accessories should be used to cover the mouth area.

“Just being out and exposed to the elements can trigger a cold sore,” Eiting said.

Increased exposure to infection

The spread of infection is more common during the winter season, and so the immune system is active in trying to fight off illness, according to Eiting. As a result, the immune system is less focused on preventing cold sores.

“People who have a weaker immune system have a harder time fighting off these reactivation responses,” Eiting said.

Eiting recommends taking a daily multi-vitamin to ensure that you are receiving adequate levels of vitamins that you may be getting less of in the winter, including vitamins C and D,

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Cold sores become reactivated at times when our body is experiencing stress, including emotional stress, according to Eiting.

Cortisol, the primary stress hormone, alters immune system responses, according to Mayo Clinic. Thus, the stress of the holiday seasons or due to work or school during the winter can result in an increased risk of cold sores.

To reduce stress, Mayo Clinic recommends taking a break from work, increasing exercise and practicing relaxation techniques when you are feeling stressed.


Fatigue can be more common in the winter due to lack of exercise and a heavier, starchier diet. Mayo Clinic recommends staying away from starches like pasta and bread and opting for fresh vegetables that are in season where you live.

Not getting enough sleep can also compromise the immune system, making one more susceptible to a cold sore.

For more safety and preparedness tips, visit

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