Most books and guides talk about the five cold sore stages. But in reality there are six stages. The sixth stage is actually the first one and is the one that never causes any pain. In fact there are no symptoms at all. This hidden cold sore stage is the latent stage. At this stage the herpes virus is dormant and hiding in the nerve ganglia. About 33% of all those who are infected with the virus remain at this cold sore stage and never even know that they carry the infection in their bodies. Since it stays dormant and never shows itself, the only way to know if a person is in the latent cold sore stage is by a blood test. And since the virus remains dormant, no action or medication is required during this often permanent cold sore stage.
The first of the palpable cold sore stages is called Prodome. In this beginning stage of a cold sore the dormant virus wakes up and moves to the surface of your face through the nerve endings. The first sensations of the virus becoming active are a tingling or burning sensation, often with dryness and itching. This stage usually lasts for up to 2 days before the next stage begins.
The second cold sore stage is that of inflammation or the pre-sore. This occurs when the virus enters the nerve cells, causing irritation and redness. The first small pimple like blisters appear on the skin, usually in small groups and are very painful to touch. Headaches and fevers often also set in at this stage.
The third cold sore stage is when the small pimples burst open and merge into one large open sore or ulcer. This is the most painful of all cold sore stages and can often keep the patient confined to bed until the symptoms subside. This is also the most infectious of the stages as the discharge from the sores is full of viruses and can infect any other part of your body it touches or anyone else who comes into contact with it.
The semi final cold sore stage is that of the scab formation. This is also a painful stage and the pain gets worse as you move and the scab cracks. This is still a very infectious stage with the pus still seeping from the sore. The scab may form and fall off 3 or 4 times during this stage. The formation of new skin under the scab only adds to the itchiness and discomfort that is felt.
The last of the cold sore stages is the post scab stage when the scab falls off and the new skin is visible. The recovery is not complete as not only will the new skin need to strengthen, below the surface millions of damaged and destroyed cells have to be replaced. Happily the patient will not feel this and even the tenderness of the new skin should be gone in about 2 weeks.