Cold Sore vs. Canker Sore

Did you know there’s a difference between canker sores and cold sores? I sure didn’t! I’ve been using them interchangeably for years, but they really, truly are not the same thing.


Growing up, I always thought that I had the mouth herp. I’d get sores on my tongue, in my nose, and on the inside of my lip whenever I got sick. Both of my parents had them, so I figured they’d been passed along during childhood kisses or drink sharing, you know, like you do. I figured it was never a big deal.

My parents, New Englanders in diaspora in the Pacific Northwest, called them, “canker sores,” (or my mother, a Bostonian, “Kyang-kaw.”) whereas my friends, locals, called them, “cold sores.” Much like the great debate of rotary vs. roundabout, marshmallow fluff vs. fluffernutter, and soda vs. pop, I thought canker sore vs. cold sore was just a regional dialect thing.

It was researching for this exact article, that I found out I’d been the wrongest of wrong for all of my twenty-four years of existence. I don’t have the mouth herp! I have only ever had canker sores. It’s not every day you find out you don’t have an STD you thought you did.

What I thought was an idiosyncrasy of my parents’ dialects was actually two separate things. Knowing the difference may seem trivial, but it can be very important in regards to spreading that disease to your loved ones.

Cold Sores


Cold sores, also called fever blisters, are blisters caused by the HSV-1 virus. They are extremely contagious, and like other viruses, they tend to crop up at any sign of stress– illness, fatigue, stress at work or school, stress within relationships, or sometimes even due to infection by other STDs.

Cold sores usually come in groups or small, reddish blisters. They often scab over after a couple of days.

But cold sores often come with other symptoms: swollen lymph nodes, sore throats, and other general common cold-like symptoms. They can be triggered by a number of different things, so it pays to know your triggers. If you think you might be at risk, take preventative measures. Use medication as though there were a sore already there, and make sure you’re extra careful with washing your hands after touching the wound, kissing your loved ones, and sharing food and drink.

It’s important to note that HSV-1 can be contracted by anyone, regardless of who they have sex with or what type of sex they are having. In fact, the largest group of people who have HSV-1 has been found to be women who have sex with other women. About one fifth of adults in the United States have either HSV-1 or HSV-2.

With cold sores, you need to be extra, extra careful when it comes to oral sex, or swapping spit of any kind. Believe it or not, it CAN be transmitted from the mouth to the genitals –including your own–and it is, pretty frequently. You may have heard differently in your health class in school– I certainly did. However, recent discoveries have proven that to be false.

To prevent the getting HSV-1 on the genitals, make sure to wear oral protection while giving head– especially if you have a cold sore. Dental dams are the best for protection when giving/receiving cunnilingus and/or anilingus, and flavored condoms can prevent the spread while giving/receiving a blow job. Strapped for a flavored condom? A regular condom will work just as well, although it may not taste quite so sweet. Read directions by our friends over at Condom Depot onhow to use a dental dam, as well as how to use a condom.

herpes vaccine is currently in the works. And the current word is that it will stop people from contracting both HSV-1 and HSV-2 from their partners; however, it’s important to remember that this vaccination is for prevention, not for getting rid of cold sores if you already have them. Like most viruses, once you get HSV-1, it’s never going away.

Preventative care can, however, help you prevent outbreaks. Over the counter measures, like Abreva, are a good place to start. Seeing a doctor will also help you manage your outbreaks and keep up-to-date on new medications.

Canker Sores

Photo via Healthline.

Photo via Healthline.

Canker sores are actual sores, or lesions. While they aren’t contagious like cold sores, it can be hard to tell why they’re popping up. For many, they’re a sign that the body is in stress, just like cold sores. Sometimes, canker sores can be the result of habits instead of a sickness– such as eating a lot of spicy or acidic foods, chewing a lot of gum, and using a hard-bristled tooth brush. If you have one that’s giving you a lot of trouble, avoid these things to prevent further irritation.

Canker sores have yellow or white heads, much like a pimple. Popping them might provide temporary relief, but it puts them at a great risk for infection. They like to pop up on the mucous membranes. This includes inside of the nose– so if you’ve been super sick and you’ve got this terrible aching inside your nose, it could be a canker.

Luckily there are a ton of over the counter canker sore treatment available. Most of the time, they’ll clear up on their own just fine, but if you’re finding them to be crazy painful, you may want to consider using a product like Oragel. Gargling with salt and water or doing a peroxide rinse can also help keep the canker sore clean so that it goes away faster.

While you can’t spread canker sores to your partner, giving oral sex while having one can irritate your sore even further. Use protection, including dental dams or flavored condoms to keep your healing sores free from bacteria.

If you have a canker sore for a couple days and it isn’t improving, you should see a doctor. They will prescribe a topical ointment or antibacterial mouthwash to keep the wound from getting infected and prolonging your suffering.


It can be very difficult to tell which one you have. Both crop up whenever you’re not feeling too well (also cold sores are often the cause of that fever and discomfort, where canker sores are a symptom alongside a sickness). Both can be really irritating,

When in doubt, look for location. Cold sores are a skin-to-skin disease, which means they form on flesh outside of the mouth and nose. Canker sores are more commonly found on mucous membranes, including the tongue and the gums. Additionally, like you can see in the images above, cold sores come in clumps of multiple sores. You can get more than one canker sore at a time, but they are typically spaced apart from one another.

It’s entirely possible to have both, by the way, so don’t think each outbreak is exclusively one or the other. Remember, both tend to happen when the body is suffering some kind of stress, so there’s no saying that the stress of having a cold sore won’t lead to an outbreak of canker sores. Sounds delightful.

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