How can the cold sore diagnosis be confirmed ?

The diagnosis is usually made by the history from the patient combined with the examination of the skin. At times it is difficult to be certain of the diagnosis.

Lab tests can be used to confirm the diagnosis if necessary.
Viral culture is the classical way of making or confirming the diagnosis but this may take 3-7 days, at which point your outbreak is over. Culturing or growing the virus is not easy and sometimes the tests will be negative even when virus is present. Generally a positive result means you have HSV-1.

Newer tests examine the virus under a microscope and give fast reliable results often within an hour of the sample reaching the lab. Cell scrapings from the blister will provide enough of a sample in which the virus can be detected. This test also is able to distinguish between herpes type 1 and 2

The use of serology which measures the antibodies to the herpes virus present in the blood is a way of knowing if the infection is new or a recurrence of the virus.

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