What is Cold Sore?
Cold sores, also called fever blisters, are a highly contagious viral infection that spreads through contact. Although it is highly contagious, having the viral infection doesn’t mean it will affect daily life. As discovered in a study done by the World Health Organization, about 67% of the global population under the age of 50 has HSV-1, or herpes simplex virus - 1, the cold sore virus that causes oral herpes. Despite it being so present in our society, most people never exhibit symptoms of herpes simplex simply because their body can control the virus. They are not to be confused with canker sores which happen inside the mouth due to stress, hormones, biting yourself, or allergies. A dermatologist can visually identify cold sores as a result of HSV from the symptoms. There are two types of HSV: herpes simplex virus type 1 (HSV-1) and sometimes the herpes simplex virus type 2 (HSV-2). Further testing on the patient’s blood or the cold sore fluid may be done on patients with a weakened immune system.
Herpes infections are generally asymptomatic. In the event of a weakened immune system or exposure to a trigger, one could see the signs and symptoms of HSV if infected. Itching, tingling, or burning can be experienced before the appearance of blisters and sores around the mouth or genitals that ooze fluid and crust over. These will disappear on their own after 1 -2 weeks and won’t leave a scar, but will recur periodically throughout one’s lifetime. The frequency of which that happens varies from person to person.
HSV-1 is also called oral herpes. The cold sores are small blisters around the mouth, but in rare cases they can also happen at the genital area as one or more anal or genital blisters or sores.
HSV-2 is also called genital herpes. The cold sores are small blisters around the genital area. Before the appearance of blisters and sores, new infections could cause fevers, body aches, and swollen lymph nodes. Over time, symptoms will become less frequent and less severe.
Cold sores are caused by HSV-1 and, less frequently, herpes simplex virus type 2.The HSV-1 virus spreads by coming into close contact with people or things that have the virus. You can get it from kissing, sharing food or utensils, or even from sharing something like a razor. The HSV-2 virus spreads via sexual contact with genitals, sores, or fluids. In rare cases, it can even be transmitted to a newborn baby from the mother during childbirth. The location and severity of the cold sores and blisters differ between the 2 types, but oral sex can cause HSV-1 to spread to genitals and HSV-2 to spread to the mouth. Once infected, the virus stays in nerve cells until the immune system is too weak to stop it from multiplying or until triggers exasperate it. The following triggers could cause a recurrence of symptoms:
• Stress and fatigue
• Illnesses like fevers and respiratory infections
• Environmental factors like sunlight, wind, and cold temperatures
• Hormonal changes during menstruation
• Immune system changes
• Diet: Too much amino acid arginine rich foods, not enough vitamin C and E, not enough amino acid L - lysine
• Reinfection with HSV
While home remedies have taken on popularity, there are little to no studies confirming the effectiveness of such treatments. In some cases, it might even do more harm than good considering their minimal effectiveness versus the unknown side effects they could have on your body. It’s best to follow the medical advice of a dermatologist because they know what will or will not treat the disease. Here are some popular home remedies that you should be careful with:
• Pain relievers or Ice
• Aloe vera gel
• 1% Lemon Lip Balm
• Increasing Vitamin C and Vitamin E intake
Over the Counter Medication
While some over the counter (OTC) medications are effective enough to be given as prescriptions, other OTC medications have limited effects on disease. They might help for mild to moderate cases, but they aren’t usually effective on severe ones. If used incorrectly and without guidance, they might even prove to be ineffective and produce unforeseen side effects. However, a dermatologist can tell you whether or not these can be effective for you. Here are some OTC medications that may or may not be included in a treatment plan given by one of our dermatologists:
Docosanol Cream – Docosanol has antiviral properties that is effective for mild to moderate cases, but much weaker than prescription medications.
Analgesic Lip Balms – Moisturizes, can protect against sun, and it can numb pain to make symptoms tolerable.
Prescriptions, alongside professional medical advice, are the most effective form of treatment. Home remedies and over the counter treatments take plenty of time, energy, and money, yet are uncertain to work. Our experienced dermatologists take your unique skin, set of symptoms, and medical history into account to take the guessing game out of your road to recovery. Here are some prescriptions your dermatologist might include in your personalized treatment plan:
Acyclovir – Treats cold sores and genital herpes.
Valacyclovir – Similar to acyclovir, but requires a much lower dose to produce the same effect.
Famciclovir – Usually prescribed to treat other herpes viruses other than HSV-1 and HSV-2.
Penciclovir – Known to shorten cold sore symptoms.
Post Treatment Prevention
After being seen by our dermatologists, you’ve been equipped with the prescriptions to treat your discomfort. However, disease can be persistent, so you have to be too. A skin care routine and a set of disease-preventing habits recommended by our dermatologists are essential for long term prevention. Here are some popular prevention strategies that could supplement your personalized treatment plan:
To avoid transmission of the virus, you can…
• Don’t touch a cold sore or blister
• Avoid sharing things like food, utensils, razors, lip balm, and towels
• Wash your hands often
To avoid recurring symptoms, you can…
• De-stress and rest more to improve your immune system’s fight against infection
• Avoid overexposure to sunlight, wind, and cold temperatures to reduce triggers
• Don’t touch the cold sores as it could spread to other parts of your body
• Increase Vitamin C, Vitamin E, L – lysine intake in diet or in supplements
• Decrease L - arginine intake
• Replace virus infected toothbrush
• Wash your hands often