Treat Cold Sores: Start your online consultation

Cold sores, or herpes, occurs on the lipsin the form of small blisters or scabs. On the early stages a person feels itching and burning in the lips area. On the next day the blisters occur. The outbreak lasts for 7-10 days and then disapears. If you start treatment as soon as you feel itching, you can prevent the blisters appearence. 

<%- Widgets.catalog.prescriptionProducts %> <%- Widgets.catalog.freeProducts %>

What are cold sores?

Cold sores, also known as fever blisters are a chronic contagious disease caused by the Herpex Simplex Virus. There are two types, Herpex virus type 1(HSV-1) and type 2(HSV-2). HSV-1 is associated with orofacial disease (cold sores)and type 2 is more associated with genital disease. Even though each type of virus is associated to a certain area, it is important to know that sometimes HSV-1 can appear in the genital area and HSV-2 in areas surrounding the mouth.

This disease causes herpetic sores or red-like blisters that are filled with fluid that break open and spread the fluid it contains around the lips, mouth and in rare cases around the fingers, tongue or nose that surround the first blister or sore. It has no cure and depending on factors such as stress, and immunocompetence, the lesions may reappear through time. 

How common is it?

It is one of the most common contagious diseases in the world. It is estimated that in average 1.6 per 1000 people per year acquire this disease and approximately one-third of all the people that suffer from this condition will experience a relapse. This type of infection occurs in childhood, in people younger than 20 years of age.

How are cold sores transmitted?

The virus is contracted through personal contact with someone that has the virus through:

• Direct contact with saliva from a person who has the virus or the sore.
  • Kissing
  • Sharing drinks, toothbrushes or razors
• Through sexual transmission.
  • Cold sores through HSV-2 by having oral sex.

What triggers a new episode?

Having a recurrence of cold sores is very common. As stated before, one third of the patients that are infected with the virus will suffer another episode throughout their lifetime. There are different aspects that can trigger a new episode such as:

• Extreme weather
• Cold or flu
• Weakened immune system
• Menstruation
• Direct sunlight exposure
• Stress
• Other sexually transmitted diseases
• Eczema
• Chemotherapy
• Recent dental work or surgery
• Fever
• Upper respiratory infection
• Fatigue
• Food allergies

What are the signs and symptoms of a first episode of herpes simplex?

The signs and symptoms depend if they are a first episode or a recurrent episode. Since first episodes usually occur during childhood, it is common for children under 20 to not present any symptoms. Usually a flu or cold like symptoms and fever may be present. Following a few weeks, the blisters and sores may appear, lasting approximately two to three weeks. 

What are the symptoms of a recurrent episode?

The person will experience sores and blisters around the mouth or, nose, tongue or lips. The symptoms of a recurrent episode are divided into different stages.

Tingling stage: This is the first stage of the episode. You will experience a tingling and itching sensation around the place that the blisters and sores will appear. Pain around the area may also be present. It usually happens 24-48 hours before the second stage begins.

Blistering stage: The second stage occurs when the blisters appear. They are red-like fluid-filled little bumps on the surface of the skin. The fluid contains the virus, and this is the second most contagious stage. If the fluid oozes unto other areas, the virus will spread, producing more and more blisters.

Sore stage: The third stage is also known as the oozing or weeping stage. At this moments, the blisters burst the fluid onto the surface of the skin producing red and shallow sores. This is considered the most contagious stage, since the fluid contains the virus. At this point, because of the itching, people usually spread the disease through other parts of their body, close areas to the first sore or even to fingers and hands.

Crusting stage: A yellowish dry crust will appear where the sore was. At this point a secondary skin infection may appear if the person hasn’t taken the necessary precautions. It is important to not scratch the sore so that it doesn’t contaminate.

Healing stage: In the fifth stage, the crusts begin to heal and scabs start to appear. After a few days, the dry sores will flake itself away without leaving a scar. It usually takes around 2 to 2 weeks for the disease to disappear.

How can cold sores be prevented?

90 percent of the population test positive for this virus, being extremely contagious it is very difficult to prevent a first infection. What you should do is:

• Avoid skin to skin contact with other people known to suffer from cold sores
• Avoid sharing items such as lip balms, drinks, or other hygiene products
• Always wash your hands before and after touching your face if you already have the disease.
• Avoid triggers that cause recurrent episodes such as emotional or stressful situations.
• Influenza vaccines should be taken every year to avoid suffering from colds, that are known to trigger this disease.
• Avoid direct contact with sunlight exposure by using sunscreen creams
• Avoid participating in oral sex with someone who has cold sores.

How are cold sores diagnosed?

Usually doctors only need to look at the blisters and sores to recognize them. Doctors may take a sample of the blister to confirm the diagnosis to differentiate it from other diseases. Most people recognize the symptoms of cold sores before they appear so it is important to take the medications during this period to make the signs and symptoms disappear faster. 

How are cold sores treated?

They usually do not require treatment and disappear in two to four weeks. Treatment does help to make the symptoms fade faster. That is why it is important to begin treatment just as the first stage of cold sores appear.

What other treatments can you add to the antiviral treatment?

• Antiviral treatment will help the symptoms fade faster, but there are other home remedies you can use to hep ease the symptoms.
• Apply ice or wash clothes soaked in cold water in the area. Be sure to not apply the ice directly on your skin. Wash the clothes every time you use them to avoid spreading sores or blisters unto other areas.
• Use sunscreen lotions on a regular basis.
• Use lip balms that contain lemon extract.
• Use aloe vera gel around three times a day to help ease the burning sensation.
• Use petroleum jelly to help keep the area moisturized. This will help you avoid getting a secondary skin infection because of the itching.
• Over the counter medicines such as acetaminophen or ibuprofen will help you reduce the pain. Take one pill every 6 to 8 hours as needed.
• Rhubarb and sage cream lotion: apply it on the affected area to ease symptoms.
• Lysine: Recent studies have shown that taking this supplement can help you reduce the incidence of suffering recurrent episodes

When should you go to a doctor?

If you are pregnant it is important that you always go to a GP to treat your cold sores. GP will decide which is the most appropriate type of medicine you should take. If your symptoms last longer than the usual and are followed by infection symptoms such as fever, you should go to the doctor. A secondary infection is probably the cause of this and you will need other type of medications to combat the symptoms. If you have recurrent cold sores and they are associated with eye discomfort, be sure to make an appointment with a doctor.

Sources:

• https://emedicine.medscape.com/article/218580-overview
• https://reference.medscape.com/drug/famvir-famciclovir-342611#6
• https://www.healthline.com/health/herpes-labialis#prevention
• https://www.healthline.com/health/skin-disorders/cold-sore-stages#takeaway
• https://www.healthline.com/health/fever-blister-causes
• https://www.nhs.uk/conditions/cold-sores/#causes
• http://www.dermatologist.org.uk/cold-sores.html
• https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2602638/
• https://www.mayoclinic.org/diseases-conditions/cold-sore/diagnosis-treatment/drc-20371023