Cold sore
DEFINITION
Cold Sores (fever blisters) are small, fluid-filled blisters
that are caused by the herpes simplex virus type 1 (HSV-1). Cold
Sores are contagious and commonly occur on the lips and outer edges
of the mouth but can also appear on other parts of the face such as
around the nostrils or on the chin, cheek, forehead or
eyelids.
that are caused by the herpes simplex virus type 1 (HSV-1). Cold
Sores are contagious and commonly occur on the lips and outer edges
of the mouth but can also appear on other parts of the face such as
around the nostrils or on the chin, cheek, forehead or
eyelids.
DESCRIPTION
HSV-1 is a very common virus. It is thought that up to 90% of
adults have been exposed to the virus in their lifetime. Cold Sores
are recurrent and affect many people at least once a year. Cold
Sores are contagious at all stages. Studies suggest that they are
most contagious during the weeping stage when the blister
bursts.
adults have been exposed to the virus in their lifetime. Cold Sores
are recurrent and affect many people at least once a year. Cold
Sores are contagious at all stages. Studies suggest that they are
most contagious during the weeping stage when the blister
bursts.
The virus enters the body through mucous membranes including
the mouth (usually by kissing) and also through cuts and grazes to
the skin. The virus will then invade nerve cells close to the
initial infection site and lie dormant until reactivated by trigger
factors. Triggers include strong sunlight and UV (ultraviolet) rays
from the sun and tanning beds, illnesses such as colds and flu,
menstrual periods, emotional upset, fatigue and cold winds. Damage
to the skin around the mouth is another trigger for Cold Sores e.g
dry, cracked lips or following cosmetic surgery, chemical peels or
laser surgery.
the mouth (usually by kissing) and also through cuts and grazes to
the skin. The virus will then invade nerve cells close to the
initial infection site and lie dormant until reactivated by trigger
factors. Triggers include strong sunlight and UV (ultraviolet) rays
from the sun and tanning beds, illnesses such as colds and flu,
menstrual periods, emotional upset, fatigue and cold winds. Damage
to the skin around the mouth is another trigger for Cold Sores e.g
dry, cracked lips or following cosmetic surgery, chemical peels or
laser surgery.
HSV-1 and HSV-2 (genital herpes) are different strains of the
herpes simplex virus. The main way of contracting Cold Sores is by
kissing and close personal contact. This means that a person with
oral Cold Sores can pass on the virus through oral sex. Most people
infected by HSV-1 in the genital area have few, if any outbreaks
after the initial episode. And in rare cases, Cold Sores can also
be caused by HSV-2. This can happen as a result of having oral sex
with a man or woman who has genital herpes.
herpes simplex virus. The main way of contracting Cold Sores is by
kissing and close personal contact. This means that a person with
oral Cold Sores can pass on the virus through oral sex. Most people
infected by HSV-1 in the genital area have few, if any outbreaks
after the initial episode. And in rare cases, Cold Sores can also
be caused by HSV-2. This can happen as a result of having oral sex
with a man or woman who has genital herpes.
SIGNS AND SYMPTOMS
Some people with HSV-1 do not develop symptoms and for others,
Cold Sores can be painful. Signs and symptoms may not appear for up
to 20 days after exposure to the HSV-1 virus. Cold Sores will often
appear at the same site and go through the same cycle of a tingling
sensation, blister formation, weeping and crusting over. The first
3 stages each last for 1 to 2 days each followed by the final stage
of crusting which may last for up to 1 week. The entire healing
process usually takes from 7 to 10 days.
Cold Sores can be painful. Signs and symptoms may not appear for up
to 20 days after exposure to the HSV-1 virus. Cold Sores will often
appear at the same site and go through the same cycle of a tingling
sensation, blister formation, weeping and crusting over. The first
3 stages each last for 1 to 2 days each followed by the final stage
of crusting which may last for up to 1 week. The entire healing
process usually takes from 7 to 10 days.
TREATMENT OPTIONS
Your Doctor or Pharmacist should be consulted for the
diagnosis and treatment of Cold Sores. Some people with HSV-1 do
not develop symptoms and for others, Cold Sores can be painful.
Signs and symptoms may not appear for up to 20 days after exposure
to the HSV-1 virus. Cold Sores will often appear at the same site
and go through the same cycle of a tingling sensation, blister
formation, weeping and crusting over. The first 3 stages each last
for 1 to 2 days each followed by the final stage of crusting which
may last for up to 1 week. The entire healing process usually takes
from 7 to 10 days. There are Cold Sore creams available which can
be used at the first sign of symptoms or if the Cold Sore has
already developed. Ask your Doctor or Pharmacist for advice.
diagnosis and treatment of Cold Sores. Some people with HSV-1 do
not develop symptoms and for others, Cold Sores can be painful.
Signs and symptoms may not appear for up to 20 days after exposure
to the HSV-1 virus. Cold Sores will often appear at the same site
and go through the same cycle of a tingling sensation, blister
formation, weeping and crusting over. The first 3 stages each last
for 1 to 2 days each followed by the final stage of crusting which
may last for up to 1 week. The entire healing process usually takes
from 7 to 10 days. There are Cold Sore creams available which can
be used at the first sign of symptoms or if the Cold Sore has
already developed. Ask your Doctor or Pharmacist for advice.
DIET HINTS
Increase foods containing lysine e.g fish (especially halibut,
mullet and mackerel), prawns, lamb, milk, poultry, lima beans,
yeast and mung beans.
mullet and mackerel), prawns, lamb, milk, poultry, lima beans,
yeast and mung beans.
Decrease foods that contain arginine e.g peanuts, cashews,
pecans, almonds, seeds, peas, lentils, chocolate, cereals (oats,
corn, buckwheat and barley) and coconut.
pecans, almonds, seeds, peas, lentils, chocolate, cereals (oats,
corn, buckwheat and barley) and coconut.
Avoid sugary foods and saturated fats as these can deplete the
immune system.
immune system.
Include fresh fruits and vegetables, cold-pressed flaxseed oil
and foods rich in zinc (pumpkin seeds, oysters and sunflower
seeds).
and foods rich in zinc (pumpkin seeds, oysters and sunflower
seeds).
VITAMINS/MINERALS/HERBS
- Lysine, an amino acid, may be used as a supplement. Lysine has
been shown in some studies to help treat acute outbreaks and reduce
recurrence. - Vitamin C may be helpful in treating and preventing Cold Sores
as it can improve immune function and reduce the duration of the
infection. - Echinacea may be effective as it supports immune function and
has antiviral properties. - Vitamin A has antiviral properties and can improve immune
function. - Hypericum (St John’s Wort) has been shown in some studies to be
useful against the herpes simplex virus. - Zinc supports immune function and in some studies it has been
shown to reduce the frequency, severity and duration of a herpes
outbreak. Zinc sulfate can also be applied topically to reduce the
recurrence of cold sores. - Lemon balm can be used topically as a cream to reduce severity
and recurrence of cold sores.
PHARMACIST’S ADVICE
Ask your Pharmacist for advice.
- Follow the Diet Hints
- To prevent a serious eye infection, avoid rubbing the eyes
after touching a Cold Sore. - To help avoid transferring the infection to another person,
avoid close contact such as kissing during a Cold Sore outbreak.
The virus may also be spread by sharing things that touch the lips
and surrounding skin such as eating utensils, towels or face
cloths. - A suitable lotion or cream may be suggested by your Pharmacist
to apply before the Cold Sore has crusted. There are preparations
available that contain aciclovir which helps to shorten the
duration of the Cold Sore by reducing the ability of the virus to
replicate. These preparations are to be used at the early stage of
the Cold Sore – at the ‘tingle’ phase. Wash hands thoroughly before
applying and use 5 times a day for 5 days. Keep away from eyes and
mucous membranes. - Creams and lotions will be more effective if they are used
frequently in the first 24 hours i.e when the tingling, itching or
pain is noticed. - Apply ice (wrapped in a clean paper towel or cloth e.g
handkerchief) to the lesion for 5 to 10 minutes every hour during
the ‘tingle’ phase. This may help to block the development of the
Cold Sore and reduce pain and swelling. - Ask your Pharmacist to recommend some pain relieving medication
if it is required. - Remember to use a suitable UV protection product to protect the
lips and nose against harmful UV rays from the sun and tanning beds
which may trigger a Cold Sore. - If the diet is inadequate, consider the supplements suggested
in this topic.
