Wellness: Diseases & Conditions

Cold Sores: A Common Complaint 

Even if you don’t get cold sores, you probably know someone who does. An estimated 50 to 80 percent of people are infected with herpes simplex virus type 1 (HSV1), the virus that most often causes them. This virus is a close relative of the virus that causes genital herpes, herpes simplex virus type 2 (HSV2). 

How sores spread

Most people who get cold sores were infected with HSV1 before age 20, usually by kissing someone with the virus, according to the National Institute of Allergy and Infectious Diseases. It’s also possible to start getting sores after using anything with infected saliva on it, such as a razor, towel, or eating utensils. Sometimes, you can be exposed to the virus even from someone who doesn’t have an active cold sore.

Although the cold sore HSV1 is different from the virus that leads to genital herpes, it still can be spread to the genital area, and HSV2 can be spread to the lips. If you touch a cold sore and then rub your eye, the virus can spread to your eyes. This can cause an infection of the eyelids, conjunctiva (white of the eyes), and cornea. Untreated lesions on the cornea can lead to scarring of the cornea, with impaired vision or blindness.

Symptoms

People who are infected with HSV1 may develop their first cold sore within one to two weeks after exposure. First-time infections are often accompanied by fever, flu-like symptoms, and malaise. The sore, or blister, usually develops on the gums, lips, or face, but it can appear anywhere on the body. Lesions on the lips are called cold sores or fever blisters. On the body, they are usually called herpes gladiatorum (because this condition is seen frequently in wrestlers); on the genitals, they are called genital herpes. Although they can be quite painful, the sores go away in about two weeks, even without treatment. After the cold sore heals, the virus stays in your nerve cells. Menstruation, sunlight, stress, illness, surgery, or fever may trigger new sores. But, sometimes they show up for no apparent reason.

You may be able to tell when a sore is about to appear. You may feel tingling, itching, or skin sensitivity. You may have slight swelling, redness, or a mild fever, too. 

Prevention

Follow these tips to protect yourself against infection by HSV1: 

  • Don’t kiss or be intimate with anyone who has a sore or feels one coming on.

  • Wash your hands regularly.

  • Avoid sharing eating utensils, drinks, lipstick, toothbrushes, or razors.

  • Use hot water to wash items used by someone who gets cold sores.

If you already experience cold sores, try these tips to help prevent flare-ups:

  • Ask your health care provider about oral antiviral medication. Taking it at the first sign of a sore (when the area begins tingling) may prevent the sore from appearing and also speed healing. Antiviral medication includes acyclovir oral, valacyclovir (oral), and penciclovir (cream).

  • Try meditation, relaxation techniques, or exercise to relieve stress.

  • Wear lip balm with an SPF of at least 15.

  • Try an over-the-counter cream. Those with docosanol may speed cold sore healing. Numbing ointments can help relieve pain, itching, and burning. Lip balm may reduce cracking so the sore heals faster. 

  • Use a cool compress to ease pain. Once a sore forms, don’t squeeze, pinch, or pick it. You may delay healing.

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