Cold sores are small sores, or blister-like lesions, that appear on the lips, chin, cheeks, inside the nostrils, and sometimes, on the gums or the roof of the mouth. Cold sores usually cause pain, a burning sensation, or itching before they burst and crust over. The most common cause of cold sores is the herpes simplex type 1 virus (HSV-1), but sometimes the herpes simplex type 2 virus (HSV-2) can also cause it. Unlike most viral infections, the cold sore virus is not completely eliminated by the body defenses, which often make it recur.
Causes of Cold Sores
Herpes simplex virus is a contagious one that can be spread from person to person by kissing or other close contacts with sores or even from contact with apparently normal skin that is shedding the virus. Infected saliva is another means of spreading the virus, and the most contagious period is when a person has active blister-like sores.
Once the blisters have dried and crusted over, the risk of contagion is lessened. But a person infected with HSV can still pass it on to another person even when a cold sore is not present. There is no cure to cold sores, but steps can be taken to reduce their frequency and duration.
After entering the body, the cold sore virus remains inactive most of the time. However, if a trigger activates the virus, a cold sore can develop. some people may have just one outbreak and no recurrence, while others may have two or three outbreaks annually.
Some people may even carry the virus and never have an outbreak because it lies dormant. Infection with HSV-2 may result from oral sex acts with a person who is suffering from genital herpes.
Some conditions that seem to be associated with recurrences include:
- fever, colds, or the flu
- ultraviolet radiation or exposure to the sun
- changes in the immune system
- hormonal changes, such as experienced during menstruation
- trauma to the skin.
Many people may only know they are infected if cold sores appear, and the first time that a cold sore appears may be severe.
After this first encounter, cold sores are considered a symptom of HSV-1 and 2, and they remain as the only recurring sign that the virus is present in the body.
In most cases, there are no other detectable signs or symptoms of a herpes infection, with severe symptoms most likely affecting young children, as they have not yet had time to build up antibodies as a defense.
Symptoms can include:
- lesions, blisters, or ulcers on the mouth
- mouth or tongue pain
- swelling of the lip
- possible difficulty in swallowing
- a sore throat and swollen glands
- high body temperature
- dehydration, nausea, and headaches
- There may also be an infection of the mouth and gums (gingivostomatitis).
- Pharyngotonsillitis which is an infection of the throat and tonsils may occur when the infection affects adults.
The diagnosis of cold sores is usually based on the appearance of lesions and no laboratory test is usually needed because most sores that look like cold sores are cold sores. Occasionally, mouth sores known as canker sores may be mistaken for cold sores, however, canker sores occur inside the mouth while cold sores usually occur on the lips.
Those with previous experience of a cold sore outbreak will easily recognize a recurrence, and people who suspect that they or their children may be having a primary infection should see their doctor. The signs and symptoms of cold sores are visible enough for a doctor to make a diagnosis. However, doctors may also order a blood test.
Most cold sore outbreaks clear up within 1 to 2 weeks without treatment, but some ointments and antiviral medications may help shorten the outbreak’s duration and alleviate discomfort and pain.
Over-the-counter cold sore antiviral creams that contain either acyclovir or penciclovir (such as Zovirax and Soothelip) can shorten the duration of a recurrent infection. They are only effective if applied as soon as symptoms and tingling suggest the onset of a cold sore.
Application of the cream can eliminate the symptoms but not the virus. on the other hand, Valacyclovir, acyclovir, or famciclovir are oral antiviral medications. They can significantly shorten or even stop a cold sore outbreak if taken at the first appearance of signs.
A patient who has several outbreaks a year may take these medications every day to prevent outbreaks.
Some creams like Bonjela, Blistex, or Cymex may reduce discomfort, but do not speed up the healing process. They may help if the cold sores are dry, itchy, or painful.
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- Avoid kissing or skin contact with other people mostly during an outbreak
- Avoid sharing towels, lipstick, lip balm, cutlery, etc…
- Follow good hand hygiene, and avoid touching other parts of the body, especially susceptible areas, such as the genitals and eyes.
- Immediately wash the hands with soap and warm water if you touch the sores.