joel schlessinger md faq - cold sores

Joel Schlessinger, MD

FREQUENTLY ASKED QUESTIONS ABOUT

COLD SORES

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According to the American Academy of Dermatology, over half of Americans ages 14-49 carry the virus that causes cold sores. Cold sores, also known as fever blisters, are small, fluid-filled blisters that form on and around the mouth. They usually appear in clusters and may break and form a crust. Cold sores are caused by the herpes simplex virus, and they are highly contagious. While symptoms of the virus are treatable, there is currently no known cure.

What are cold sores?

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Cold sores are caused by the herpes simplex virus (HSV-1), a communicable virus that can lie dormant deep in the roots of the nerves of the affected area until activated. The virus is associated with HSV-2, a strain that is responsible for sores and lesions below the waist. Though HSV-1 and HSV-2 are considered separate strains of the herpes simplex virus, they are transferable, and either type is capable of infecting any area of the body.

What causes cold sores?

After



The most obvious symptom of cold sores is a group of red blisters on and around the mouth. The blisters are filled with fluid and may burst, then dry up rapidly, leaving a crust and eventual scab. Scabs could last a few days to a few weeks, depending on severity.

Some patients experience a prodrome, or the occurrence of certain symptoms before the blisters manifest. Typically, a patient will feel a burning, tingling or itching sensation hours or days before a blister appears.

During an initial cold sore outbreak (usually the most severe), patients may experience flu-like symptoms such as aches and pains, fever and swollen lymph nodes.

What are the symptoms of cold sores?

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Cold sores are usually spread through close or direct contact. Kissing and other forms of intimacy, as well as sharing drinking glasses and food utensils are common ways the virus can transfer. In some cases, the virus may spread through contact with hands that have recently touched a weeping sore.

How are cold sores spread?

Before After



Cold sores can develop at any time, but the following factors are known triggers for outbreaks:

• Weather changes, particularly excessive sunlight and prolonged sun exposure

• Stress and fatigue

• Hormonal fluctuations from pregnancy or menstruation

• Illness such as cold or flu

• Trauma to the mouth from an injury, surgery or dental work

What can trigger a cold sore outbreak?

After



The key to treating cold sores is to treat them early, as soon as you notice any indication of tingling or burning on and around the lips. While there is no known cure for the herpes virus that causes cold sores, blisters are usually very manageable and relatively easy to heal at home. Read on to learn about over-the-counter and prescription-strength treatments.

How can I treat cold sores?

Before After



Applying over-the-counter ointments can drastically reduce healing time and help you stay comfortable during the process. Abreva is one such treatment, and it may be applied before a blister has even appeared to help encourage repair.

To relieve pain and prevent painful cracking, you can also apply a cool, moist compress to the area for up to 10 minutes at a time. It’s important to never reuse compresses. Always wash your hands after touching a sore to avoid spreading it to other areas of the body or other people.

Over-the-counter and at-home treatments

After



For particularly large, painful or stubborn sores, there are prescription-strength topical treatments, such as Zovirax 5% cream or Denavir 1% cream. You can also ask your doctor about Valtrex, an oral medication that can be taken to hasten healing time when a cold sore outbreak is imminent. For those who struggle with frequent cold sores, Valtrex can be taken regularly to help prevent outbreaks.

Prescription medications



The best way to prevent cold sores is to avoid physical contact with anyone who has an active sore, which is when the virus is most contagious. You should also avoid sharing eating utensils, drinking glasses, toothbrushes, lip balms and anything else that might come into direct contact with blisters. Wash your hands frequently to avoid contracting the herpes virus and other bacteria and viruses that could cause illness. You should also always wash your hands after touching an active sore. The herpes virus can spread to other parts of the body and cause sores on any area, but particularly on fingers and on or around eyes and genitals.

Schedule an appointment with your doctor if you struggle with frequent or severe outbreaks or if you are unsure whether your blisters are cold sores. Other conditions and lesions, such as canker sores, can be mistaken for cold sores, and getting a diagnosis will ensure that you receive the best treatment.

How can I prevent cold sores?

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