Cold Sores

Riddle: How is a cold sore like a brother-in-law visiting from out-of-town for the week?
Answer: You can’t dispose of either of them easily; you usually have to wait until they go away.

What is a Cold Sore?

Unlike brothers-in-law, cold sores are not irritants brought on by marriage but are small, painful infections that attack skin and nerves, look like chicken pox, and are caused by the herpes simplex virus. They can appear on various parts of your body but usually show up on the lips and, less commonly, on the nose. They start invisibly with a tingling sensation, followed two days later by the red, fluid-filled pustules that we call cold sores or fever blisters or, simply, “those disgusting looking things.” And there they sit, painful to the touch, for a week to 10 days.

Unlike canker sores, with which they are often confused, they seldom appear inside the mouth.

During that 7-to-10-day period, the blisters break, ooze, and form a yellow crust. They thus get even uglier. The scabs then fall off, and the skin heals without scarring. During that period, the sores are communicable through direct contact with others (or with yourself) or through an intermediary like a towel or razor. So, if you can actually find someone who will kiss you on the lips during that period, refuse them that dubious privilege.

After that’s over, and your skin is back to normal, you might be fooled into thinking the virus causing the infection has died and gone off to virus limbo. No, it doesn’t. It becomes dormant in the skin’s nerve cells and can be reawakened quickly by such things as stress, menses, a fever, or getting a sunburn. The first infection by the virus usually occurs in childhood; once the virus enters the body, it remains there forever. The first outbreak is typically the most severe as no antibodies have been produced to resist it. Meningitis is a possible complication.

Cold Sore Treatments

Unless you really like hanging around clinics, there is generally no need to visit a doctor to get cold sores treated. Non-prescription ointments are available to ease the pain, and an oral analgesic may also help. That said, however, there is a remote chance of complications. For instance, if the infection spreads to the eyes, the result can be blindness. There is also increased risk of more serious infections for people with defective immune systems or eczema, and also for infants. So if you are in a group at increased risk, or if you are having severe symptoms, or if there is an itching in your eye while you have cold sores, or if you have a crush on your medical care provider, it’s best to see your doctor. Whatever you do, avoid touching your eye after touching a cold sore. Wash your hands frequently to avoid spreading the disease.

Severe infections can be brought under control – they may be treated with a prescription cream, Zovirax. But, regardless of its severity, no cold sore can actually be cured. If treated early, however, the period of viral activity can be shortened with drugs like Penciclovir, Aciclovire, Valicyclovir, and Ganciclovir. A derivative of castor oil, undecylenic acid, is also thought to be effective against viral skin infections.

Preventing Cold Sores

• Use a lip moisturizer if your lips tend to be dry or chapped; when outdoors, use a sunscreen lip balm with an SPF of at least 15
• Limit your exposure to sun or UV lamps
• Avoid stress
• In support of your immune system, follow a healthy diet and sleep regimen
• Avoid skin contact with others who have cold sores or with any cups/glasses/cans, utensils or towels they have used, and avoid sharing food with them
• Wash your hands frequently.

There are those who promote various cold sore remedies for terminating them early or even preventing them from starting up. You will find dozens of them, involving such things as nail polish remover, here. Try them at your own risk, and please feel free to add any of your own cold sore home remedies to this page using the form below.