Cold sores are painful, open blisters that develop in or around your mouth, usually on your lips. Once you’ve had a cold sore, it’s likely you will have more over the course of your life. That’s because cold sores are caused by a virus known as herpes simplex virus (HSV-1). After you get an HSV infection, the virus travels to nearby nerve cells where it can lie dormant for long periods of time. When triggered, the virus can start replicating again, causing
another cold sore. It can be hard to predict what triggers a cold sore, and they might seem to appear at the worst times. But research has identified some common triggers. We’ve partnered with Burt’s Bees, known for its lip balms and other lip care
products, to explore the triggers of cold sores, and help you prevent and prepare for future flare-ups. For such a ubiquitous plague, cold sores can be mighty shaming. In addition to the indignity of wearing a bulging, weepy blister on your lip, sufferers also must contend with the stigma of its source: HSV-1, a type of herpes simplex virus. But unlike HSV-2, the virus that usually causes genital herpes, cold sores are not usually sexually transmitted (though they can be). Most people get infected with HSV-1 as kids, from kissy adults. "It is one of the most common viral infections, and yet you're a pariah," said Dr. Adam Friedman, director of dermatologic research at Albert Einstein College of Medicine at Yeshiva University in New York. "People look at you like you're a leper." About 70 percent of Americans are infected with HSV-1, but just a third of those infected have cold sore outbreaks, said Bryan Cullen, professor in the department of molecular genetics and microbiology at Duke University Medical Center. Genetics likely separates the lucky from the unlucky, he said. The hardy virus, which stays in your body your whole life, survives by moving up the sensory nerves after initial infection and vacationing in nerve bundles, where immune cells can't find and destroy it. Triggers such as stress, fatigue, sun exposure, picking at your lip or having a cold or the flu can reactivate some infected cells, which travel back to the initial infection site to cause a new outbreak. There is no cure. Cullen and fellow researchers hope to find a way to disrupt the processes that keep the virus latent, so that they can coax it out of hiding all at once and ambush it with medication. But they're not close to clinical trials, Cullen said. HSV-1 has been implicated in a number of diseases, including Alzheimer's, though that link is disputed. Though there are rare cases of severe complications from HSV-1 — such as when the virus spreads to the brain in immunocompromised people, causing death or neurological damage — for the most part "the worst part about (HSV-1) is probably the social stigma," Friedman said. Prevention and treatment Though the virus is most contagious during an outbreak, when the virus is "shedding," it's also possible to transmit when no outbreak is visible. According to a study published in 2008 in an oral medicine journal, at least 70 percent of people with HSV-1 shed asymptomatically at least once a month. Friedman recommends keeping your mouth away from others when you feel a cold sore coming, during the outbreak and for a few days after it goes away. That includes oral sex, as HSV-1 can be transmitted from mouth to genitals (HSV-2 also can be transmitted from genitals to mouth). Taking prescription antivirals such as acyclovir (Zovirax) or valacyclovir (Valtrex) can reduce healing time or prevent a blister from forming at all, clinical trials have shown. It's best to attack during the "prodrome" stage, when many people feel tingling or itching at the infection site, or have flulike symptoms, before a blister appears. Friedman suggests applying ice at the first hint of a cold sore, holding it against the infected site for no more than 15 minutes, to reduce swelling. You might also soak a cotton ball in whole milk and hold it against the sore for 10 to 15 minutes daily, Friedman said. Milk contains the protein monocaprin, which can halt HSV-1. Finally, cover a blister with a thick emollient such as petroleum jelly to speed healing and protect the wound from bacteria, Friedman said.
Cold sores usually clear up without treatment within 7 to 10 days. Antiviral tablets or cream can be used to ease your symptoms and speed up the healing time. If you develop a cold sore, some general advice to follow includes:
Antiviral creams and tabletsAntiviral creams such as aciclovir or penciclovir (also known as Fenistil®) may speed up the healing time of a recurrent cold sore infection if used correctly. Cold sore creams are widely available over the counter from pharmacies without a prescription. They're only effective if you apply them as soon as the first signs of a cold sore appear, when the herpes simplex virus is spreading and replicating. Using an antiviral cream after this initial period is unlikely to have much effect. If you have frequently recurring bouts of cold sores, use antiviral medication as soon as you feel the tingling sensation that indicates a cold sore is about to develop. You'll need to apply the cream up to five times a day for four to five days. Antiviral creams can only help to heal a current outbreak of cold sores. They don't get rid of the herpes simplex virus or prevent future outbreaks of cold sores occurring. Antiviral tablets are generally more effective than creams at treating cold sores, but are usually only prescribed for more severe cases. Cold sore patchesCold sore patches that contain a special gel called hydrocolloid are also available. They're an effective treatment for skin wounds and are placed over the cold sore to hide the sore area while it heals. Non-antiviral treatmentsSeveral non-antiviral creams are also available over the counter from pharmacies without the need for a prescription. These creams aren't specifically designed to treat cold sores and won't help them heal faster, but they may help ease any pain or irritation. Ask your pharmacist to recommend a suitable treatment for you. Pain can also be treated with painkillers such as ibuprofen or paracetamol – both are available in liquid form for young children. However, don't take ibuprofen if you have asthma or stomach ulcers, or you've had them in the past. Children under the age of 16 shouldn't be given aspirin. Speak to your pharmacist if you have cold sores and you're pregnant. Treating complicationsIf your cold sores are particularly severe or your immune system is damaged – for example, if you have HIV or you're having chemotherapy treatment – you may be at risk of developing serious complications. For example, your risk of developing encephalitis or the infection spreading to other parts of your body, such as your eyes, is increased. Speak to your GP if you're at risk. They may prescribe antiviral tablets and refer you for specialist treatment. The type of treatment recommended will depend on the severity of your cold sore symptoms and the complication that's causing problems. For example, if you develop herpetic keratoconjunctivitis – a secondary eye infection – you may need to see an ophthalmologist, a specialist eye doctor. GingivostomatitisVisit your pharmacist if you or your child develops swollen, painful gums (gingivostomatitis) as a result of the primary herpes simplex infection. They'll be able to suggest treatments to help ease your symptoms. If the infection is painful, your pharmacist may suggest using a preparation that contains benzydamine, which is available as an oral rinse or oral spray, to help relieve any pain in your mouth or throat. Brushing your teeth may also be painful because of the swelling of your gums. Your pharmacist may suggest using an antiseptic mouthwash. This helps prevent secondary infections and will also control a build-up of plaque if you can't brush your teeth effectively. As with the treatment of cold sores, any pain or fever can be treated using ibuprofen or paracetamol. In rare cases of gingivostomatitis, it's possible for your lips to become stuck together in places. Using a lip barrier cream available from your local pharmacist will help prevent this. DehydrationIf you or your child has gingivostomatitis, it's important to drink plenty of fluids to avoid becoming dehydrated. Young children are particularly at risk as they may refuse to eat or drink because of the pain in their mouth. It's important to watch out for signs of dehydration, such as:
Most cases of gingivostomatitis get better in 7 to 14 days, although it may take up to three weeks for the sores to heal completely. Specialist treatmentIf you or your child still has symptoms of gingivostomatitis after two weeks or the infection is severe your pharmacist may advise you to contact your GP, who may refer you for specialist treatment. Specialist referral may also be needed for gingivostomatitis if you're pregnant or have a weakened immune system. Visit your GP if you have a newborn baby who develops gingivostomatitis, as they may also need to be referred for specialist treatment. How do I stop recurring cold sores?If you have frequently recurring bouts of cold sores, use antiviral medication as soon as you feel the tingling sensation that indicates a cold sore is about to develop. You'll need to apply the cream up to five times a day for four to five days. Antiviral creams can only help to heal a current outbreak of cold sores.
What causes frequent cold sores?Cold sores are caused by the herpes simplex virus. Once this virus is in you, it can cause outbreaks of cold sores. Cold sore outbreaks are often triggered by exposure to hot sun, cold wind, a cold or other illness, a weak immune system, changing hormone levels, or even stress.
What does it mean when you get a cold sore every month?If a person keeps getting cold sores, there may be an underlying cause. Many factors can trigger reactivation and subsequent cold sore outbreaks, including: hormonal changes, such as those associated with pregnancy or menopause. another viral infection or illness.
Why do I keep getting back to back cold sores?ANSWER: Cold sores are caused by the herpes simplex virus. Once you're exposed to the virus, which is typically passed from skin-to-skin contact, it's present in your body for life. After the initial infection, the virus will travel to your nerves, where it remains dormant but may awaken periodically.
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Why am i getting cold sores every month
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