COLD SORES: A HOT TOPIC

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Anyone who has suffered from a cold sore knows the first sign of onset is as deflating and disappointing as your favorite team losing the Super Bowl or as embarrassing as being turned down for a first date. In fact, anyone who has suffered knows that a first date will likely cause an eruption in the first place!  It is certain that for nearly the next two weeks you will be uncomfortable and frustrated by what you feel is an unsightly growth that will capture the attention of everyone for whom you meet.  For some, this occurs a few times a year but for others, it can be a monthly eruption that brings anxiety, self-consciousness, pain and an altered lifestyle until the sore heals.

A cold sore or fever blister is a viral infection caused the herpes simplex virus (HSV 1) and is, therefore, an incurable viral infection that can only be managed during outbreaks.  The herpes virus, once contracted, lays dormant in nerve bundles called ganglions until an outbreak occurs. The virus is contagious and is spread by close contact with an infected person possessing an open sore, kissing, and exposure to saliva containing the virus.

Starting out with a tingling sensation, the initial outbreak results in the formation of blisters, most commonly seen on the lip or areas around the lip and nose, leading to a painful open sore that oozes fluid containing the virus, eventually drying and cracking into a scab, that can bleed, until healed.  The entire process can take an average of 7-10 days from the first sensation of tingling to complete healing and loss of the scab.  Again the stages of a fever blister are as follows: Tingling, blister, drying sore, scab, health and is most contagious from the first sight of the blister and should be avoided until healed.

Some of the most common triggers associated with an outbreak include stress, illness, trauma, extreme weather exposure (sunburn or cold), and a weakened immune system.  When the body’s defenses are compromised or weak, the virus finds the footing to take hold and a painful outbreak occurs.   The most common location for blisters to develop is generally on the border of the lip, but because it is contagious it can also be transferred to the nose, roof of mouth, eyes, and fingers (herpetic Whitlow).  More than one outbreak can occur simultaneously or they can develop one after another if the outbreak is more severe or the immune system is more compromised.  After the initial exposure and outbreak, blisters will most often occur in the same area, but be careful as they can be spread.

It is impossible to stop the herpes virus completely; therefore treatment for cold sores is limited to reducing the number of outbreaks and the duration of the sore.  Anti-viral medications are available for those suffering on a frequent basis i.e. monthly lesions.  But if you are plagued a couple of times a year then treating the symptoms may be more practical.

Acyclovir is a common generic anti-viral medication that is often used to treat the herpes virus (Type 1 oral and Type 2 genital), as well as chicken pox.  This medication is commonly known as Zovirax or Valtrex and can not only be taken to help reduce the number of outbreaks but also decreases the severity of the outbreak and shortens the healing time.

Abreva is an over- the- counter (OTC) anti-viral that can be purchased without a prescription and if placed at the first sign of a blister can help speed recovery time.

Additional treatment suggestions are aimed at reducing discomfort and pain while promoting optimal conditions for speedy healing.  Most of these options are recommendations by sufferers as well as health professionals.  Though many of the suggestions may help some, they may also vary in effectiveness from person to person and outbreak to outbreak.  Using what works best for you and that which brings the most comfort during the outbreak is what is recommended.

Ice cubes directly on the sore or placement of a frozen cloth on the blister can bring relief to the tingling and stinging phase of the development of the sore.  Alternating with a hot or warm compress has also contributed to smaller blisters being formed and therefore a smaller sore in the end.

A moist tea bag placed on the blister/sore for approximately 15-20 minutes releases flavonoids into the area which can help reduce inflammation and discomfort.

Echinacea at first tingle can help decrease duration and in some cases stop the eruption of a blister altogether.

Zinx Oxide cream can not only speed healing of an existing sore but also protect certain common areas of risk from the traumatic influences that cause an outbreak.  A popular California look, especially in the 80’s, are the images of people with bright white zinc oxide cream on their nose and lips, while either at the beach and on the slopes of a sunny snowy mountainside.  The application was most often used to help reduce the incidence of sunburn on the nose and lips, thereby reducing the development of fever blisters that follow sustained sun exposure like that seen on the west coast.

The best attack, however, for a herpetic viral history is to take care of one’s health to avoid a compromised immune system and the subsequent development of a fever blister.  Rest, a healthy diet, reducing stress, and exercise will help maintain a strong defense in keeping the virus down.

Two- thirds of the population possesses the HSV-1 virus.  That means the majority of us have been exposed at some time in our lifetime.  However, 1 in 4 develops the blister leading to a full blown cold sore and are periodically plagued by the virus for a lifetime.  Taking care of your health and avoiding the spread of the virus is, unfortunately, the greater responsibility of the beholder. When the tingling sensation becomes apparent, avoiding personal contact with the area, washing hands often, avoiding kissing or sharing food, utensils and cups are all responsible suggestions to reduce further transmission of the virus to friends and loved ones.

COLD SORES: A HOT TOPIC julia

By Julia Guerra, RDH, BA
julia@randolphnjdentist.com