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Advice for Cold Sore
Cold sores are a common viral infection. A cold sore consists of a group of small, painful, fluid filled blisters that appear around the mouth and lips, and in some cases, the nose, cheeks and inside the mouth. These blisters are often grouped together in patches. After the blisters break, a scab forms that become dry and crusty, and can last several days. Cold sores are also known as herpes simplex labialis or fever blisters.
The symptoms of a cold sore are usually most severe the first time you get one. Cold sores usually heal in two to three weeks without leaving a scar. The healing process can be uncomfortable and painful. Once you experience the first outbreak, your body will create antibodies. It’s common for people to get recurrent cold sores in the same places. This is because the virus lives dormant in the nerve cells of your skin, reappearing once it’s triggered.
Cold sores spread from person to person by close contact, such as kissing and the sharing of objects such as cutlery, lipstick, creams, toothbrushes and razors. They're usually caused by herpes simplex virus type 1 (HSV-1), and less commonly herpes simplex virus type 2 (HSV-2). Both of these viruses can affect your mouth or genitals and can be spread by oral sex. Cold sores are very contagious from the moment you feel the tell-tale tingling sensation.
There's no cure for cold sores, but treatment can help manage outbreaks. Antiviral creams and cold sore patches are commonly bought over the counter, but where the frequency and severity is greater, prescription antiviral oral medication can help sores heal more quickly and reduce the severity. And they may reduce the frequency, length and severity of future outbreaks.
At Pharmacinta, we provide prescription Aciclovir and Valaciclovir to help treat and manage recurrent cold sore symptoms in a fast and effective way. It’s important to use antiviral medication early on to significantly reduce the length of time symptoms last for.
Cold sores will normally appear in stages. This means you won’t suddenly develop an open sore around your mouth and can use preventative medication to reduce your symptoms before they start showing.
The main symptom of oral herpes is cold sores including: red, painful blisters that develop around the mouth and lips. It begins with a tingling, itching or burning feeling in the skin around your mouth. Over the course of 48 hours later the area will become red, swollen and painful as blisters form. The blisters that form due to cold sores can crack and bleed which can be particularly uncomfortable. It will usually remain for around 10 days. During this time the blisters will break open and fluid may ooze out which will last 2-3 days. A scab will form over the sore and it may crack or bleed. The scab will fall off and the blister will heal fully within 10-14 days in most cases.
When cold sores first develop they are fluid-filled blisters that usually appear red and shiny. After bursting, the blisters start to scab over. At this point they might look crusty and yellow or brown in colour. As well as the cold sore symptoms, some people may experience red or swollen gums, swollen neck glands, muscle aches or a fever.
Cold sores are caused by a virus called the herpes simplex virus (HSV). Herpes simplex is a type of herpes virus that can cause many conditions. Two of the most common ones are cold sores and genital herpes. This virus is very common and it’s estimated to affect approximately 67% of the world’s population.
The herpes simplex virus is highly contagious and spreads through skin-to-skin contact. The virus is caught by coming into contact with other people with an active infection. This is often during childhood when children come into close contact through activities such as play.You’re more likely to catch HSV from someone who carries the virus and has symptoms, but you can also catch it from people who don’t have any symptoms.
You can contract the herpes simplex virus in several different ways. The following activities can cause cold sores:
- Kissing someone with a cold sore
- Sharing lip products, utensils or cups with someone who has a cold sore
- Giving oral sex to someone who has genital herpes
For most of your life, the virus will lie dormant in your skin, suppressed by your immune system. Occasionally the virus will reactivate causing a cold sore. This is often when your immune system is temporarily weakened, for example through stress or illness.
Avoiding these triggers and making healthy changes to your lifestyle can reduce the risk of developing a cold sore. Cold sores can be triggered by a range of issues including the following triggers:
- Getting an infection, like a cold or the flu
- Exhaustion
- Hormonal changes, like having your period
- Strong, or direct, sunlight
- Being out in a cold wind
- Weak immune system
- Exposure to the hot sun
- Having a fever
- Feeling very stressed or upset
- Being very tired
- Receiving an injury to the affected area
Some people will never learn what their triggers are, whereas others will feel like each cold sore is triggered by something different. Keeping track of your cold sores is advisable not only for pinpointing your triggers but for recording how long it lasts and whether you treated it effectively.
There is no cure for the virus that causes cold sores, but there are things you can do to treat your cold sore when you experience an outbreak. Though treatment of an uncomplicated cold sore is not essential, acting fast with the right medication can reduce the length and severity of your symptoms.
Antiviral oral medications are available to treat illnesses that are caused by HSV, including cold sores. At Pharmacinta, you can be prescribed the following antiviral medications if you’ve suffered from infections before or if you have a weak immune system:
Aciclovir - an antiviral that works by preventing the herpes virus from reproducing, thereby reducing symptom severity
Valaciclovir - the precursor to aciclovir, which is converted to aciclovir in the body. Valaciclovir is better absorbed by and remains longer in the body, meaning less frequent doses are required.
Both these medications have two uses: outbreak control and suppression. The first is to stop an outbreak when it emerges, and only requires the medication to be taken for a few days. Suppression treatment is designed to stop an outbreak occurring over an extended period of time. You might choose to use this, for example, if you have important events coming up in your life that you want to avoid an outbreak for.
Creams
Antiviral cold sore creams such as Zovirax are available over the counter. If you start to experience these symptoms, you should apply your cold sore cream as soon as possible. You will typically have to apply the cream 5 times a day for 5 days. If you start to apply antiviral cream after the cold sore has fully developed, you are unlikely to see any improvement.
Patches
Cold sore patches are different to cold sore creams as they are applied after infection has developed. This makes them a good option if you already have a cold sore. You use a cold sore patch by peeling it off and sticking it over the cold sore. It works by helping the blister to heal, and also effectively covers the area.
Ibuprofen
Ibuprofen lessens your body’s ability to make prostaglandins, which are chemicals that can cause pain, inflammation, and fever. All three of those symptoms link with cold sores. Taking ibuprofen, which is readily available, can ease the pain and discomfort linked with cold sores.
Home Remedies
Below are some of the most effective home remedies for treating cold sores. Home remedies provide relief for some people but do not work for everyone.
Lemon Balm
Lemon balm is an herb that’s part of the mint family. Lemon balm has been used for many years to improve mood and cognitive function. This lemon-scented herb is also known to have antiviral properties.
A 2023 research review involved findings about lemon balm and its potential benefits for healing certain viruses, including HSV, SARS, and HIV. The review found that lemon balm may help treat HSV-1 by preventing the virus from binding to cells in the body and replicating.
The simplest ways to use this potentially healing herb include a lip balm with at least 1% lemon balm, drinking lemon balm tea, or applying a warm compress soaked in lemon balm tea.
Ice- Ice will likely not reduce the duration of a cold sore outbreak, but it can ease the discomfort and inflammation of cold sores. Apply a cold pack directly to the sores for temporary relief. To avoid the risk of irritating or burning your skin, limit your cold pack time to 15 minutes at a time.
Aloe Vera- While research connecting the plant to cold sores is limited, one in vitro 2016 study showed that its anti-inflammatory and antiviral effects could have inhibitory effects. Apply a small amount of aloe vera gel — either from a tube or by breaking open an aloe vera leaf — directly onto your cold sores.
Sunscreen- Sunburns are one of the major triggers for cold sore outbreaks. But there are plenty of ways to reduce your sun exposure. Wear sunscreen daily, whether you currently have a cold sore or not. It not only protects your lips while the cold sore heals, but it can also reduce future flare-ups Trusted Source when applied to the lips daily.
Stress Reduction- Another major trigger that can cause the herpes virus to come out of dormancy is stress. But finding ways to reduce your stress can also reduce your risk of future cold sores. Add 10 to 30 minutes of anti-stress techniques into your daily routine by trying meditation, exercise, journaling, or anything that helps you feel calmer and more relaxed.
Frequently Asked Questions
A cold sore is a form of herpes. The herpes simplex virus type 1 (HSV-1) causes cold sores, whereas the herpes simplex virus type 2 (HSV-2) causes genital herpes. Even though HSV-1 commonly causes cold sores around the mouth and lips and HSV-2 causes sores around the genitals, both viruses can cause sores in both areas.
Cold sores are extremely common. Up to 90% of the population have experienced HSV1. However, it’s important to note that cold sores aren’t usually a serious medical condition.
These things will help you stop the spread of a cold sore virus and help you to recover quicker from an outbreak: Drink plenty of fluid and avoid dehydration; Wash your hands before and after applying any makeup or cream; Use SPF 15 or higher lip balm;. Eat cool, soft foods; Take painkillers to help with the pain and swelling.
It is possible to develop a cold sore at any age, though the chance of having a cold sore outbreak decreases after the age of 35. It is common in children and teens.
Yes, often people report cold sores are worse or more painful the first time they experience an outbreak.
Many people report experiencing cold sores in times of high stress or anxiety. Responses to HSV-1 vary widely from person to person, so while stress may trigger cold sores in one person, it may not in another person.
<ul> <li>Avoid touching your cold sore.</li> <li>Avoid kissing during an outbreak.</li> <li>Avoid oral sex until your cold sore has completely healed.</li> <li>Do not share cutlery, makeup, etc. during an outbreak.</li> <li>Avoid salty, acidic food that could aggravate a blister.</li> </ul>
Cold sores are contagious as soon as you feel a tingling, itching or burning sensation on your face, until the blister has burst, scabbed over and fully healed.
The virus which causes cold sores can also be transmitted to the genitals and anus, potentially causing genital herpes, but this is not as common. You should not engage in oral sex while you have a cold sore as this can increase the risk of passing the virus to a partner.
Most cold sores will not require treatment and cold sores are very common, particularly in children. However, some people may experience particularly large, painful or prolonged cold sores and in these scenarios, treatment may be appropriate.
Cold sores usually take 4-5 days to scab over and 1-2 weeks to heal completely. More severe or frequent cold sore outbreaks may warrant medical attention.
It depends. Some people get them several times a year, while others may only get them a few times in their life. It’s not clear why cold sore frequency varies so widely from person to person.
Anyone can become infected with the virus that causes cold sores. The majority of people seem to get it during childhood, but anyone is susceptible to cold sores. Outbreaks tend to decrease into middle-age.
Yes, the virus that causes cold sores can be spread by oral contact like kissing and sharing food.
Cold sore outbreaks usually begin with a tingling or itching feeling around the lips. Over the next 24 hours, the area becomes redder and swells as a painful sore develops.
Most cold sores heal on their own within 1-2 weeks, but the virus that causes cold sores, HSV-1, remains in the body for a person’s entire life.
No, HSV-1 remains dormant in a person’s nerve cells for their entire life, and may cause cold sore outbreaks periodically.
No. Cold sore tablets are only available on prescription. Topical treatments, such as cold sore creams, are available over the counter.
You may be able to get cold sore tablets on the NHS. Whether you are prescribed these depends on your medical history, the severity of your condition and local prescribing guidelines
Yes, light therapy is used for cold sores. Numerous peer-reviewed clinical trials have shown light therapy treatments can improve healing results and limit outbreaks of herpes labialis.
Some people choose to treat cold sores with oral antiviral drugs like acyclovir (Zovirax), famciclovir (Famvir), and valacyclovir (Valtrex). Doctors may prescribe these medications if outbreaks are frequent and severe.
Aciclovir and Valaciclovir are closely related. Valaciclovir is a pro-drug of aciclovir which means that after it is taken, it is converted in the body to aciclovir. The advantage of taking valaciclovir over aciclovir is that it doesn’t have to be taken as frequently so it is more convenient for the patient to comply with the regime.
Valaciclovir is the active ingredient in Valtrex and is available in a generic, unbranded tablet. Valaciclovir and Valtrex are medically equivalent but Valaciclovir is available at a much lower cost as it is generic.
