Cold sores: What to know

Cold sores are little blister-like lesions that appear on the lips, chin, and cheeks, as well as in the nostrils. They are less common on the gums and the roof of the mouth.

Before they burst and crust over, cold sores usually cause pain, a burning sensation, or itching. They’re also known as fever blisters.

The herpes simplex virus type 1 is the most prevalent cause of cold sores (HSV-1). These sores can also be caused by an infection with a different strain of the herpes simplex virus, known as herpes simplex virus type 2. (HSV-2).

HSV-1 is carried by 48.1 percent of all 14–49-year-olds in the United States, making them more prone to cold sores.

Although there is no method to cure or prevent cold sores, there are steps that can be taken to lessen the frequency and duration of outbreaks.

The causes

causes of cold sores

HSV-1 and HSV-2, the viral strains that cause cold sores, are highly contagious and spread rapidly during close contact, such as sexual contact.

Following the virus’s entry into the body, a person may experience the following symptoms:

  • sores around the genital area, in some cases
  • sores in or around their mouth or in their nostrils
  • flu-like symptoms

If transmission occurs during oral sex, oral herpes blisters, often known as cold sores, can develop around the genitals.

Without therapy, a cold sore outbreak usually lasts 1–2 weeks before the virus is suppressed by the body’s immune system.

The virus does not leave the body, and while it is usually dormant, it can reactivate to cause cold sores on occasion.

The majority of people with oral herpes are unaware of their infection until they develop cold sores or other symptoms. Because the virus remains dormant, some people only experience one outbreak with no recurrence.

Others may experience recurrent outbreaks that last for years.

What is the definition of genital herpes?

The symptoms

Some people with oral herpes have no symptoms, while others develop them after their initial infection.

Despite this, at least 25% of people with oral herpes have recurrent outbreaks. Cold sores occur in the same places over and over again in this example.

The following are some of the first signs of an HSV-1 infection that may develop 2–20 days after introduction to the virus:

  • swollen lymph nodes
  • lesions on the tongue, mouth, chin, cheeks, or in the nostrils
  • mouth or tongue pain
  • lip swelling
  • a high body temperature
  • headaches
  • dehydration
  • nausea
  • difficulty swallowing
  • a sore throat

Gingivostomatitis, an infection of the mouth and gums, may also be present. This lasts 1–2 weeks and does not happen again.

With the initial oral herpes infection, adults may develop pharyngotonsillitis, an infection of the throat and tonsils.

Symptoms of cold sores at various stages

When a cold sore recurs, it goes through various stages.

  • The sores break and produce fluid.
  • A yellow crust forms on the sores.
  • The crust comes off, revealing pink skin that heals in 3–4 days.
  • A tingling, itching, or burning sensation around the mouth often indicates the start of an outbreak.
  • Painful, fluid-filled sores appear, usually around the mouth.

Most cold sores heal in 1–2 weeks without treatment and do not leave a scar.

Diagnosis

Recurrent outbreaks can be managed at home by recognising the people and taking medication.

Consult a doctor if you have any of the following symptoms:

  • The signs and symptoms are severe.
  • Within ten days, a cold sore does not begin to heal.
    Gums swell up.
  • The person’s immune system is compromised.
  • Other signs and symptoms are alarming.

A doctor can typically diagnose the problem based on the symptoms and a visual inspection, but in some situations — such as if the patient has a weaker immune system — a blood test or a sample of the sore’s fluid may be ordered.

HIV, drugs after an organ transplant, certain types of cancer, and various cancer treatments are all factors that might decrease the immune system.

Treatment

Without therapy, most cold sore breakouts go away in 1–2 weeks.

Some over-the-counter and prescription treatments, on the other hand, can shorten the duration of an outbreak and alleviate any discomfort or pain, though they do not remove the virus from the body.

Treatments should be used as soon as the first signs of an outbreak show in most cases.

Creams with antiviral properties

Antiviral lotions sold over the counter can help to decrease the duration of an epidemic. Acyclovir or penciclovir is found in most creams, including Zovirax and Soothelip.

For 5 days, the cream should be applied to the affected area every 2–3 hours.

Antiviral medicines taken orally

The following are some examples of antiviral drugs that can be taken by mouth:

  • valacyclovir (Valtrex)
  • acyclovir (Zovirax)
  • famciclovir (Famvir)

If a person has a weaker immune system or has frequent breakouts, a doctor may prescribe one of these drugs.

It is taken once or twice a day.

These drugs can help to decrease the duration of an outbreak and prevent it from happening again.

Pain relief

Analgesics like benzocaine or lidocaine are used in over-the-counter solutions. They do not hasten the healing process, although they can help to alleviate pain.

The following are some cold sore pain relief medications:

  • Orajel
  • Blistex
  • Cymex
  • Anbesol

People should use a Q-tip to dab these ointments, lotions, or gels onto the sores, and they should not share these goods.

If a person uses their finger to apply the drug, they should wash their hands before and after.

Alternative drugs include ibuprofen (Advil) and acetaminophen (Tylenol).

At home remedies

Some people find relief from cold sore symptoms by using the following home care techniques:

  • using petroleum jelly to keep the skin moist, preventing cracking
  • dabbing the area with diluted geranium, lavender, or tea tree oil
  • applying cold, soaked tea bags to the area every hour

There is no scientific proof that these therapies are effective or safe.

Complications

Oral herpes can cause difficulties in some people, especially those with compromised immune systems.

Complications that may arise include:

  • If the sores make it difficult to drink, you may be dehydrated.
  • Herpetic whitlow is a painful infection caused by a wound on the skin that causes blisters on the fingers.
  • Herpetic keratoconjunctivitis is a secondary infection that can cause eye swelling and irritation, as well as sores on the eyelids and vision loss if left untreated.
  • If the infection spreads, encephalitis (brain swelling) may ensue.

Encephalitis is a life-threatening condition.

Preventive tips

When you have sores, attempt to:

  • Kissing and other skin-to-skin contact with the affected area should be avoided.
  • During oral sex, use a dental dam or a condom.
  • Personal things, such as towels and lip balm, should not be shared.
  • Use proper handwashing practises.
  • Avoid touching regions including the eyes, mouth, nose, and genitals where sores can form.
  • If it’s necessary to touch the sores, wash your hands with soap and warm water before and after.

Conclusion

Oral herpes can cause painful and inconvenient cold sores.

Many people have no problems and may treat outbreaks at home with over-the-counter or prescription medications.

If you experience cold sores or any other oral herpes symptoms, you should see a doctor very away if you have a weakened immune system.

Recognizing early signs of an outbreak and acting quickly to treat it can assist. Cold sores usually resolve after 1–2 weeks without treatment.

Sources:

  • https://www.ncbi.nlm.nih.gov/books/NBK526068/
  • https://www.nhs.uk/conditions/cold-sores/
  • https://www.ncbi.nlm.nih.gov/books/NBK525782/
  • https://herpes.org.uk/cold-sores/
  • https://www.medicalnewstoday.com/articles/172389
  • https://rarediseases.org/rare-diseases/encephalitis-herpes-simplex/
  • https://www.who.int/en/news-room/fact-sheets/detail/herpes-simplex-virus
  • https://www.aad.org/public/diseases/a-z/herpes-simplex-overview
  • https://www.cdc.gov/nchs/products/databriefs/db304.htm
  • https://www.ashasexualhealth.org/oral-herpes/
  • https://www.aao.org/eye-health/diseases/herpes-keratitis
  • http://www.aafp.org/afp/2010/1101/p1075.html
  • http://www.aapd.org/media/Policies_Guidelines/RS_CommonMeds1.pdf

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