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Dermatology

Shingles: Things you need to know

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Shingles is a viral infection caused by the varicella-zoster virus (VZV), the same virus that causes chickenpox. This usually affects the ganglion of a single sensory nerve and the surface of the skin produced by the nerve.

Anyone who has had chickenpox can develop shingles later.

In addition, an estimated 1 in 3 people in the United States develop shingles during their lifetime, according to the Centers for Disease Control and Prevention (CDC).

But a person can only develop shingles if they have been exposed to chickenpox or the virus that causes it. For years, the virus can lie dormant.

Most adults with the inactive virus never develop shingles but the virus reactivates several times for others.

Shingles are most common after 50 years of age, but if a person has previously had chickenpox it may occur at any age.

Learn more about shingles in this post, including the signs, causes and treatments.

Symptoms

A lady with shingles on her face
Shingles results from the same virus that causes chicken pox.

Shingles usually reach one side of the body. Most often this is the waist, chest, belly or back. Symptoms can also appear on the face and in the eyes, mouth, and ears. Any internal organs can also get infected by the virus.

Shingles usually affect a single ganglion of the sensory nerve near the spinal cord, called the dorsal root ganglion. That is why the signs arise, rather than all over, in different parts of the body. The discomfort is the product of touching the nerves, rather than the rash itself.

Some people do, in truth, have pain but no rash. Others, however, may have a pain rash that comes with other symptoms, such as fever, chills, or headache.

Symptoms can vary in nature, depending on where on the body they appear.

Common symptoms

Some of the most common symptoms of shingles include:

  • a constant dull, burning, or gnawing pain, or a sharp, stabbing pain that comes and goes
  • a skin rash that resembles a chickenpox rash but only affects certain areas
  • fluid-filled blisters that develop as part of the rash

Symptoms on the body

A skin blistering rash can occur in one or more distinct bands of skin sensory nerves, called dermatomes.

Common locations for this include:

  • the chest
  • the abdomen
  • the back
  • around the waist

It usually occurs only on one side of the body.

The location of the symptoms will depend on which dermatome distribution the virus affects.

Facial symptoms

If the rash affects the face, symptoms usually appear on one side only — usually around one eye and the forehead.

They can include:

  • pain over the affected dermatome
  • a rash
  • muscle weakness
  • headache

Eye symptoms

If the virus affects an ophthalmic nerve it means a person has an ophthalmic herpes zoster.

This can cause discomfort, redness, swelling in and around the eye and temporary or permanent vision loss.

Ear symptoms

Shingles may also occur in or around the head, causing balance and hearing issues as well as muscle weakness on the affected side of the face.

Such improvements can be temporary or even long-term. A person who has symptoms in or around his or her ears and eyes should seek prompt medical care to minimize the risk of complications.

Mouth symptoms

If shingles affects the mouth, a person may experience:

  • facial tenderness
  • pain in the mouth
  • toothache
  • lesions in hard and soft palate tissues

The pain and discomfort of these symptoms can make it difficult to eat or drink.

Internal shingles

Shingles can affect internal organs, too. There won’t be a panic but there might be other issues.

Researchers have found signs of shingles in the digestive system, for example, which can contribute to gastrointestinal dysfunction, and in the brain arteries, which can increase the risk of stroke and dementia.

Other symptoms

There may also be other symptoms, including:

  • fever
  • fatigue
  • chills
  • headache
  • upset stomach

Symptom progression

Symptoms typically progress as follows:

  • Pain, tingling, numbness, and itching start to affect a specific part of the skin.
  • After up to 2 weeks, a rash appears.
  • Red blotches and itchy, fluid-filled blisters develop and continue to do so for 3-5 days.
  • The blisters may merge, forming a solid red band that looks similar to a severe burn. The gentlest touch may be painful.
  • Inflammation may affect the soft tissue under and around the rash.
  • After 7–10 days, the blisters gradually dry up and form scabs or crusts. As the blisters disappear, they may leave minor scarring.

Shingles usually last around 2–4 weeks. It is contagious until the blisters dry up and crust over.

Some people can only get an episode of shingles once, but in certain cases it can recur.

Pictures: What does shingles look like?

  • Nccmed-shingles-rash-caused-by-herpes
  • Nccmed-shingles-rash-on-person-s-shoulder.jpg
  • Nccmed-a-woman-with-shingles-on-her-face-image-credit-burntfingers-2015.jpg
  • Nccmed-shingles-on-a-persons-back-image-credit-yesyouisnot-2011
  • Nccmed-shingles-on-the-face

Complications

Rarely, complications can arise — especially in people with an impaired immune system.

Possible complications of shingles include:

  • postherpetic neuralgia (PHN)
  • inflammation of the brain or spinal cord, increasing the risk of stroke, encephalitis, and meningitis
  • eye and vision problems
  • weakness
  • problems with balance and hearing
  • damage to blood vessels, which could lead to stroke
  • pneumonia

According to the CDC, approximately 10–18 percent of people with shingles may experience PHN, a long-term complication in which a shingles rash’s discomfort lasts longer than the rash itself.

It is more likely to happen if a person develops shingles after 40 years of age, and the risk continues to increase with age.

In people with weak immune systems

People with a weakened immune system will have a higher risk of developing shingles and of experiencing severe symptoms and complications.

This include people who:

  • have cancer, especially leukemia or lymphoma
  • have HIV
  • have undergone an organ transplant
  • are taking medications to suppress the immune system, including chemotherapy drugs

Such individuals will seek medical attention as soon as possible if they have questions about symptoms associated with shingles.

Is shingles contagious?

Shingles can not be transmitted directly to another person. A person who has never had chickenpox, however, may contract VZV by coming into direct contact with the fluid in a person’s blisters that currently has shingles.

If this occurs and the individual has not received vaccination against chickenpox, they will first develop chickenpox and not shingles.

Shingles may not spread by coughing or by sneezing. The virus can only spread by direct contact with fluid from the blisters. Covering the blisters thus decreases the possibility of contagion.

Remember that the virus is only active when the blisters first appear until they warm up and crust over. There’s no transmission before the blisters grow and after the crusts form. In the conventional sense, if a person does not develop blisters, the virus can not spread.

Taking the following measures will help prevent the virus from spreading:

  • Cover the rash.
  • Wash the hands often.
  • Avoid touching or scratching the rash.

It is also important to avoid contact with:

  • infants who are preterm or have a low birth weight
  • pregnant women who have never had chickenpox or the vaccine for it
  • those with a weakened immune system

Treatment

A doctor may prescribe antiviral drugs to stop the virus from multiplying.

Antiviral treatment

Antiviral treatment can help:

  • reduce the severity and duration of symptoms
  • prevent complications from developing
  • lower the risk of the rash coming back

Managing symptoms

Tips for managing symptoms include:

  • using pain relief medication
  • reducing stress as much as possible
  • eating regular, nutritious meals
  • getting some gentle exercise
  • wearing loose fitting clothes, for comfort

To relieve itching, the CDC recommend:

  • applying calamine lotion
  • taking a lukewarm, oatmeal bath
  • placing a cool, damp washcloth on the blisters

Most people should recover with treatment at home, but if other symptoms occur, such as fever, a person should seek medical assistance. Due to injuries, about 1–4 percent of people would continue to spend time in hospital.

Vaccine

Undergoing vaccination can offer protection from both chickenpox and shingles.

For children: Chickenpox vaccine

Experts suggest daily vaccination in childhood with the varicella vaccine (chickenpox vaccine).

With two doses of the vaccine, chances of avoiding chickenpox are at least 90 per cent. Preventing varicose veins also avoids shingles.

The first dose for children will be administered at 12–15 months. The latter dosage is 4–6 years.

Tests have shown that the vaccine is safe while some kids can experience:

  • pain at the injection site
  • a fever and a mild rash
  • temporary joint pain and stiffness

Since vaccination started in children, the number of shingles cases has dropped.

For older adults: Shingles vaccine

Another vaccine, the herpes zoster vaccine, is available for people aged 50 years and over who have had chickenpox and are still carrying VZV. Doctors also recommend this vaccine to those who did not have chickenpox or shingles.

In the US, this virus still occurs in 99.5 percent of people born before 1980. The herpes zoster vaccine in people who already have it may help prevent shingles.

Zostavax and a newer vaccine called Shingrix are the choices available.

After two doses of Shingrix, according to the CDC, a individual will have more than 90 percent shingle safety, dropping to just over 85 per cent after four years.

Who should not have the vaccine?

People who shouldn’t have the shingles vaccine without talking to their doctor about it first include those who:

  • have an allergy to any component of the shingles vaccine
  • have a weakened immune system
  • are or might be pregnant

Causes

Shingles is the product of VZV, the same virus that causes chickenpox. The virus persists inside the body after recovery from chickenpox. It resides dormanently in the peripheral nervous system’s dorsal root ganglion.

VZV is part of a community of viruses called herpes viruses. For this reason shingles also have the name “herpes zoster.”

All herpes viruses can hide in the nervous system, where they can live in a latent state forever.

The herpes zoster virus will “reactivate” under the right circumstances, similar to waking up from hibernation, and move down the nerve fibers to cause a new active infection.

It’s typically not clear what causes this, but it can happen when anything weakens the immune system, causing the virus to reactivate.

Risk factors and triggers

Possible risk factors and triggers include:

  • older age
  • certain cancers or cancer treatment options
  • HIV
  • treatments that suppress the immune system
  • stress or trauma

Outlook

Whoever has had chickenpox can develop shingles.

Most people get a complete recovery from shingles within 3–5 weeks, but some experience severe complications. Those with compromised immune systems are the ones most at risk.

Chickenpox and shingles can be prevented from getting varicella vaccination during childhood. Certain inoculations are available for those who didn’t have the vaccination during childhood.

People aged 50 and over will talk about vaccination with their doctor.

Q:

Is it possible to have the virus without ever having symptoms of chickenpox?

A:

The virus that causes chickenpox and shingles spreads as a result of exposure to the infected fluid in the blisters that develop as a symptom of these conditions.

Those who receive the live vaccination for chickenpox will receive an injection of a weaker form of the virus. This should cause the body to make antibodies that can fight against the virus. Because of this, 90% of those who have the vaccination will not get chickenpox.

If a person comes into contact with blister fluid from someone with chickenpox or shingles, if they were vaccinated and have formed immunity against the virus, they should not develop chickenpox symptoms. Nor should they be able to catch any infection that they can spread to others, even if they have exposure to the virus when someone near them has chickenpox or shingles. Stacy Sampson, DO

Answers represent the opinions of our medical experts. All content is strictly informational and should not be considered medical advice.

Dermatology

Causes, symptoms, treatment of psoriasis in the ears

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Psoriasis is a skin condition caused by an autoimmune disease. In some parts of the body, such as the ears, a thick layer of skin cells can form.

It usually affects the elbows, knees, legs, back, and scalp, although it can also affect more sensitive body parts.

Psoriasis is the most common autoimmune condition in the United States, and it comes in a variety of degrees of severity.

This article discusses the causes of psoriasis in the ears as well as treatment alternatives.

What is psoriasis?

psoriasism in ear

Psoriasis is caused by an overactive immune system, which causes the fast development of extra skin cells. Experts aren’t sure whatcauses causing it.

It takes roughly 28 days for healthy skin cells to form. The body eliminates old skin cells during this time to make place for new ones.

In people with psoriasis, the body produces new skin cells every 3 to 4 days, leaving little time for old cells to slough.

This results in the accumulation of old and new cells on the affected areas, resulting in thick, red or silvery scales. These scales are often itchy, crack, and bleed, and they can be uncomfortable.

Researchers are still trying to figure out why psoriasis arises in certain parts of the body, including why some people get it in their ears while others don’t. They do know, however, that it cannot be passed from person to person.

According to a report published in the journal American Family Physician, psoriasis is not contagious. Scratching or touching does not cause psoriasis or transfer it to other parts of the body.

Psoriasis around the ears

People with psoriasis in their ears are extremely uncommon. However, if this occurs, an individual’s emotional and physical well-being may be jeopardised.

Psoriasis can cause the skin rough and scaly. Self-consciousness may be felt by people who have symptoms on their face and ears.

Because the skin on the face is frequently more delicate than that on the elbows, knees, and scalp, some treatments may be excessively harsh for this area. As a result, ear psoriasis might be more difficult to cure.

A blockage can occur if scales and wax build up inside the ear. Itching, pain, and hearing loss may cause from this obstruction.

Scales should be kept out of the ear canal to avoid hearing loss and discomfort.

Psoriasis might worsen over time for certain people. This can happen when something sparks a flare, but it’s often unknown why some people’s psoriasis spreads or worsens. New parts of the body, such as the ears, can be affected at any time.

There is no link between psoriasis in the ears and cleanliness, contact, or other things.

Anyone with psoriasis in their ears should see a doctor to find out which psoriasis treatments are safe to use in their ears.

Treatment

Although there is no cure for psoriasis, it is generally managed with treatments.

People who have psoriasis in their ears may need constant medical attention to keep flares under control and avoid problems like hearing loss.

Some psoriasis drugs should not be used in the ears. Certain topical lotions and ointments, for example, may irritate the fragile eardrum. People should inquire about drugs that are safe for the ear canal with their doctor.

Among the treatment options available are:

  • Eardrops containing liquid steroids.
  • In addition, liquid steroids may be used in conjunction with another psoriasis treatment, such as a vitamin D cream.
  • Shampoos with antifungal properties to help clean the ear and kill fungus.
  • Medications that help the immune system work more efficiently.
  • A few drops of heated olive oil to moisturise and remove wax inside the ears and keep them clean

If psoriasis in the ear causes discomfort or interferes with hearing, a specialist can safely and effectively remove the scales and wax.

It is critical not to attempt to remove the scales by inserting things into the ears.

Pushing the debris deeper into the ear can cause in a blockage, eardrum damage, or skin injury.

A doctor may give a systemic drug if the symptoms are mild to severe. Biologics, a relatively new class of medications, can treat the underlying causes of psoriasis.

Causes

The causes of psoriasis differ from individual to person. Certain factors can briefly aggravate psoriasis before it returns to normal for some people.

Others see their scales and other symptoms get worse over time.

In any case, psoriasis people should strive to avoid triggers wherever feasible. Those who have psoriasis in their ears may notice that a flare affects their hearing, which can be extremely aggravating and frustrating.

The following are some of the most common psoriasis triggers:

  • Stress: While it may not always be feasible to avoid the causes of stress, being able to manage it can help prevent flare-ups. Relaxation, exercise, deep breathing, and meditation may all be beneficial.
  • Medications: Certain medications, such as those for high blood pressure, heart disease, arthritis, mental health disorders, and malaria, might aggravate psoriasis. People with psoriasis should work with their doctors to discover treatments that do not exacerbate their condition.
  • Cuts, scrapes, sunburn, and other skin injuries: Any type of skin trauma might cause in a new case of psoriasis in the affected area.
  • Certain illnesses: When an infection strikes, the immune system goes into overdrive. This can also cause psoriasis flare-ups. Strep throat, ear infections, tonsillitis, and even regular colds can all cause flare-ups.

Avoiding triggers, whether on the ears, face, or other parts of the body, is an important component of controlling this condition.

Hearing loss and psoriasis

Even if psoriasis does not damage the skin in and around the ears, a person may nevertheless experience hearing loss.

People with psoriasis are more prone to acquire abrupt deafness, according to a study published in the American Journal of Clinical Dermatology.

This type of hearing loss might happen in a matter of minutes or over the course of a few days. People over the age of 50 are more likely to be affected by it.

The cause of sudden deafness in psoriasis is unknown, however it could be linked to the immune system harming part of the inner ear. Within 2–3 weeks, almost half of those who have abrupt deafness regain some or all of their hearing.

Doctors may advise that people with psoriasis and psoriatic arthritis have regular hearing tests to ensure that any abnormalities are detected and treated early.

Living with psoriasis in the ears

Many people suffer from psoriasis, which can be emotionally and physically draining, but with the help of a doctor, they can generally manage the condition.

Finding an effective treatment, whether the flares occur in the ears or elsewhere, is critical to reducing symptoms and flares.

Hearing tests and ear examinations should be done on a regular basis for people who have psoriasis in their ears so that any difficulties can be addressed as soon as feasible.

Because everyone with psoriasis reacts to drugs differently, finding the proper treatment may take some time. Some people’s psoriasis medicine stops working over time, necessitating the use of a different treatment.

People with psoriasis should be able to live full, active lives once they find a suitable treatment.

Conclusion

Psoriasis is a painful, long-term skin condition that can affect the inside and outside of the ear.

It is more difficult to treat than psoriasis elsewhere on the body when it does this. Hearing loss can occur as a result of the condition, both temporary and permanent. Although a complete treatment is not yet attainable, people can control their symptoms with condition and live a normal life.

To avoid serious flare-ups, get regular hearing tests and consultations.

Sources:

  • https://www.psoriasis.org/about-psoriasis/causes
  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4797675/
  • https://www.jaad.org/article/S0190-9622(18)33001-9/fulltext
  • https://www.psoriasis.org/about-psoriasis/specific-locations/face
  • https://www.aad.org/public/diseases/scaly-skin/psoriasis
  • http://www.niams.nih.gov/Health_Info/psoriasis/default.asp
  • https://www.medicalnewstoday.com/articles/314768
  • http://www.aafp.org/afp/2007/0301/p715.html
  • https://www.psoriasis.org/content/statistics
  • https://www.nidcd.nih.gov/health/sudden-deafness
  • http://www.arthritis.org/about-arthritis/types/psoriatic-arthritis/what-is-psoriatic-arthritis.php
  • https://www.ncbi.nlm.nih.gov/pubmed/25687690

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Dermatology

Causes, symptoms, and treatments of nasal polyps

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Nasal polyps are fleshy swellings that grow in the lining of the nose and the paranasal sinuses, which are air-filled cavities that connect the nasal cavity to the rest of the body. They aren’t malignant tumours.

Polyps come in a variety of sizes, colors, and shapes, such as teardrops. They eventually resemble grapes on a stem as they mature.

Polyps can appear in one or both nostrils at the same time, and they can grow alone or in groups.

Large polyps or clusters can obstruct the patient’s ability to breathe and cause their sense of smell. They have the potential to obstruct the sinuses and cause issues such as recurring infections.

Nasal polyps afflict 4-40% of the general population, and males appear to be 2-4 times more likely than females to develop them. People that develop them are usually in their twenties or thirties.

They are more prone to forming in people who have asthma, sinus infections, or allergies. Nasal polyps can occur in children with cystic fibrosis.

The causes

nasal polyps

Nasal polyps are caused by a variety of causes that are unknown. Although non-allergic asthma is associated to a large percentage of cases, no respiratory or allergic trigger is detected in some cases.

Colonic and uterine polyps, which are found in the digestive tract and uterus, respectively, have no relation to nasal polyps.

Although the specific mechanism of polyp creation is uncertain, most studies agree that they are caused by swelling (inflammation) in the nose or sinuses and are not a disease.

Inflammation, according to some experts, causes fluid to accumulate in the interstitial space (the space between mucous-forming cells) of the nose and sinuses. Gravity eventually pushes these heavy cells down, becoming polyps. A bacterial or viral infection, an allergy, or an immunological response to a fungus are all possible triggers, according to scientists.

Nasal polyps most commonly arise around the sinus openings (in the nasal passage), however they can form elsewhere in the nasal passages or sinuses.

Diagnosis

After asking about symptoms and seeing the patient’s nose, a doctor should be able to make a diagnosis. With the help of a lit tool, polyps are frequently visible.

The following tests may be ordered by the doctor:

  • Nasal endoscopy – a narrow tube with a small camera (or magnifying lens) is inserted into the patient’s nose.
  • CT scan – this enables the doctor to locate nasal polyps and other abnormalities linked to chronic inflammation. The doctor will also be able to identify any other obstructions.
  • Skin prick allergy test – if the doctor thinks that allergies may be contributing to polyp development, he or she may do an allergy test.
  • Cystic fibrosis – if the patient is a young child, the doctor may order a cystic fibrosis test.

Treatment options

Nasal polyps are commonly treated with the following methods:

1) Steroids

The doctor may prescribe a steroid nasal spray or drops to reduce inflammation and shrink the polyps. Patients with one or more small polyps are more likely to receive this treatment. The following are examples of possible side effects:

2) Tablets containing steroids

In cases of larger polyps or more severe inflammation, steroid tablets may be administered, either alone or in combination with a nasal spray. Although steroid tablets are successful at shrinking polyps, they carry the risk of more serious side effects, such as weight gain, and should only be used for a few weeks at a time.

3) Additional drugs

Other medications may be used to treat disorders that exacerbate the inflammation. Antihistamines for allergies, antibiotics for bacterial infections, and antifungal medicines for fungus allergies are just a few examples.

4) Surgery

Surgery is only utilised if the polyps are exceedingly large or if the patient’s other therapies have failed.

Polypectomy

The most common method for removing polyps is surgery. A local or general anaesthetic is administered to the patient. In the patient’s nose and sinuses, a long, thin tube containing a video camera is introduced.

Micro-telescopes and surgical equipment are then used to cut away the polyps. To free up the nasal canal, the surgeon may remove small pieces of bone from the nose.

To help prevent recurrence, the patient will most likely be prescribed a corticosteroid nasal spray after surgery. To aid post-surgical healing, some doctors prescribe using a saline (saltwater) rinse.

Natural treatments

If the symptoms of a nasal polyp appear to be related to an allergic reaction, avoiding the allergen that causes the reaction would most likely assist.

Although tea tree oil and other therapies have been suggested, there appears to be little evidence to back them up.

A steam bath might help relieve congestion symptoms.

Only a high therapeutic dose of vitamin D can help lessen symptoms. It is unknown how this works, how it should be supplied, or how effective it might be.

Complications

A big polyp, or cluster of polyps, can sometimes obstruct the flow of air and the drainage of fluids from the sinuses or nasal cavity, resulting in the following complications:

  • Chronic or frequent sinus infections.
  • Obstructive sleep apnea.
  • The structure of the face may be altered, leading to double vision. Sometimes, the eyes may be set wider apart than normal (more common in patients with cystic fibrosis).

Preventive tips

  • Humidity. Consider using a humidifier if your home’s air is dry.
  • Hygiene. Handwashing frequently and thoroughly lowers the risk of bacterial or viral infection, resulting in fewer incidences of sinus and nasal tract inflammation.
  • Irritants. Some people may be able to lower their risk of developing polyps by avoiding irritants such as allergies, chemicals, and airborne pollution (which cause inflammation).
  • Asthma and allergy management. Patients who follow their doctor’s asthma and/or allergy treatment guidelines are less likely to develop nasal polyps.
  • Nasal lavage or nasal rinse. Using a nasal lavage or saline spray to rinse the nasal passages can assist increase mucus flow and remove irritants and allergens.

Sources:

  • http://onlinelibrary.wiley.com/doi/10.1002/lary.23610/full
  • http://www.ncbi.nlm.nih.gov/pubmed/12383287
  • http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3179194/
  • https://www.medicalnewstoday.com/articles/177020
  • http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2504067/
  • http://www.hoajonline.com/histology/2055-091X/1/2
  • http://www.mayoclinic.org/diseases-conditions/nasal-polyps/basics/symptoms/con-20023206
  • http://www.nhs.uk/Conditions/Polyps-nose/Pages/Treatment.aspx
  • https://journalotohns.biomedcentral.com/articles/10.1186/1916-0216-42-27

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Dermatology

Cold sores: What to know

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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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