Connect with us

Dermatology

What’s to know about neurofibromatosis?

Published

on

Neurofibromatosis is an incurable nervous-system genetic disorder. It mainly impacts nerve cell tissue growth. Tumors known on the nerves as neurofibromas develop, and these may lead to other problems.

The tumors may be harmless, or may compress nerves and other tissues, resulting in severe damage.

Neurofibromatosis (Nf) is the most common neurological genetic condition caused by a single gene. The gene mutation means the nerve tissue isn’t properly controlled.

Three forms exist: nf1, nf2, and schwannomatosis. They are not linked to each other. This article focuses primarily on Nf1 and Nf2.

Treatment

 A lady under cochlear implant
A cochlear implant can help people with hearing loss.

While neurofibromatosis has no cure, its symptoms can be treated.

Neurofibromas are not normally harmful but they may be removed if their position on the body means they graze or catch on clothes. This reduces the chance of scratching, infection, numbness and pain in general. They can however grow back.

Medications and lifestyle improvements can be used to treat Hypertension. Daily inspections are recommended.

If eyesight is compromised by tumors arising on the optic nerve, these may be removed surgically.

Scoliosis, or spine curvature, may be treated by surgery, or by wearing a back brace.

Tumors are typically monitored periodically, and care is administered as appropriate.

Acoustic neuroma

Acoustic neuromas surgery does not always enhance hearing, and can make it worse. The decision to remove an acoustic neuroma will depend on the tumor size and how rapidly it develops, not just hearing loss.

Often, an auditory brain stem implant (ABI) is implanted by a surgeon to help a person hear. We can at the same time remove a tumor in the vestibulocochlear nerve.

The surgeon must make an incision on the side of the head in the skin and remove some of the bone from behind the ear. This reveals the tumor and provides access to the brain stem below for removal.

Individuals with an ABI wear external receivers and speech processors. It transforms sound into electrical signals which will be sent to the implant afterwards.

After the tumor has been removed a cochlear implant can be mounted. A tiny, complex electronic system will help give someone with serious or extreme hearing issues a sense of sound.

An outer portion is placed behind the ear, and a second portion under the skin is surgically inserted. The implant consists of a amplifier, a speech processor, and a transmitter and receiver or stimulator to absorb signals and transform them into electrical impulses from the speech processor.

The stimulator impulses are received by a group of electrodes and sent to various parts of the auditory nerve.

The implant is unable to restore natural hearing, but it does provide useful sound reproduction and this can help a person understand speech.

An audiologist can advise on managing tinnitus and balance, or ringing in the ears. Some people suffering from neurofibromatosis learn to read lips and use sign language.

Radiotherapy or chemotherapy can help shrink a tumor, and research is ongoing to find a drug that can eliminate or reduce tumors.

Symptoms

The neurofibromatosis symptoms are dependent on the type.

The disorder can spread all over the body, leading to tumors and irregular pigmentation of the skin.

It can manifest as bumps under the skin, dark spots, bone problems, pressure on the roots of the spinal nerve and other neurological issues.

You may experience learning disorders, behavioral problems, and loss of vision or hearing.

Nf1

Some people with Nf1 have only one skin disorder, and no other associated medical issues. In general, signs and symptoms occur during early childhood. They seem not to be harmful to health.

Skin growths may occur with both Nf1 and Nf2.
Skin growths may occur with both Nf1 and Nf2.

Birthmarks are common, and so are the freckles. Coffee-colored marks typically develop on the skin at birth. Where more than six marks appear at 5 years of age, this may mean Nf1. The number of spots may increase, and over time they can get bigger and darker.

Freckles can occur under the breasts or in the axes at an unusual position, such as the groin.

Neurofibromas are tumors, normally non-cancerous, which develop on the skin’s nerves, and often on deeper within the body’s nerves. Under the the skin they feel like lumps. They may grow over time, and they can get bigger. Neurofibromas may be soft, or round and firm.

Lisch nodules can also be present. There are very small brown spots that can appear in the eye iris.

People with Nf1 often face a higher risk of high blood pressure, or hypertension.

Nf2

Nf2 is a more serious condition where tumors develop deep within the body on nerves.

An acoustic neuroma is a common type of brain tumor that spreads from the brain to the inner ear into the nerve.

Symptoms may include:

  • facial numbness, weakness and sometimes paralysis
  • gradual, or more rarely sudden, hearing loss
  • loss of balance, dizziness, and vertigo
  • tinnitus, or ringing in the affected ear

Symptoms can worsen as the tumor grows. The neuroma can compress the brainstem, which is potentially life-threatening. There could be no complications with a small tumor.

Tumors develop sometimes on the skin, brain, and spinal cord, with potentially severe consequences. Some tumors develop rapidly, but most grow slowly, and for several years the effect may not be noticable.

Regular monitoring can allow for the removal of tumors before complications occur.

Light brown pigmentation spots can occur but they will be less common and less numerous than in Nf1 people.

Cataracts can happen. That could be a symptom of Nf2 if a child develops a cataract. These are easily removed, and are not usually troublesome when treated.

Types

The three types of neurofibromatosis are Nf1, Nf2, and schwannomatosis.

Type 1 neurofibromatosis (Nf1)

The most common type of neurofibromatosis is NF1, also known as von Recklinghausen’s disease, von Recklinghausen NF, or peripheral neurofibromatosis. This results more from a mutation of the Nf1 gene, rather than a deletion. 1 in every 3000 people is thought to be affected.

Birthmarks can show up in different parts of the body shortly after birth.

Late childhood lesions, or tumors, can appear on or below the skin, counting from a few to thousands. The tumors also become cancerous.

Nf1 can hardly be seen, it can be unsightly or it can lead to problems that are potentially dangerous. Of the cases, about 60 percent are minor.

Did the ‘elephant man’ have Nf1?

It’s a common misconception that Nf1 was made famous by Joseph Merrick, the “Elephant Man,” the 1980 movie starring John Hurt.

In 1986, however, geneticists revealed that Merrick did not have Nf1 but Proteus syndrome, a rare disorder affecting less than 1 in 1 million people.

Researchers suggest uncertainty between the two conditions may be detrimental to people with Nf1.

Claire-Marie Legendre and co-authors point out in a study published in 2011:

“Confusing NF1 with the Elephant Man’s condition harms the interests of those with NF1, all the more so because it is known that NF1 sufferers experience difficulty establishing social ties and developing good self-esteem.”

The authors call for changes in attitude to dispel the confusion.

Type 2 neurofibromatosis (Nf2)

Bilateral neurofibromatoses, or Nf2, are usually caused by a mutation of the Nf2 gene, rather than a deletion. It is transmitted into Nf1 on a separate chromosome.

In the nervous system, tumors form, usually inside the skull. These are called intracranial tumors. Tumors in the intraspinal spinal canal may develop.

Acoustic neuromas that develop on the vestibulocochlear nerve, or the eighth cranial nerve, are typical in Nf2.

The vestibulocochlear nerve is responsible for hearing and affects the sense of balance and position of a person’s body so that a hearing and balance loss may occur.

Symptoms tend to arise during the late teens and early twenties. Tumors may become cancerous.

Schwannomatosis

Schwannomatosis is a rare form of neurofibromatosis that is genetically different from Nf1 and Nf2. It affects fewer than 1 in 40,000 people.

Schwannomas, or tumors in the tissue around a nerve, can develop anywhere in the body, except for the vestibulocochlear nerve, which is the nerve that goes to the ear. It does not involve the neurofibromas that are common in Nf1 and Nf2.

The tumors can cause severe pain, numbness, tingling, and weakness in the toes and fingers.

Causes

Birthmarks and freckles are a common sign of Nf1.
Birthmarks and freckles are a common sign of Nf1.

Neurofibromatosis can affect all cells of the neural crest, including those of Schwann, melanocytes, and endoneurial fibroblasts. It can damage the bones and cause intense pain.

Nf1 causes a gene mutation also known as Nf1. This gene normally yields a protein that keeps nerve tissue growth in check.

However the gene produces an incomplete protein in people with the disease. This protein is much less effective in moderating tissue growth in the nervous system, and this leads to tumors developing in someone with Nf1.

This gene is found on the 17th chromosome.

On chromosome number 22 Nf2 affects a related gene.

In roughly half of all known cases, both major types are passed from a parent to a child, and only one parent needs the faulty gene for a child to face the risk of developing neurofibromatosis.

In the other half of cases, those genes in a sperm or egg cell will undergo what is known as a sporadic mutation. The causes of sporadic mutations and their risk factors are unclear.

The mutation may also occur in Nf2, after an embryo is conceived in a form called Mosaic Nf2. This is a milder type of the illness.

Diagnosis

Nf1 is normally diagnosed in infancy. A diagnosis is confirmed when a person has at least two of these:

  • a family history of Nf1
  • a glioma, or tumor, on the optic nerve, usually without symptoms
  • lesions in the bone
  • at least six “café-au-lait” spots measuring more than 5 millimeters across in children or 15 millimeters in adolescents and adults
  • at least two Lisch nodules, or small brown spots in the iris
  • freckling in the armpits, under the breast, or in the groin area
  • two or more neurofibromas, or one “plexiform”

Plexiforms affect approximately 25 percent of Nf1 men. Plexiforms are neurofibromas that spread as they expand around large nerves, causing the nerve to become thick and disfigured. They sound like knots under the fat, or ropes. They may be tall, painful and disfiguring. Plexiforms usually begin to develop during infancy.

To test for marks on the skin a special lamp is used. Many methods for the diagnosis include an X-ray, CT or MRI scan. In addition, a genetic blood test may be used.

Diagnosing Nf2

Symptoms of Nf2 normally occur in adulthood or around puberty. The most prevalent starting age appears to be 18 to 24 years.

A diagnosis of Nf2 is made when there is:

  • acoustic neuroma in one ear, plus two or more typical symptoms, such as cataracts, brain tumors, and a family history of the condition
  • acoustic neuroma in both ears
  • acoustic neuroma plus brain or spinal tumors, detected by an MRI or CT scan
  • a faulty gene, identified through a blood test

A Neurologist will be assigned to a individual with Nf2. Hearing and eye testing will search for cataracts, other eye conditions and issues with hearing.

Complications

The complications for each type of neurofibromatosis are different.

Complications of Nf1

Problems of vision and hearing can occur when a tumor or neuroma presses on the nerves leading to the ears or eyes. As a result, children may suffer learning and behavioral challenges.

Approximately 50 percent of Nf1 children face learning challenges. It can also affect the short-term memory, spatial perception, and coordination.

Many Nf1 issues cover:

  • epilepsy
  • large head size
  • benign skin tumors that, in a few cases, may become cancerous
  • curvature of the spine, or scoliosis
  • gliomas, or tumors on the eye nerves, occasionally causing eyesight problems
  • hypertension
  • problems with speech
  • short stature
  • skeletal problems

There may be early or late sexual development and puberty.

Complications of Nf2

People with Nf2 may develop benign tumors in the skin, similar to the NF1 characteristics. These should be monitored if they are growing, changing or causing pain.

Benign brain tumors can place pressure on parts of the brain and cause seizures, problems with eyesight and problems with balance. Some get cancer.

Tumors of the spinal cord may develop on the nerves surrounding the spine, causing tremor, numbness and pain in the limbs. Tumors around the neck area can, for example , cause facial problems with smiling, blinking or swallowing.

Outlook

Many people with Nf1 have only mild symptoms, and they can live a healthy, normal life. Complications can shorten lifespan, but a person with Nf1 can still expect to live without the condition for the same period of time as anyone else.

Symptoms may need to be monitored periodically to prevent complications from forming.

There is a less optimistic view to Nf2. While its tumors are generally benign, the location and amount of tumors can impair quality of life and cause early mortality. People with Nf2 live on average until they are 36 years old.

Dermatology

Causes, symptoms, treatment of psoriasis in the ears

Published

on

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

Continue Reading

Dermatology

Causes, symptoms, and treatments of nasal polyps

Published

on

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

Continue Reading

Dermatology

Cold sores: What to know

Published

on

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

Continue Reading

Copyright © 2022 NccMed.com