Cold Sores

Cold Sores (also called facial herpes, labial herpes or orofacial herpes) are caused by a virus, usually herpes simplex virus type 1 (HSV-1), which is passed from person to person by direct contact with infected skin or saliva.

Most people are infected with HSV-1 for the first time during childhood. The first infection, known as a primary infection, is not accompanied by symptoms in 70% of individuals. If symptoms do occur, they most often include a fever, flu-like symptoms, a sore mouth and a sore throat (pharyngitis).

Painful blisters can occur on the tongue, in the mouth and near or on the lips. These blisters are most often mild. The blisters, which develop into ulcers, last for approximately 12 days. The number of blisters generally peaks at about 6 days and then decreases. There can be neck pain and enlarged lymph nodes. The lymph nodes can be seen or felt as bumps below the skin. There can be bad breath and drooling. In severe cases, children may refuse to eat or drink because of the pain caused by the infection. In such cases, their guardians should visit a physician. In older people (such as teenagers) who become infected with the virus for the first time, the symptoms may be more severe than in young children. The sore throat and flu-like symptoms may be difficult to distinguish from glandular fever.

Recurrent Cold Sores (HSV-1 Infection):

Infection with HSV-1 can cause recurrent symptoms, commonly known as cold sores. Most people are infected with HSV-1 but only one-fifth to two-fifths are thought to develop cold sores. Many people, who experience cold sores, have two or three outbreaks (recurrences) each year. Recurrences are shorter and there is generally less discomfort than during a primary infection. Blisters tend to be more localized than during a primary infection and normally heal within 8-10 days. Pain subsides quickly, often in 4-5 days. The triggers for a cold sore outbreak are not certain but may include sunlight (UV light), fever, stress, or surgical procedures (e.g. dentistry).

Cause of Cold Sores
  • Cold sores are caused by the herpes simplex virus, usually by type 1 (known as HSV-1). The other type of herpes simplex virus, HSV-2, usually causes genital herpes
  • In general, we are infected with HSV-1 when we are children; in the majority of these initial (“primary”) infections, there are no symptoms
  • Usually, the virus infects our mouths. Some children experience mouth and gum symptoms (“gingivostomatitis”) or a sore throat (“pharyngitis”).
You get Cold Sores due to virus reactivating in our bodies
  • Once HSV-1 has entered our bodies, it never leaves. The virus moves from the mouth to quietly reside (“remain latent”) in the central nervous system.
  • In approximately one third of people, the virus can “wake up” or reactivate to cause disease
  • When reactivation occurs, the virus travels down the nerves to the skin where it may cause blisters (cold sores) around the lips, in the mouth or, in about 10% of cases, on the nose, chin, or cheeks
  • Many people who suffer from cold sores are aware in advance that a cold sore is about to break out — they have a tingling or burning feeling, redness, itching, or pain (“prodromal symptoms”) around their lips or mouth
  • Cold sore outbreaks may be influenced by stress, menstruation, sunlight, sunburn, fever, or local skin trauma.
The Virus that Causes Cold Sores is Infectious
  • 30%-60% of children below 10 years of age are infected with HSV-1. They have acquired the virus from family and friends through sharing utensils or toothbrushes, and from kissing
  • The virus is transmitted from cold sores and also when there are no symptoms, as it can make copies of itself on the skin in the absence of a blister. This phenomenon is called “asymptomatic shedding”
  • By 50 years of age, 80%-90% of us harbour HSV-1 because we have caught it from someone close to us
  • HSV-1 can sometimes be transmitted to newborn babies by family members or hospital staff members who have cold sores; this can cause a severe disease called neonatal herpes.
The Virus from Cold Sores can infect other areas of the body
  • People can transfer the virus from their cold sores to other areas of the body, such as the eye, skin, or fingers; this is called “autoinoculation”
  • Eye infection, in the form of conjunctivitis or keratitis, can happen when you rub the cold sore, then rub your eyes before washing your hands
  • Finger infection (“herpetic whitlow”) can occur when a child with cold sores or primary HSV-1 infection sucks his/her fingers
  • HSV-1 can infect your genital area if you engage in oral sex with a partner with a cold sore
Early Treatment Can Help Eliminate the Cold Sore
  • Some products can accelerate healing if they are used at the prodromal stage of the cold sore
  • Frequent hand washing minimizes the risk of transferring the virus to other areas of your body
Cold Sores - Prevent and Treat Them

Cold sores are very common and quite contagious. Sometimes referred to as fever blisters, cold sores are caused by the herpes simplex1 virus (HSV-1). They can appear as a single blister or cluster of them, often recurring in the same location, including on and around your lips, nose, chin or cheeks. Cold sores are often confused with canker sores, but canker sores are actually sores or ulcers that occur inside your mouth, and are not contagious.

Causes and Triggers

We are usually infected by the virus when we are children, and once the virus enters our bodies it never leaves. Most of the times, the virus quietly hides or sleeps in our central nervous system, but certain triggers cause it to "wake up" and cause cold sores. Common triggers include stress, menstruation, sunlight, fever, dry chapped lips, or local skin trauma.

How a Cold Sore Develops

Many people who suffer from cold sores know when one is coming by the distinctive (and often dreaded) tingling or burning, redness, itching or pain they feel around their lips or mouth. This is the first stage of a cold sore and these symptoms are sometimes called prodromal symptoms. This first stage can happen very quickly - from a few hours to a day or two. You might even go to bed without any symptoms and wake up to find you have a cold sore!

The next stage of a cold sore is the formation of one or more blisters. After the blister(s) has developed, it breaks and an unsightly yellow crust forms. Within a few days this crust falls off and leaves behind a pinkish skin that heals without a scar. The entire process usually takes between 8 to 10 days.

It is important to remember that cold sores are contagious. The virus can be passed from person to person and from one area of your body to another through skin-to-skin contact - even when blisters are not present. The virus is often transferred by kissing or oral sex, as well as by hands or fingers that have touched a cold sore. The virus can even be passed by sharing cups, cans, glasses, eating utensils, towels and food items such as sandwiches.

Cold Sore Treatment

You can't cure or prevent cold sores, but you can take steps to reduce how often they occur and shorten the length of an outbreak.

Cold sores often clear up without treatment in 7 to 10 days. Early treatment during the initial tingling or burning stage may stop the blister from forming, or help the cold sore heal faster once it has formed. It's good to know that there are certain antiviral products that can help. Also, herbal and homeopathic preparations are known to stimulate the immune system of the affected individual so as to combat the virus and cause healing of the outbreaks.

Cold Sore Prevention

You can take steps to guard against cold sores - to prevent them from occurring and to prevent the virus from being passed to other parts of your body or to other persons:

  • Use a lip moisturizer regularly to prevent your lips from becoming dry or chapped.
  • Try to avoid cold sore triggers such as stress or overexposure to the sun.
  • Limit your exposure to the sun or UV lamps, and always use a sunscreen lip balm with an SPF of at least 15.
  • During times of high stress, consider trying relaxation therapy.
  • Keep your immune system strong by maintaining a healthy diet and getting enough sleep.
  • Avoid kissing and skin contact with people, especially children, while blisters are present.
  • Avoid sharing food, cups/glasses/cans, utensils and towels when blisters are presen Keep your hands clean - wash them frequently to avoid passing on the virus or infecting other areas of your body.
Symptoms caused by HSV 1 infection (HSV 1 is known to affect the following areas of the body.)

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Types of Human Herpes Virus
After reviewing the following data you are now in a position to take an informed decision. We hope you make the right choice and we will be with you on your journey to recovery. Please get in contact with any of our Doctors if you need any further information.

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