“Cold sores are very common and highly contagious. Most people catch cold sores at a young age through close contact with someone who has the herpes simplex virus. Whilst cold sores are a minor condition in most cases, they can cause embarrassment and pain, so treatment may be needed. Many people are not aware that for treatment to be effective, it needs to be taken before the sore appears. Treating cold sores in the very early ‘tingling’ stage will reduce the outbreak significantly.”
What are cold sores?
Cold sores are blisters which are highly contagious and caused by the herpes simplex virus, also known as HSV-1. Blisters usually appear around the mouth and are sore, pus-filled and itchy, and can last for around 10 days. Type 1 of the herpes simplex virus usually affects the face and lips but it can spread to other parts of the body including the genitals which is most commonly caused by HSV-2. The herpes simplex virus is very common with 75% of the population are estimated to be infected, but not all will develop cold sores or are aware that they have the virus.
The herpes simplex virus is easily passed on through close contact to infected skin or fluids. The virus can lay dormant in the body for months or years before it shows the symptoms of cold sores. Once you catch the virus it will stay in the body for life and you may have recurrent outbreaks. Outbreaks are caused by a number of triggers such as stress, sunlight, or illness, and if you know your trigger it’s best to avoid them to prevent an outbreak.
There are many stages of the the herpes simplex virus when cold sores develop. Before a cold sore shows you will feel a tingling or itching sensation on the lip which can happen a few days before the start of a cold sore appears in the form of a spot. These spots are usually painful and will develop into blisters which are filled with fluid, cold sores are particularly contagious at this stage and when they’re oozing.
Cold sores will eventually begin to heal and a scab will form. You may develop a cluster of cold sores in one place and they can be irritating and painful. This virus can be unsightly and sore so it’s important to be hygienic when you have cold sore to prevent spreading to other people or other parts of your body.
What are the other symptoms of cold sores?
In the first outbreak you may experience more symptoms other than blisters. As well as cold sores, the herpes simplex virus may cause a fever, sore throat and swollen glands, painful sores inside the mouth, headaches, muscle aches, and painful gums. These symptoms are common in children but adults can also develop these symptoms, particularly if it’s the first outbreak. The symptoms of cold sores usually clear up in 7-10 days but if they persist you should see a GP to avoid the complications of the herpes simplex virus.
Are cold sores serious?
In the majority of cases cold sores are nothing to worry about, although they’re unsightly and can cause some people embarrassment and discomfort, they will be cleared within two weeks. In rare cases you may develop complications from the cold sore virus. These complications are more likely to occur in people who have weakened immune systems such as those who are going through chemotherapy treatment or have HIV. It’s important to be particularly careful around people who have illnesses such as these if you have a cold sore so that they don’t catch the virus, which could potentially be dangerous for them.
To avoid the risk of complications it’s important to not let the virus spread to other parts of the body by regularly washing your hands and avoiding touching any other part of the body after touching the cold sore.
The spread of cold sores can cause infections of the skin, particularly if the virus has come into contact with broken skin or wounds. You can also develop further conditions known as herpetic whitlow which infects the fingers with sores and blisters, and herpetic keratoconjunctivitis which causes swelling and irritation of the eyes and sores on the eyelid. Herpetic keratoconjunctivitis can seriously affect your vision so it’s important to avoid touching your eyes whilst you have a cold sore.
Eczema sufferers can also suffer badly with an outbreak of cold sores, particularly if the virus comes into contact with eczema and develops into a serious condition known as eczema herpeticum which may require antibiotics.
In very rare cases you can develop encephalitis, a serious condition which causes swelling of the brain, sometimes as a result of the herpes simplex virus spreading.
Many people also suffer dehydration when a cold sore is present. Cold sores can make eating and drinking painful and it can be easy to neglect drinking enough fluids whilst you have sore blisters on your lip.
How to prevent catching the cold sore virus or an outbreak
Given that so many people carry the herpes simplex virus it is difficult to prevent as so many of these people have the virus without knowing and will not be aware that they need to take precautions. If you are aware that you have the virus you can reduce the spread of infection when you have a cold sore. Cold sores are more contagious when blisters burst, therefore you should avoid close contact with people until the sore has healed. You should also regularly wash your hands and avoid touching the infected area as much as possible, always remembering to wash your hand thoroughly if you do happen to touch it. You should also avoid sharing cutlery, or kissing and oral sex as you may cause genital herpes.
There are ways to avoid an outbreak. Firstly, you should get to know what triggers a cold sore outbreak. Stress, fatigue, cold weather, sunlight and a weakened immune system can all cause an outbreak of the virus. You should keep your lips moisturised in cold weather and use an SPF sunblock lip balm in the sunshine. Avoid stress as much as possible and strengthen your immune system by eating healthily to prevent illnesses and infections.
When you feel the tingling or itching sensation this is the time to apply creams or try other methods to prevent the virus reaching the surface of the lip. Cold sores creams are best applied in these early stages of the virus to prevent or shorten an outbreak. Before a cold sore appears the lip can also burn and cold sores thrive in a warm environment, apply ice to the infected area when the tingling and burning occurs and it may stop the cold sore in its tracks. This will also help to reduce pain and inflammation if the cold sore has appeared.
How to treat a cold sore and shorten the duration
If you haven’t caught the virus in its early stages, there are ways to help the cold sore heal quicker. Antiviral medications such as Zovirax help to reduce the severity and duration of the outbreak. Zovirax contains the active ingredient, aciclovir, which is used to treat many types of herpes in both mild and severe cases. Zovirax is available in cream, liquid and tablet form, when the cold sore is mild a cream is usually applied to the affected area, but for more severe cases liquid and tablets may be needed. Aciclovir works by stopping the herpes simplex virus from multiplying and effectively controls the outbreak, and reduces the painful symptoms. Antiviral medication is most effective when it is taken at the very start of the infection, when the first symptoms appear.
Boosting your immune system will also help to fight the cold sore virus faster. Boost your immune system by getting plenty of vitamins into your body from fruit and veg and exercise regularly. You can also take painkillers such as ibuprofen to help the throbbing or burning pain of a cold sore.
Can cold sores return?
Yes, once you have the herpes simplex virus in your body it’s likely that you will have a cold sore more than once in your lifetime, even if you have previously treated a cold sore. If your immune system is low or if you’re exposed to one of the triggers, you will develop a cold sore. By keeping healthy, avoiding triggers, and acting fast with treatment (catching the infection in its early stages) you’re less likely to have a severe outbreak of cold sores and they should heal nicely (without scarring) and quickly.