Cold sore

August 24th, 2012 | Posted by admin in Diseases and Conditions

About 1 in 5 people in the UK have recurrent herpes labialis. Cold sores usually resolve on their own without treatment in 7-10 days. Antiviral creams can help reduce the severity of symptoms and are more effective the sooner it is used when a cold sore is beginning to develop.

How does cold sores?

Cold sores are caused by the herpes simplex virus (HSV). Coldest sores are caused by the strain type 1 (HSV1). Strain type 2 (HSV-2) usually causes genital herpes, but very occasionally can cause sores around the mouth. (See separate leaflet called "genital herpes" for more information).

A cold sore usually occurs first in childhood. The virus infects through the inner skin lining the mouth moist. Commonly spread by skin contact, such as kissing a family member who has a cold sore. The first infection may not cause symptoms. For more information on primary infection with herpes labialis, see separate leaflet called "cold sores – primary infection.

After the initial infection, the virus is installed on a nearby nerve sheath and remains there for the rest of his life. During most of the time, the virus remains dormant (inactive) and causes no symptoms. However, in some people the virus is activated from time to time. When activated, the virus multiplies and moves down the sheath of the nerves that causes pain, cold sores around the mouth. Some people get cold sores frequently, others only occasionally. It is unclear what causes the latent virus is activated. Some things that can trigger the virus to activate and cause cold sores are:

Disease. Cold sores can occur during febrile illnesses such as colds, coughs and flu.
Menstruation. Cold sores are common at the time of menstruation.
Stress or simply be "exhausted" by one of the many reasons.
Sunshine. The strong, direct sunlight can cause mouth ulcers in some people.

What are the symptoms of a cold sore?

You may feel a tingling or itching before the blisters appear, usually around the lips or nose. This may take several hours or even a day or two. After tickling, one or more blisters that usually appear pain. The blisters contain fluid that oozes with the herpes virus. Blisters can mourn and take several days to scab. Cold sores can be very sensitive and painful.

So cold sores have scabbed and are completely dry, cold sores are very contagious and can be transmitted to others. The crust slowly disappears in one to two weeks without scarring. Some viruses remain dormant in nerve sheath ready to make another cold sore at some point in the future.

Can cold sores is transmitted to other people?

Yes, when you have a cold sore do not kiss anyone or allow anyone to come in contact with irritated skin. In particular, avoid kissing newborn babies and anyone who has a weakened immune system (immunocompromised). Immunocompromised persons are people who have chemotherapy for cancer and people with diseases such as AIDS. Avoid oral sex until the cold sores have completely healed. When you have no symptoms (when the virus is dormant), are usually not infectious. Healthy people who already have cold sores can not be re-infected.

Do I need any tests?

Evidence is needed to confirm the diagnosis of herpes labialis. Tingling pain symptoms followed the typical blisters crust around the nose and mouth are usually sufficient to make the diagnosis.

A sample of the liquid from the vial into a special swab viral can help confirm the diagnosis of HSV. A blood test can detect the virus also more reliable than using a swab. Neither test is routinely available in the GP surgery. The tests could be done in people who are immunocompromised.

Self-care advice

Try not to touch or pick up cold sores. Just touch the cold sore in applying topical creams.
Creams, gels and other topical treatments are cold sores spread on instead of rubbing it in. This is to minimize damage to the blisters can spread the virus around or cause more pain to break blisters or scabs.
Wash hands thoroughly with soap and water after touching the cold sore and after application of creams for them.
If you find that sunlight causes your cold sores, try using lip balm sunscreen (SPF 15 or higher) when in full sun. This has been found to prevent some outbreaks of cold sores in some people. No lip balms share with others if you have cold sores. Pots of lip balm sunscreen may be less convenient than lipsticks, but minimize the risk of product contamination, if applied with a clean finger.
The pain can be relieved by analgesics such as acetaminophen or ibuprofen.
A pharmacist can advise a soothing cream or gel. Again, it is important not to share these treatments.
There is a risk of infecting your eyes with cold sore virus if your contact lenses are contaminated. This can be prevented by washing hands thoroughly before handling your contact lenses. If you have disposable lenses and are suspected to have contaminated, is probably the best way to throw away. If in doubt, it may be better to use your lenses and consult your doctor or optometrist.

What are the treatments for cold sores?

Antiviral creams

Acyclovir (Zovirax ® brand) and penciclovir (Vectavir ® brand) can be purchased over the counter (OTC) in pharmacies, or be prescribed by a doctor. They do not kill the virus but prevent the virus from multiplying. They have little effect on existing blisters, but you can prevent it from getting worse. These creams will not prevent future episodes of herpes labialis. If you use an antiviral cream as soon as symptoms start after the cold sore can last as long as usual, and may be less severe. There is debate as to how well these creams work. Acyclovir has to be applied four times a day for five days. Penciclovir is applied every two hours (during waking hours) for four days.

Antiviral Tablets

Acyclovir is also available in tablet form. There are also other oral antiviral medications, as Famciclovir (Famvir ® brand) and valacyclovir (brand Valrex ®). Antiviral oral tablets is not routinely used for the treatment of cold sores. Tablets may be prescribed oral antiviral serious infections herpes labialis, in newborns or immunocompromised individuals. As with topical antivirals, do not prevent recurrent outbreaks of cold sores, or have no effect on existing blisters. Oral Antivirals are used in order to stop the virus multiplication and preventing cold sores from becoming too severe. Serious viral infections such as herpes severe infection can be extremely dangerous to the health of immunocompromised persons.

Do I have to see my doctor?

Usually, you do not need to see their GP with cold sores. With recurrent cold sores is likely to come to recognize the symptoms. You should see your doctor if you are unsure of the diagnosis, or cold sores is not resolved after a week or so. If you are immunosuppressed and develop possible cold sores, you should consult your doctor as you may need tests to confirm the virus, and / or oral antiviral medications.

More help and information

Cold Sore Advice Line

A service provided by the Association Herpes Virus
Tel: 0845 123 2305 Web: www.herpes.org.uk / coldsores.html

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