If you often get cold sores, have you noticed that they always seem to pop-up at the worst possible times?
Like when you are preparing for a really important social event, or maybe even your wedding? Here’s what you need to know about these dreaded sores and how to get rid of them…fast!
Cold sores are very common and can be seen on and around the lips. Most people get infected as children or young adults and the infection lasts throughout the course of life.
Despite the name, they are NOT caused by or related to cold. These sores are actually caused by a virus – Herpes Simplex Virus (HSV) and often clears up by itself in a few days.
What Is The Herpes Simplex Virus?
There are two main types of Herpes Simplex Viruses, Herpes simplex virus 1 (HSV-1) and Herpes simplex virus 2 (HSV-2). Cold sores are caused particularly by the HSV-1 while HSV-2 is majorly responsible for the genital disease popularly known as ‘Herpes’.
What Makes It Special?
The HSV-1 has a predisposition for the face area and can attach to nerve cells. This means that it can reside and multiply in these nerve cells and may become inactive – a process called dormancy. This causes it to be permanently resident in the individual and can be reactivated at any time in the future.
Who Is Affected?
Herpes simplex virus 1 (HSV-1) is found in the majority of people from every part of the world. It has no predilection for a specific region, race, gender or age group. It is seen in about 90% of adults, with many of them being unknown “carriers”. Every year, there are about 20 million new cases worldwide.
How Is It Spread?
Herpes simplex virus 1 is spread through close personal contact with someone who already has the virus. It is spread through the entry of the virus into the body via:
- Small cuts or breaks in the skin due to physical contact
- Contact with a cold sore
- Contact with objects like razors, toothbrushes, cosmetics, towels and kitchen utensils
- Kissing, especially between an infected adult and a kid. It may also occur when there is an exchange of saliva.
- Body fluids like blood and genital fluids (via oral sex)
When the virus gets into the body through the skin, it locates the collection point of the nearest nerve cells (called a ganglion) and moves in there but does not cause any symptoms in the immediate period.
Then, the areas around the ganglion flare-up by first becoming itchy and subsequently tingling or burning up before blisters show up.
The spread is greatest when the affected individual has an active cold sore. Spread, however, may occur even in the absence or resolution of a cold sore. Frequent contact with the affected individual increases the chances of spread.
How Are Cold Sores Treated?
Although cold sores can’t be cured, most times they go away on their own in a few days. Treatment is sometimes instituted to reduce disease severity and to prevent complications. In some cases, treatment is also aimed at keeping the individual in such a state that they are not actively spreading the virus.
Treatment is mostly by prescribed antiviral medications, specific drugs that target and check the proliferation of viruses – most commonly, acyclovir (Zovirax). These are tailored based on the individual’s immune status and severity of the disease.
Additional medications may be required if complications are present, for example, some individuals may require medicines for treating skin diseases due to the presence of skin complications. Your doctor may also prescribe pain medicines, and a gel or cream to be applied on the sore for pain relief and to speed up healing.
If you have a cold sore that refuses to go after 2 weeks, are pregnant or have swollen gums, it is imperative to see your doctor.
How Can You Get Rid Of Cold Sores At Home?
Cold sores are often painful and aesthetically displeasing. Because they clear up naturally in a few days (up to 2 weeks), you may choose not to go to your health provider. To address the immediate problems and reduce the severity of symptoms, here are some cold sore home remedies you can try:
- Follow your doctor’s advice. As with other health-related issues, follow your health provider’s advice and ask questions to make clarifications.
- Apply ice packs or cold compresses: This reduces the painful sensation and swelling by applying ice packs or cold compresses on the sores.
- Avoid spicy food and hot beverages. They generally increase the pain and burning sensation felt.
- Ensure that you do not pick the cold sore. This will delay healing and may help introduce other germs into the sore, leading to a worse outcome.
- If you accidentally touch it, wash your hands thoroughly.
What Are The Symptoms Of Cold Sores?
Cold sores may appear for the first time or recur at any given period of time. This affects how symptoms may be seen although the initial appearance of symptoms is often longer and more serious. Usually, individuals affected do not have any symptoms. In persons with symptoms, the most common ones are:
- Loss of appetite
- Muscle aches
- Swollen gums
- Sore throat
- Blisters in the mouth, lips, and on the tongue.
- Swollen lymph nodes
These symptoms often appear in the first week of exposure and subside within 2 weeks.
When Herpes simplex virus 1 (HSV-1) causes cold sore, it is often accompanied by pain, burning and tingling sensation at the site on the face, nose or lips as well as the aforementioned symptoms.
Fluid-filled raisings called vesicles which are blister-like often appear before breaking down and drying up, to be replaced by a yellow crust which eventually falls off, all in a matter of a few days. These blisters may be grouped together and oozing clear fluid, a means of spreading the infection.
This continues to recur throughout life, often with no particular pattern. However, it may be seen as frequently as monthly in some people or as infrequently as once every year.
What Triggers Reoccurrence Of Cold Sores?
After reaching a period of inactivity or dormancy in nerve cells, recurrences may be triggered by any of the following –
Infection is particularly worse in people with weakened immunity, such as people with HIV, people on steroid therapy or chemotherapy. It may also be worse with eczema and in people with a concurrent infection.
How Is A Diagnosis Of Cold Sores Made?
The most accurate way to make a diagnosis of herpes simplex virus 1 (HSV-1) is after a proper consultation with your doctor who will ask you questions before proceeding to examine you.
Thereafter, samples may be taken for a test called Tissue culture which confirms the diagnosis. A rapid confirmatory test, as well as other blood or imaging tests, may also be embarked on to make an accurate diagnosis of cold sores as well as concurrent infections or complications.
What Complications May Arise From Untreated Or Poorly Treated Infections?
Complications are typically common in individuals with Herpes simplex virus 1 who have not had any treatment. These complications are often caused by other disease-causing entities like bacteria and fungi which take advantage of the current infection to establish dominance. Some of the commonest complications include:
- Eye disease: This is commonest in children and is due to the transfer of the virus from the site of the blisters to the eyes, usually inadvertently during play. It is frequently seen as redness in one eye and ulceration of the outermost covering of the eye, the cornea. It may also cause several other eye complications like the inflammation of the eye layers.
- Skin disease: This is caused by the presence of germs in the skin of an individual with concurrent herpes simplex virus 1 infection. It may be located in a certain part of the body or widespread, covering the whole body, including nails (herpetic whitlow).
- Infection of internal organs: This occurs due to the spread of herpes simplex virus 1 (HSV-1) in the blood. Usually, more than one organ is involved and is worse in individuals with lowered immunity, like cancer patients, people who are living with HIV and individuals who had a kidney transplant.
- Nerve and nerve tissue disease: When HSV-1 tracks into nerve tissues or the nervous system, a great number of complications may result, including the inflammation of the covering of the brain (called Meningitis), as well as the brain itself (Encephalitis)
- Respiratory tract disease: Sometimes, the virus may track into the respiratory tract. Here, it may cause the inflammation of the epiglottis and larynx. It is mostly a complication seen in children and is self-limiting, usually lasting about 2 weeks.
How Can You Keep From Contracting The Virus?
Because most carriers are often without any symptoms, it may be difficult to avoid physical contact with individuals who are currently infected. However, here are some tips that will help prevent the spread of the virus:
- Avoiding contact with people with cold sore blisters
- Avoid putting your hands in the mouths of people with mouth and facial herpetic disease. If you have to, wear gloves.
- Wash your hands after inadvertently touching a cold sore
- Avoid sharing items such as razors and towels
- Use dental dams when engaging in oral sex
- If you already have the virus, ask your doctor about suppressive antiviral therapy to reduce the possibility of you spreading the disease.
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