Cold Sores


Ann Clark RDH

Ever have that “ tingling” feeling under your skin? An estimated 50-80% of people are familiar with this feeling and are infected with herpes simplex virus type 1 (HSV1). Cold sores aka: fever blisters are ugly, uncomfortable and embarrassing. These lesions are not caused by the common cold and they are not a canker sore( inside the mouth). They are a herpetic sores brought on through contact with infected skin or body fluid, manifesting around the mouth. They are clear, filled with fluid and unfortunately, a common problem that never really goes away.


The first symptom of an outbreak is a tingling feeling in the skin, a warning… then, small fluid-filled blisters appear around the mouth on red, swollen areas of skin or mucous membranes. They rupture and crust over before healing. They are tender and painful and heal without scaring. In 80% of the adult population have antibodies against HSV1 and 25% against HSV2. They are extremely common and are only transmitted by close, personal contact…Kissing etc. The virus is usually present on an infected person’s lips, even if there’s no obvious sore. Because it can live in saliva sharing utensils or drinking glasses can also allow infection. Oral sex can lead to HSV1 infection of their partner’s genitals. HSV invades the cells of the epidermis (outer layer of skin), causing the blister to appear. The virus travels from the epidermis along the nerve paths to the roots of the nerves where it becomes inactive. A weakening of the body’s defenses due to severe cold, for example, can reactivate the virus causing reoccurring blisters.

HSV1 damages the skin as it reproduces itself creating a sore lasting approximately 1 week. Between sores, HSV1 hides itself inside the nerve cells, so you are never completely cured. Although usually inactive, a few things can trigger a reactivation such as: stress, sunlight, fever and menstruation. Though some will only get them 1-2x a year, others can get the outbreak monthly.


The primary infection can progress in different ways. Some only get very mild symptoms or none. The first outbreak occurs 1-3 weeks after contracting the virus and usually goes away in a few weeks. The first symptom is an unpleasant tingling in the skin, then, the blisters appear. The sores become covered by scabs that usually fall off 8-10 days after they appear. The virus can spread until the sores are completely covered by scabs. 20% of people with HSV1 have recurrent attacks throughout their lives. In children the virus affects their mouth and throat and can be accompanied with fever, general aches and pains.


Oral antivirus meds help reduce the healing time if taken at the first sign- red/itchy skin.

Zovirax is taken before the virus fully flares and is taken 5x daily.

Vatnex is taken at first sign, then, 12 hours later.

Famvir is taken as a single dose.

Is THIS the virus? Not on the lips is not as common but anywhere on the face-cheeks, chin, nose. They usually will reappear in the same area each time. You can even get them on your finger or in your eye; most commonly the cornea causing damage or even blindness. Self-spreading can be prevented by washing hands and not touch the infection. Outbreaks can last up to 2 weeks. Recurrent outbreaks usually 1 week. Hot/cold compresses, OTC or Rx creams/gels (Abreva, Zovirax, Denavir) can relieve symptoms.


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