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Cold Sores and Fever Blisters

Cold sores and fever blisters are names for a common medical condition called herpes. They are uncomfortable, annoying little blisters that form on the lips and around the mouth and nose. Up to 25% of all adults are troubled by this incurable condition, which can reoccur for many people time and time again.

What causes cold sores and fever blisters?

Cold sores and fever blisters are caused primarily by the herpes simplex virus type 1 (HSV-1). Herpes simplex virus type 2 (HSV-2), which usually causes genital herpes infections, is also now known to infect the face and mouth and cause cold sores. HSV-1 and HSV-2 are very common viruses among humans and are easily spread from person to person.

Infection occurs when someone is exposed to the virus by contact with fluids containing herpes virus from an infected person. Simple things like kissing, sharing of utensils and drinks, and not washing hands after touching blisters can result in the spread of HSV to others and cause infection. Furthermore, it is suspected that oral-genital sexual contact with an infected person can also lead to HSV-1 or HSV-2 cold sores.

Once infected, the virus continues to live in nerve cells within the skin. The virus lays dormant in nerve roots until the time it might resurface and cause a cold sore outbreak. Recurrent cold sore outbreaks can be triggered by emotional or physical stress. Trauma, illness, menstruation, and sun exposure can all activate dormant herpes virus. It is not possible to predict the frequency or severity of recurrences; in fact some people may never have a recurrence at all.

What are the symptoms?

There are two types of HSV infections: primary and recurrent. Primary infection after initial exposure is often associated with fever, headache, sore throat, and malaise, as well as the characteristic blisters. Sores of a primary infection appear two to twenty days after contact with an infected person and can last from seven to ten days.

Recurrent cold sores usually affect the same location as the initial outbreak. They are usually less severe than primary infections and associated symptoms are often absent. Sores tend to be smaller, less painful, and of shorter duration, resolving in an average of 5 days.

Both primary and recurrent cold sore outbreaks are often preceded by a sense of numbness, itching, tingling, or burning around the area where blisters will form. These symptoms may occur 1 to 48 hours prior to the appearance of blisters.

As the blisters emerge they fill with virus containing fluid and can be painful. Over the next two to three days the sores may ooze and then form a yellow crust. Eventually, the crusts fall off, leaving slightly red skin, which usually heals completely and rarely leaves a scar.
How can you avoid cold sores?

Avoiding infection by HSV is the only sure way to avoid getting cold sores; unfortunately, this is no easy task. This requires careful avoidance of contact with virus containing fluids from infected people. Kissing, sharing of foods, beverages, utensils, towels, toothbrushes, etc. with someone with active cold sores is a sure way to get infected. This also requires individuals infected with HSV-1 or HSV-2 to actively avoid exposing others to the virus. Sexual partners should be informed of herpes status prior to engaging in behaviors with high risk of transmitting HSV.
Avoiding triggers, such as physical or emotional stress, can minimize recurrent cold sore outbreaks.

How can you treat active cold sores?

Herpes is often left untreated and outbreaks usually resolve on their own without scarring. Good wound care is essential to avoid secondary bacterial infection of the involved tissue. The sores should be kept clean and picking at sores or crusts should be avoided in order to promote quick healing and limit spreading of the virus containing blister fluids. Prescription and nonprescription medications such as Lespain may be used as soon as an outbreak is felt to effectively control symptoms and expedite healing.

Topical analgesics such as Lespain are effective for quick relief of pain and itching. Urea, the moisturizer used in Lespain has been shown to impair the herpes virus in monkeys but this observation while interesting, has not yet been clinically tested in large scale trials in humans. Lespain is gel format is best suited for cold sores.

When lidocaine is applied to the skin, it produces pain relief by blocking the signals at the nerve endings.

Apply topical LESPAIN^® sparingly for temporary relief from minor pain