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Cold sores: The good, the bad and the ugly


Cold sores: The good, the bad and the ugly

Anyone who’s ever dealt with a cold sore knows how annoying and painful the lesions can be.
Somehow, cold sores always seem to appear at the most inopportune times, and they can never go away fast enough.
Cold sores are caused by a common virus called the herpes simplex virus type 1, says Dr. James Turek, a family medicine physician at Tidelands Health Family Medicine at Garden City. The virus lives in nerves near the spinal column and can lie dormant indefinitely without causing symptoms.
“More than 50 percent of adults in the U.S. are infected with herpes simplex 1,” Dr. Turek says. “While some people who have the virus never develop symptoms, others can struggle with occasional or recurring cold sores.”
Also called fever blisters, cold sores are contagious and can last two weeks or longer.
“Of course, most people who develop a cold sore want it to go away quickly,” says Dr. Turek. “While there is no cure once you’ve been infected with the herpes simplex 1, there are ways to ease the discomfort and shorten the duration of cold sores when you get them.”

The good

Medication is one way to help combat cold sores.
“We can prescribe an oral antiviral medication to reduce the pain and hasten healing,” says Dr. Turek. “It’s most effective when initiated within the first day or so after the sore erupts, and the best-case scenario is to begin the medication at the first sign of a cold sore – when you feel a tingling sensation around the nose or mouth.”

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Patients with frequent outbreaks can also talk with a physician or other qualified care provider about using a daily antiviral to reduce the risk of reoccurrences.
Over-the-counter antiviral creams are less effective than their prescription alternatives, but can help control pain and promote faster healing.
Other ways to treat cold sores:

  • Use a cold compress to help reduce pain and redness.
  • Apply petroleum jelly, which can help limit cracking.
  • Use ibuprofen or acetaminophen to ease the pain.

Stress is one potential trigger for cold sore outbreaks, so managing your stress levels through exercise or other means can help limit the risk of cold sore development, especially when an anxiety-provoking event or situation is approaching.

The bad

Stress is one of many potential triggers for cold sores. Others include:

  • Illness, including the common cold
  • Fever
  • Menstruation
  • Sunlight
  • Weakened immune system
  • Lack of sleep

“Applying sunscreen or using a sun-protective lip balm may help if you find sunlight seems to trigger your cold sores,” Dr. Turek says.

The ugly

The virus that causes cold sores is most contagious when a lesion is visible and oozing. It can be spread person-to-person through close contact such as kissing, sharing utensils and drinking glasses and cosmetics.
“Keep in mind that even after a cold sore disappears, you can still spread the herpes virus, so it’s wise to avoid sharing food and drink with other people,” Dr. Turek adds.
When you have a cold sore:

  • Don’t touch, pick or scratch the lesion.
  • Don’t pop it, which can increase the risk of spreading it to another person or causing another lesion.
  • Avoid eating or drinking acidic foods or hot and spicy foods, which can add to the discomfort.
  • Avoid foods that contain amino acids such as seeds, almonds, chocolate and peanut butter, which the virus needs to thrive.
  • Wash your hands frequently.
  • Drink plenty of water to avoid dehydration.
  • Be careful around babies, pregnant women or people with weakened or compromised immune systems.

If you suffer from frequent cold sores, have one that won’t heal, develop a high fever or have a lesion that seems to be spreading, make an appointment with your physician or other qualified care provider.

Dr. James Turek is a family medicine physician who practices at Tidelands Health Family Medicine at Garden City. 

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