The local pharmacy is usually patients’ first stop when searching for relief from cold sores. Fortunately there are some simple options for patients looking to prevent or treat the uncomfortable and annoying sores. 

Cold sores are small blisters that develop around the lips or mouth, caused by the herpes simplex virus.

CAUSE & TRIGGERS 

“Cold sores are small blisters that develop around the lips or mouth, caused by the herpes simplex virus (HSV),” said Dr Anjali Mahto, consultant dermatologist and spokesperson for The British Skin Foundation. Generally infected as children, although most people carry the virus in their bodies, not everyone will get cold sores. After an initial mild or even unnoticed infection, the virus then lies dormant in the nerves until it is reactivated and causes a cold sore. According to New Zealand’s Southern Cross Medical Library, cold sores tend to appear in the same place every time because the virus lies dormant in the nerves that lead to that spot on the skin  

The HSV usually enters the body through a break in the skin around or inside the mouth. “It is usually spread when a person touches a cold sore or touches infected fluid – such as from sharing eating utensils or razors, kissing an infected person, or touching that person’s saliva,” cautioned British Columbia HealthLink (HealthLink BC).  

Cold sore outbreaks are often triggered by exposure to hot sun, cold wind, a cold or other illness, a weak immune system, changing hormone levels, or even stress.  

SYMPTOMS 

Although they are usually found on or around the lips, nose, and inside the mouth, cold sore blisters can actually occur anywhere on the body. Cold sore symptoms differ depending on whether it is a first outbreak or a recurrence and can typically last several days. Symptoms of cold sore recurrences tend to be less severe than the initial outbreak.  

4 STAGES OF A COLD SORE EPISODE 

1. Burning or tingling and itching around the lips for a day or so before blisters appear. This stage is the best time to treat a cold sore.

2. Small fluid-filled blisters, which are often painful, breakout along the outer lips and, less often, around the nose or on the cheeks.

3. The blisters burst, leaving shallow open fluid-filled sores.

4. The sores eventually dry, scab over, and heal without scarring after 8-10 days.

“A first-time episode may be accompanied by fever, painful gums, sore throat, headache, muscle aches, and/or swollen lymph nodes,” according to New Zealand’s Southern Cross Medical Library.

Recurrent cold sores may be triggered by emotional stress, sun exposures and hormonal changes.

TREATMENT 

“The HSV that causes cold sores can’t be cured,” said HealthLink BC. Once a patient is infected, the virus stays in the body forever. If a patient is prone to recurrent cold sores, treatment can reduce the number of outbreaks and their severity. Cold sores are generally not dangerous and don’t cause any permanent damage to the skin. However, in young babies, immunocompromised people and those with eczema, cold sores can cause life-threatening infections.  

For most patients, not picking or touching the scab is all that is necessary to heal their cold sore. The Victoria, Australia, Department of Health recommended that creams and ointments can be used to soothe the blisters, provide relief, and reduce symptoms. “Simple painkillers may occasionally be required and povidone-iodine ointments can be dabbed onto the cold sores. Antiviral medications come in many forms, including creams and tablets. Medications such as acyclovir and famciclovir shorten the duration of the cold sore by reducing the ability of the virus to reproduce.”  

It is also important to wear sunscreen and SPF lip balm to ensure the sores don’t get sunburnt while healing. Cleveland Clinic suggested applying a cool, damp facecloth to soothe cold sores and advised patients to avoid acidic foods like orange juice and tomatoes which can aggravate the wound.  

Remind patients to always wash their hands before and after touching the cold sore or applying cream to the area.   

PREVENTION  

To reduce the risk of a cold sore outbreak, Cleveland Clinic recommended patients: 

    • Try to stay healthy as a fever can trigger a cold sore, which is why it is often referred to as fever blisters. 
    • Get enough rest because fatigue weakens the immune system and makes a patient more likely to get sick. 
    • Wear lip balm with SPF to protect lips from sunburn, which can trigger an outbreak.