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Cold sores are often known as fever blisters given their appearance. Most cold sores are caused by HSV-1, also known as Herpes Simplex Virus.
According to the World Health Organization, around two-thirds of adults aged 50 and older have HSV-1. The University of Michigan’s Health Service estimates that 50 percent of American kindergarten-age children already have HSV-1.
While a majority of HSV-1 cases involve oral herpes or cold sores, around 40 percent of cases involve genital sores. Although related, the genital herpes virus (HSV-2) and HSV-1 are usually unique in presentation.
Cold sores usually appear on the upper body, mainly around the lips and mouth, but they can emerge anywhere on the skin, including the tongue. In infants, cold sores are often mistaken for canker sores.
Cold sores caused by HSV-1 often last little over a week and then clear up on their own. There’s currently no cure, and infections are lifelong. However there are ways to decrease the length, intensity, and frequency of outbreaks.
Drugs are available, but many remedies use common grocery store ingredients and household staples.
Compounds that are antiviral, antimicrobial, and immune-boosting are often good for treating cold sores.
Some remedies help limit the spread of the virus. Others reduce the chance of further infections or decrease pain and discomfort.
Not every treatment works for every individual, but a wide range of natural products may help reduce symptoms and prevent future flare-ups.
- lip balms with at least 1 percent lemon balm
- lemon tea and lemon tea compresses
- peppermint, mint, and witch hazel oil
- aloe vera gel, which is available to buy online, to soothe inflamed sores while providing crucial moisture.
- licorice root, which contains glycyrrhizic acid, considered to be an antiviral
- licorice powder, mixed with water or petroleum jelly and applied directly to sores
- echinacea as an immune booster, best consumed in tea or supplement form. Echinacea is available to buy online.
- lysine cream or l-lysine supplements, as l-lysine may boost the immune system and aid cell repair
- milk, which contains antibodies and l-lysine
- cornstarch paste, made of equal parts starch and water
- rhubarb and sage mixtures
Vitamin E helps the body repair damaged skin cells and grow new ones. Vitamin E-rich food choices include nuts, whole wheats, and leafy greens. Vitamin E oils are also available.
Vitamin C can boost levels of white cells, the body’s main infection-fighting cells. Vitamin C-rich foods are often red, orange, or deep green in color. These include most berries, tomatoes, peppers, kiwis, broccoli, and spinach.
There are also over the counter (OTC) medications available to treat cold sores symptoms. Many offer child-friendly dosages.
- Abreva and Zilactin, which are both available to buy online, may help reduce recovery time
- Anbesol and Orajel numb sores, lessening pain
- Zinc oxide creams applied to scabs may kill virus cells released from the sore
- Hydrogen peroxide and rubbing alcohol keep cold sores clean
- Pain- and inflammation-reducing medications like ibuprofen can also help
People with cold sores should seek medical care if the sores do not improve within a few weeks, if symptoms are severe, or if sores continue to weep.
Complications from HSV-1 are rare but possible. People with weakened immune systems should seek medical advice, as should those with frequent outbreaks.
Complications can arise when the virus spreads to others parts of the body. For example, the virus can spread to the fingertips, as with herpes whitlow, or eyes as with herpes keratitis.
Commonly prescribed treatments for cold sores include anti-viral tablets and creams. According to the British National Health Service (NHS), creams are usually only effective if applied when the sores first appear.
Prescribed cold sore medications include:
- Acyclovir (Xerese, Zovirax)
- Valacyclovir (Valtrex)
- Famciclovir (Famvir)
- Penciclovir (Denavir)
The American Academy of Dermatology (AAD) note that the first outbreak of the virus typically occurs within 2 to 20 days after exposure.
The initial outbreak of HSV-1 is normally the most severe.
These symptoms normally occur along with the onset of cold sores. They can last 3 to 4 days.
The HSV-1 virus spends most of its time inactive in facial nerve cells. Outbreaks usually occur alongside events like illness and stress that weaken the immune system.
Most people experience a sense of burning or tingling around the edge of lips 24 to 48 hours before blisters emerge.
This is normally followed by a tiny red or inflamed bump. These bumps soon appear on the skin’s surface as multiple connected blisters. The bumps appear clear at first, then cloudy as the body’s immune cells fight off the infection.
Soon after becoming cloudy, the blisters will normally break. This releases the infected fluid held within the sore.
Once the blister has drained, it often dries up, eventually crusting over with a scab. Keeping the scab in place is important for keeping the sore safe from outside bacteria and stopping the virus’ spread.
Most cold sores will clear up after 7 to 10 days, although the wound can take several weeks to heal fully. Outbreaks recur in about 25 percent of cases, often in the same location.
HSV-1 is extremely contagious, spread by direct contact. The American Sexual Health Association explain that the virus can spread whether cold sores are visible or not.
People infected with HSV-1 are most contagious a few times a year when the virus is shedding.
There is still debate as to the precise link between HSV-1 and genital herpes, or HSV-2.
People with active HSV-1 sores can transmit a form of genital herpes to partners by direct contact.
Adopting a good hygiene routine and limiting contact with infected individuals should help stop the spread of the virus.
General cold sore prevention methods include:
- not touching cold sores
- washing hands frequently, especially before handling a sore
- using something sterile like a cotton swab to apply ointments, creams, and oils
- dabbing creams onto sores instead of rubbing them in
- getting rid of mouth hygiene tools like toothbrushes at the first sign of an outbreak and after the infection has cleared up
- avoiding acidic, salty, or roughly textured foods that can irritate sores
- avoiding kissing or engaging in other intimate activities
- using sunscreen