Cold sore

What Is a Cold Sore

A cold sore is a group of tiny, painful blisters caused by the herpes simplex virus (HSV). They’re also called fever blisters or herpes simplex labials. Up to 90% of people around the world have at least one form of HSV.
The symptoms are usually the most severe the first you time you get cold sores. A first-time cold sore can make a child seriously ill.

Cold Sore Symptoms

Cold sores are most likely to show up on the outside of your mouth and lips, but you can also get them on your nose and cheeks. You may get cold sores as late as 20 days after you’re infected. The sore might appear near where the virus entered your body. Cold sores also called fever blisters are a common viral infection. They are tiny, fluid-filled blisters on and around your lips. These blisters are often grouped together in patches. After the blisters break, a scab forms that can last several days. Cold sores usually heal in two to three weeks without leaving a scar.

Cold sores spread from person to person by close contact, such as kissing. They’re usually caused by herpes simplex virus type 1 (HSV-1), and less commonly herpes simplex virus type 2 (HSV-2). Both of these viruses can affect your mouth or genitals and can be spread by oral sex. Cold sores are contagious even if you don’t see the sores.
• Tingling and itching. Many people feel itching, burning or tingling around the lips for a day or so before a small, hard, painful spot appears and blisters erupt.
• Blisters. Small fluid-filled blisters typically erupt along the border of your lips. Sometimes they appear around the nose or cheeks or inside the mouth.
• Oozing and crusting. The small blisters may merge and then burst, leaving shallow open sores that ooze and crust over.
Signs and symptoms vary, depending on whether this is your first outbreak or a recurrence. The first time you have a cold sore, symptoms may not start for up to 20 days after you were first exposed to the virus. The sores can last several days, and the blisters can take two to three weeks to heal completely

Causes of Cold sore

Cold sores are caused by certain strains of the herpes simplex virus (HSV). HSV-1 usually causes cold sores. HSV-2 is usually responsible for genital herpes. But either type can spread to the face or genitals through close contact, such as kissing or oral sex. Shared eating utensils, razors and towels might also spread HSV-1. Cold sores are most contagious when you have oozing blisters because the virus easily spreads through contact with infected body fluids. But you can spread the virus even if you don’t have blisters. Many people who are infected with the virus that causes cold sores never develop signs and symptoms.

Cold sores happen in stages:
1. You have a tingling, burning, or itching feeling.
2. About 12 to 24 hours later, blisters form. The area becomes red, swollen, and painful.
3. The blisters break open, and fluid comes out. This usually lasts 2 or 3 days.
4. A scab forms on the sore. It might crack or bleed.
5. The scab falls off.
You might also have red or swollen gums, swollen glands in your neck, fever, or muscle aches.
First-time infections can also cause:
• Burning and pain inside your mouth
• Sore throat
• Pain when swallowing
• Headache
• Upset stomach
• Viral infection or fever
• Hormonal changes, such as those related to menstruation
• Stress
• Fatigue
• Exposure to sunlight and wind
• Changes in the immune system
• Injury to the skin

Diagnosis

Your doctor can usually diagnose cold sores just by looking at them. To confirm the diagnosis, your doctor might take a sample from the blister for testing in a laboratory.

Treatment

Cold sores generally clear up without treatment in two to four weeks. Several types of prescription antiviral medications may speed the healing process. Examples include:
• .Acyclovir (Zovirax)
• Valacyclovir (Valtrex)
• Famciclovir
• Penciclovir (Denavir)
Some of these products are packaged as pills to be swallowed. Others are creams to be applied to the sores several times a day. In general, the pills work better than the creams. For very severe infections, some antiviral drugs can be given with an injection.

Medications

Antiviral creams or ointments such as aciclovir, famciclovir and valaciclovir should be used in the first few days of a cold sore outbreak when a tingling sensation or a raised sore or blister is first noticed. These are available without prescription from pharmacies and other shops and supermarkets.

Complementary medicines

Some complementary medicines have been promoted as preventing cold sores. One of these products is an amino acid called lysine — but there is no evidence that it is effective.

Self-help

If you have a cold sore there are several things you can do to help manage the condition.
• Creams and ointments should be gently dabbed on to the cold sore rather than rubbed on.
• Ice can be soothing.
• Lip balms, including petroleum jelly, may help if your cold sore is painful or dry. They may also help to prevent the cold sore from cracking once it has crusted over.
• If brushing your teeth is too painful, try using an antiseptic mouthwash instead.

How do you get rid of a cold sore

Although it may take a while to get rid of a cold sore, some medicines can shorten the healing time and make the symptoms less painful. Cold sore treatments include:
• Over-the-counter medications: You can buy without a prescription creams or ointments that you apply directly to the cold sore. If you start using these creams when you first notice tingling or itching — before the cold sore forms — you may be able to prevent the cold sore from appearing.
• Oral antiviral medicine: Your doctor may prescribe an antiviral medication that you take orally (by mouth).
• Intravenous (IV) antiviral medicine: If other medications aren’t working, your doctor may need to prescribe an antiviral medication that will be administered through an IV. In this case, your doctor will monitor you closely throughout treatment.

Prevention

To help avoid spreading cold sores to other people or to other parts of your body, you might try some of the following precautions:
• Avoid kissing and skin contact with people while blisters are present. The virus spreads most easily when the blisters leak fluid.
• Avoid sharing items. Utensils, towels, lip balm and other personal items can spread the virus when blisters are present.
• Keep your hands clean. When you have a cold sore, wash your hands carefully before touching yourself and other people, especially babies.

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