Cold Sores

What Are Cold Sores?

Cold sores are usually caused by herpes simplex virus type 1 (HSV-1). Cold sores are very common affecting over 50% of American adults. HSV-1 is a contagious infection that many people acquire during childhood. HSV-1 is a lifelong infection that for the most part is asymptomatic. It mainly affects the area around the mouth but can also cause genital herpes in some cases. Genital herpes is primarily caused by HSV-2.

How Do I Know If I Have Cold Sores?

Individuals infected with HSV-1 will experience an initial outbreak of the virus, causing painful blisters, and open sores in or around the mouth. Fever, body aches, and swollen glands may also be experienced during the initial outbreak. The sores usually take about 2-4 weeks to heal. Before the appearance of sores individuals may experience a tingling, burning, or itching sensation around the mouth. After the initial infection the sores can periodically recur throughout a person’s life. The frequency of recurrence varies from person to person, but can be brought on by stress, illness, sun exposure, or certain procedures, like filler injections or dental work. HSV-1 can be diagnosed from symptoms alone, or a sample can be taken from an open sore, and tested. A blood test can be used to look for herpes antibodies, which indicate that a person has been infected, but is positive whether the infection was years ago or current.

How Do Cold Sores Form?

HSV-1 is transmitted through direct contact with sores, saliva, or the mouth or other affected area. The greatest risk of transmission is when an individual has active sores, but HSV-1 can be spread when there are no symptoms present. People with active symptoms should avoid oral contact with others, and avoid sharing items that have contact with saliva (such as drinks, face towels). People with active symptoms should wash their hands frequently, and avoid touching other body parts, such as the eyes to prevent the virus from spreading to another part of the body. Because HSV-1 is lifelong a person cannot be re-infected, however they are still able to be infected with HSV-2, which can be avoided through practicing safe sex.

How Can I Treat My Cold Sores?

Antiviral drugs, such as valacyclovir and acyclovir, are the most effective medications against HSV-1. These drugs do not cure the infections, but can help reduce the severity, and frequency of symptoms. These drugs are most effective when taken as soon as symptoms appear. These drugs can also be taken as a protective measure to prevent an outbreak if an individual is at an increased risk for developing one. This is a good idea if going on a sunny vacation or other situation likely to provoke an outbreak.  Over counter treatments can also be applied to cold sores, such as Abreva. Acetaminophen, ibuprofen, and over counter creams with lidocaine or benzocaine that can provide pain relief.  However these OTC treatments are not as effective as the oral prescription medications.

If cold sores are interfering with your personal or professional life, see your dermatologist for a plan to treat and avoid future infections.