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Cold Sores

Recurrent Herpes labialis, better known as “cold sore” or “fever blister”, is caused by the presence of a virus in the body: Herpes simplex type I Virus. Even though it is contracted very often during childhood years, this contagious virus may also be contracted later in life. After the initial infection, the virus stays “dormant” and, when activated by triggers, will erupt into another cold sore. It is estimates that every year, about 20 to 40% of the population get cold sore.

What triggers an outbreak of recurrent Herpes labialis ?

Here are some of the factors that may trigger a cold sore outbreak:

Ultraviolet rays (from sun exposure or tanning beds)
Cold weather
Skin dryness
Fever, cold or flu
Stress
Fatigue
Menstruation
Mouth trauma (cut, cracks on the mouth, etc)

What are the symptoms of recurrent Herpes labialis?

Typical symptoms are tingling, itching, and burning followed by eruption of a cold sore blister. Generally, a cold sore lasts around 8 to 10 days in total. Here are the different stages of a cold sore:

Days 1-2: The Tingle Stage
Before any visible symptoms appear, you may feel a tingle, itch and/or burning sensation. This stage lasts approximately 6 hours. The infection is contagious even at this stage, so avoid close physical contact . If pharmacologic treatment is considered (like applying a medicated cream). It should be started at this stage. Early treatment will maximize the efficiency of the medication

Days 2-4: The blister Stage
The blister appears. A group of small painful lumps multiple and/or become enlarges. White blood cells travel to the blister and help fight the infection. The cold sore fills with vesicle fluid (pus) and contains millions of virus particles. This stage is very contagious

Day 4: The Ulcer Stage
During the ulcer stage (typically the most painful), you will notice a shallow, cold sore develop. A red ring of inflammation around the affected are army also appear.

Days 5-8: The scabbing Stage
As your cols sore dries out. A golden-brown crust appears and forms a scab. As the scab shrinks, you may experience painful cracks that can be bleed. Severe itching and/or burning is also common.

Days 8-10: The Healing stage
As the cold sore heals and your scab starts to come off, you may experience some dry flaking and residual swelling. Your skin may also remain slightly pink or red. Typically cold sores heal within 8 to 10 days, but in some cases may last up to 2 weeks.

What are treatment options:

Currently, there is no treatment able to eliminate the infection permanently. Very few products may be used to accelerate healing and reduce the duration of the symptoms. Most of these are prescription only products, as ointments or creams, as well as some oral medication sold as tablets

A few tips to help avoid cold sore triggers

Use regularly a lip balm to prevent the lips from getting dry.
Avoid prolonged sun exposure and tanning salons. Use a lip balm containing a sun protection factor (SPF) of at least 15, or to wear a hat.
Avoid exposing the area surrounding your mouth to intense wind or cold weather. Wear a scarf covering your mouth, and apply a lip balm.
Avoid stress and fatigue as much as possible.
Avoid contact with people with cold or flu symptoms. Wash your hands frequently
Learn to recognize signs indicating a cold sore such as tingling feeling. Start the treatment as soon as possible once you recognize the presence of these symptoms
Adopt healthy eating habits. A good diet helps to maintain a healthy immune system and helps to reduce stress and fatigue
Avoid touching your cold sore unless you are applying medicine and, if so wash your hands immediately after
Avoid kissing or other intimate situations when you have a cold sore.