Awhile back -- something like a year ago -- I blogged about cold sores and Herpes. I'd like to return to that topic today. Last time, I went over what cold sores were, how you get Herpes, and such -- today, we'll focus more on treatment, although first, I'll give a quick overview.
Cold sores (or fever blisters) are a small blister caused by a virus called herpes, which you've likely heard of. It's one of the most common viruses in the world, in fact. There are two types of herpes -- herpes simplex virus one (HSV-1 for short) and herpes simplex virus two (HSV-2). Both of these cause cold sores, but HSV-1 is the one that most commonly causes cold sores around the mouth.
Cold sores around the mouth are a real issue for sufferers, because let's face it -- any type of blemish on one's face is going to cause concern. So let's talk about how to treat cold sores.
• One of the most effective treatments is using a prescription-strength antiviral cream as soon as you feel the onset of a cold sore. I'm putting this one first because, in my opinion, it has the best chance of making it so the sore doesn't even appear, which is really what most people are after. There are several good antiviral creams, including Penciclovir (Denavir) and Acyclovir (Zovirax). Again, these will need a prescription, so ask your doctor or dentist about them.
The way to use these creams is to apply them immediately when the symptoms of a cold sore first appear (the prodromal phase -- aka, that tingly feeling in the lip.) This gives a good chance of nipping the cold sore in the bud, and making it so it doesn't ever appear.
The downside to these creams is the cost -- they are usually pretty expensive, but can be a (figurative) lifesaver when your wedding photos are to be taken in a day. If you have frequent outbreaks, it's probably prudent to have a cream available, even for occasional use.
• You can also use non-prescription based creams in the same manner. However, I have personally found these largely ineffective. Still, maybe you'll react differently -- it won't hurt to try.
• Another "won't hurt to try" are several home remedies I have heard of (trust me, in my long career as a NYC Cosmetic Dentist, I've heard of all kinds of things working, including some that seem to have some merit). These home remedies range from Petroleum Jelly to licorice powder to dabbing some milk or ice on the tingly spot (remember, do this when you first feel it.) I've included a link at the end of this article to a few home remedies.
• For chronic/sever cold sore sufferers, antiviral pills might be the answer. Again, this is a prescription-based solution. But it is effective (at least from what I have personally seen).
One common theme in most of the remedies I wrote about above is the fact that timing is the issue. In short, you have to move fast. Once the cold sore makes its appearance, the chances of it going away quickly diminish greatly. Yes, creams and the like will probably help it heal/ go away faster, but if the big interview is tomorrow, well... (Side note here -- don't put makeup on a cold sore -- it can irritate it).
Ok, two final points on cold sores and treatment -- if you have one, should you keep it moist, or let it dry out and crust? And how long is it infectious to others?
The answers here vary -- if you look online, you'll find both schools of thought in regards to keeping it moist or letting it dry. To illustrate such, I put an e-zine article that recommends both at the end of this post. (Also, if you asked both of your grandmothers, they'd each probably say something different as well!)
Keeping it moist is supposed to deprive the infection of oxygen, thereby helping it heal. Letting it dry is to subscribe to the side that says a cold sore needs a moist environment to thrive. I say do whichever seems to work better for you. Like I mentioned, both seem to be a valid treatment, and each will have their fans, which lends strength to my "whatever works for YOU is best" recommendation.
Last thing on cold sores -- how long are they contagious? Well, the prudent answer (and the only one I'll get behind) is "as long as you can see it, and then probably just a little longer to be 100 percent safe". Really -- if you have a cold sore, don't go kissing anybody, don't share utensils, drinking glasses, or anything else. They can be very contagious, and again, if you can see it, you can probably give it to someone else.
I hope this post has given some insight into these unsightly little things, and perhaps helped someone prevent a cold sore from cropping up before that important event.
Until next time, keep smiling!
Follow Thomas P. Connelly, D.D.S. on Twitter: www.twitter.com/dr_connelly