It seems like once a year or so I get around to doing a blog post on cold sores, so here's one for 2012. Specifically, today I want to talk about treating a cold sore, and whether it is better to let it dry out, or to keep it moist.
This topic came up the other day when I was talking to a patient about cold sores. He told me about his two grandmothers and their conflicting views on treating everything, cold sores included. (They conflicted on lots of stuff, it appears.) I wrote almost this exact thing a year ago (that two grandmothers might provide two different remedies), so I really thought his story was interesting, and I asked for permission to retell it here. He said it was fine. (Obviously, I won't use any names.) Anyway, I'll paraphrase it like I heard it -- so when I say "I" in the following, I mean my patient.
Like most people, I had two grandmothers growing up. The grandmother on my mom's side (Italian) was called "Nana," and my grandmother on my father's side, "Oma." (My father's side was comprised of a cornucopia of European nationalities.) Nana and Oma really didn't like each other very much. OK, they co-existed on our holiday gatherings, but there was definite competition. Like who got the center of the table for their main holiday dish (Nana always had sauce, meatballs and garlic bread that would bring tears to your eyes, and Oma would make a bratwurst with all the trimmings that would have ended World War II.) Really, these two should have teamed up, but they didn't. It was somewhat comical when Nana would subtly, over a few minutes, nudge the brats off the table center and replace it with her sauce. And the inevitable counterattack by the potato pancakes. Really, it was like two generals moving pieces on the chessboard.
Not surprisingly, each had a bevy of "home remedies" for any and all afflictions. And sometimes they were odd: Oma said use an onion for a toothache, Nana said to use oregano. (Were they trying to help me, or make a salad?) But one Christmas I had a cold sore, and at the family gathering, unsurprisingly, both grandmothers were on opposite sides regarding an effective remedy.
Nana told me to keep it moist. Her reasoning was that it was a virus, and to keep it moist would starve it of oxygen. It almost didn't matter to her what I used to keep it moist -- Vaseline, butter, olive oil (What is it with the food remedies?) -- just keep it moist, and it would go away.
Before I could get to the bathroom and get the Vaseline (because I didn't want to smell like olive oil), Oma ambushed me and asked what I was doing. (Oma already knew, of course -- her espionage skills were top-notch.) When I told her, her nose did that wrinkle thing that essentially said "Nana is crazy, and has sauce on the brain. Oma knows what you need." I'm not certain whether Oma really knew of a cure, or if she was just contradicting Nana because that's what was expected. But Oma had the exact opposite take as Nana -- she said that a cold sore was a virus, and that my body needed oxygen to fight off the virus. When I told her that I got plenty of oxygen by breathing, she did the nose thing again and said that's not what she meant -- that the cold sore had to dry out.
Ok, this was a tough spot, because there was no way I could hide which side I chose -- the cold sore would either be moist or dry, and it would be visible to all. I really didn't know what to do, so I did what any teenaged boy would do -- I checked the kitchen. Nana had her traditional sauce, which made me very happy. Oma, on the other hand, had a problem with her stove that year and instead of brats, she made a salad and some things made out of eggs that I didn't recognize. That settled it -- moist it was for the cold sore. I made sure to eat my sauce messily, so that covered me a little, but I'm sure Oma knew. Sorry, Oma -- your brats would have pulled you even and made for a long night for me. But the salad just didn't cut it. And you knew it too, conceding the table center for the first time ever.
A side note -- the next year, the brats, and the table war, were back in full force. And I was cold sore free, so I could enjoy the conflict without being in the middle of it.
Ok, Tom's back. Neat story, huh? But who is right?
Last year, I posted that there were two schools of thought, and that my opinion was to do whatever worked for you. And I still stand by that, but I will say that in looking for answers online, it seems that the "moist" side has more medical clout behind it. (The Mayo Clinic endorses moist.) I could not find any peer-reviewed or "name" information recommending dry, so I will have to throw my recommendation to keeping it moist, although there is probably an army of grandmothers out there who may disagree.
Until next time, keep smiling.
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