Cold Sores

Cold Sores: Free advice – ask me today!

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By Dr Helen Webberley MBChB MRCGP MFSRH | GMC no. 3657058

I am a GP and a sexual health and hormone specialist. I can give advice on any medical matter, and I offer safe access to medical advice, prescription medication, blood tests and x-rays, and specialist referrals to your local private hospital as needed.

Cold Sores

 

Cold sores, most commonly known as fever blisters, manifest themselves as small blisters around the mouth area, especially on the lip. They cause a burning sensation, pain or itching, then they break open and leak a clear fluid, crusting over after a few days or even weeks.

Herpes simplex virus (HSV-1 and sometimes HSV-2), a highly contagious virus, is the primary cause of cold sores, being present in about 50-80% of the population, but not all of them develop fever blisters, genetics playing a big part in who gets them and who does not.

Frequently Asked Questions

What causes cold sores?
Despite the name, cold isn’t to blame for their development. Herpes simplex virus is most often the cause. The herpes family of viruses consists of eight different types, but only the first two can cause fever blisters. You can get the virus by direct contact with an infected person’s body fluid or skin. The herpes virus produces damages to your skin as it reproduces.

It hides inside nerve cells between outbreaks and it can’t be cured. The only measures you can take are to reduce their frequency and duration.

What are the triggers?
  • Direct sunlight exposure
  • Stress
  • Fever
  • Period
  • Fatigue
  • Dental Trauma or injury of your mouth and lips area
  • Weakened immunity
What are the symptoms?
  • Tingling, burning or itching sensation
  • Swelling, lesions, blisters or even ulcers around the mouth area
  • Swallowing difficulties
  • Sore throat
  • Nausea
  • Headaches
  • Muscle aches
  • Fever
Is there a blood test that confirms the infection?
Normally, you would recognize the condition spot on – especially if you had a previous experience with cold sores – and the signs and symptoms are usually clear enough for you or your doctor to make a diagnosis.

But there are certain situations – patients with weakened immunity during chemotherapy or those with HIV or AIDS – when a blood test is ordered to detect the presence of the virus, so they can start treatment right away.

The virus can also be detected from a sample of the fluid inside the blister.

What are the stages of cold sores?
  • Tingling and itching sensations
  • Small fluid-filled blisters
  • Oozing and crusting
When are you contagious?
Trough bodily fluids, you can spread the virus at any time, but direct contact transmission occurs only during the active phase of the condition – from the beginning of symptoms to when the skin is completely clear.

How can you stop the herpes virus to spread?
  • Don’t kiss
  • Don’t share toothbrushes, kitchen utensils or glasses, towels, lipstick
  • Wash your hands regularly
  • Avoid oral sex

 

When to see a doctor?
  • Cold sores doesn’t go away after 2 weeks
  • Symptoms are severe
  • Frequent recurrences
  • Eye irritation
Are there any treatments or medications for cold sores?
There is no cure for cold sores. Most cold sores outbreaks clear up by themselves after 1-2 weeks. But there are some medications and ointments that may shorten the duration of the outbreak and ameliorate the discomfort. These include:

  • Antivirals
  • Some OTC creams or gels
  • Hot or cold compresses
  • Painkillers
Can cold sores lead to serious complications?
Complications appear only in immunodeficient patients and include:

  • Dehydration
  • Herpetic whitlow – blisters appear in other parts of the body due to a cut or graze of the skin
  • Herpetic keratoconjunctivitis – untreated, it can lead to vision loss
  • Encephalitis – untreated, it can lead to brain damage or can even be fatal

Medication

Acyclovir cream

Acyclovir creamis an antiviral medication used for treating herpes virus infections by stopping viral replication. It can’t eliminate the virus completely, neither can prevent transmission to other people.

Discuss with your doctor any current medications or conditions and if you are pregnant or planning to have a child. Also, consult your physician or pharmacist regarding the way you should apply the cream.

Acyclovir tablets

Acyclovir tabletstablets and other forms of administration (except the topical one described above) are usually used in hospital settings, for immune compromised patients (HIV, transplant). Monitoring these patients is essential because of the serious side effects that can occur.

Famcyclovir tablets

Famcyclovir tabletsFamcyclovir is another antiviral drug from the same family and it is indicated in the first 3 types of herpes virus infections (HSV-1, HSV-2 and varicella-zoster). Some studies said that if you start the famcyclovir treatment right after the first infection, it can significantly lower the chance of recurrence.

Safe, real prescriptions for Cold Sores.

Blood Tests

HSV-1

HSV-1 –  it is a type-specific IgG (Immunoglobulin G) test that uses the immunoblot format to differentiate between the two types of herpes simplex antibodies. A positive tests means that HSV-1 antibodies are present and thus confirm the oral herpes infection. Almost 90% of people infected don’t have any symptoms.

HSV-2

HSV-2 – uses the same technique as the HSV-1 test, but positive results are rare if you have cold sores, HSV-2 antibodies being more specific to the genital herpes.
A negative result doesn’t always mean that you are not infected. If you take the test too early – before 3 weeks from when you first contacted the virus – antibodies are not detected by this test (same for HSV-1 test). 100% accuracy occurs only after 6 months from infection.

Immune screening

Immune screening – screening for HSV-1 and HSV-2 is done only when there are diagnostic dilemmas or special circumstances like:

  • Pregnancy
  • Recurrent genital ulcer
  • Partner testing for genital herpes

Contact me now for advice, prescriptions, blood tests and referrals.

Please note that this service does not aim to replace advice given to you by your own doctor, it is meant to supplement your health knowledge and awareness.

It is never to be used in the case of a medical emergency.

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