Cold sores, also known as fever blisters, oral herpes or herpes labialis, usually appear on the mouth and lips in the form of small, fluid-filled blisters, lasting approximately one-to-two weeks. Cold sores are extremely common, with an estimated 50–80% of adults in the U.S. thought to carry the virus that causes them, and up to 90% of adults exposed to the virus by age 50.Oral Herpes also known as cold sores are...
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Cold sores appear as tiny, fluid-filled blisters around the mouth and lips and often appear in clusters. Cold sores are often reccurring, although some people will only experience one outbreak in their lifetime. Subsequent outbreaks usually occur in the same location as the initial eruption, but are generally less severe and of lesser duration than the initial outbreak.
Cold sores are usually caused by the herpes simplex virus type 1, or HSV1. Most people are exposed to HSV1 in childhood, usually from an infected friend or family member, although only about 30% will ever go on to show symptoms. As part of the herpes simplex family of viruses, HSV1 is not curable and may reoccur. When not active, the virus hides in the nerve cells until reemerging during the next outbreak.
Although less common, cold sores can also be caused by herpes simplex virus type 2 (HSV2), generally known as genital herpes.
Once the virus has been acquired, there are many factors known to contribute to triggering an outbreak:
Like all herpes simplex viruses, cold sores are highly contagious and transmitted by skin-to-skin contact. Generally associated with HSV1, cold sores are typically transmitted through mouth-to-mouth contact, such as kissing.
The HSV2 genital herpes virus can also cause cold sores, however. In these cases, transmission is usually through genital-to-mouth contact during oral sex. The reverse is also possible, with an HSV1 cold sore being transmitted to a partner’s genitals via mouth-to-genital contact.
The virus is most contagious during an outbreak, particularly when blisters are oozing, but may be transmitted even when the virus is dormant. Avoid contact whenever an active cold sore outbreak is present.
You can further help prevent transmission by avoiding sharing items such as toothbrushes, towels, lip balm and utensils, as well as washing your hands carefully after touching the affected area. If transmission is of concern, antiviral medications may be considered.
Symptoms can appear from two to 12 days after initial exposure to the virus. The first sign can often be flu-like symptoms, such as fever, body aches, swollen glands in the neck, and a sore throat.
Although cold sores can last up to a month, outbreaks rarely last longer than two weeks and move through a predictable pattern of stages:
Often, cold sores do not require medical attention and will heal on their own. However, see your doctor if:
Your doctor will generally diagnose a cold sore visually, just by looking at it. If confirmation is desired, a swab of the sore may be taken to confirm the presence of the herpes simplex virus.
Although not common, complications from cold sores can arise in other parts of the body, including:
Certain medical conditions and treatments increase the risk of complications from HSV infections. Be sure to inform your doctor of any of the following compromises to your immune system:
In these cases, your doctor may recommend regular use of antiviral medications such as Famciclovir (Famvir) to prevent complications.
Cold sores are often mild and may not require any specialized treatment. In cases where cold sores are particularly frequent or severe, antiviral medications can be used to reduce the frequency, severity and duration of cold sore outbreaks.
Antiviral creams such as Doconazole cream or Acyclovir cream are applied directly to the affected area. Other antivirals, including Acyclovir and Valacyclovir are taken by mouth. Acyclovir (Zovirax) is most often used to treat an existing outbreak, while Valacyclovir (Valtrex) is often taken on a daily basis to help prevent recurrences. Your doctor will decide which is best for you.
For those with compromised immune systems, the prescription cream Penciclovir may be prescribed for use at the first tingle of an outbreak to help reduce its duration. In cases of severe complications, an IV antiviral along with close doctor supervision may be warranted.
If your cold sore outbreaks are particularly frequent or severe, you may want to consider antiviral medications such as Acyclovir (Zovirax), Famciclovir (Famvir) or Valacyclovir (Valtrex) taken on a daily basis to reduce the rate of recurrence. As stress, fatigue and a compromised immune system are all known triggers for cold sore outbreaks, take steps to keep your body and mind healthy through regular relaxation, moderate exercise, and healthy eating. Add high-lysine foods to your diet, including red meats, fish and dairy products. Additionally, apply sunscreen to your face and mouth daily, and regularly replace your toothbrush and razor - particularly after experiencing an outbreak.
Cold sores are highly contagious. To prevent transmission to others: avoid touching the blisters; always wash your hands after applying any medication; do not share toothbrushes, towels, razors or eating utensils; and avoid physical contact between the affected area and others when you are experiencing an outbreak. Note that it may still be possible to transmit the virus, even when you are not having an outbreak. Antiviral medications such as Acyclovir (Zovirax), Famciclovir (Famvir) or Valacyclovir (Valtrex) taken on a daily basis can help reduce the likelihood of giving a cold sore to someone else.
Cold sores normally appear on the outside of the mouth around the lips. When cold sores do appear inside the mouth it is usually in non-movable areas, such as the gums or roof of the mouth. Sores inside the mouth could be canker sores, also known as aphthous ulcers. Like cold sores, canker sores can be a reccurring problem and quite painful. Unlike cold sores, however, canker sores are not contagious.
Yes. While cold sores are usually associated with HSV1 and genital herpes associated with HSV2, it is possible for either strain of the virus to affect both the mouth and the genitals. If someone with a history of cold sores performs oral sex on a partner, it is possible to transmit the virus to their partner’s genitals. While transmission is most likely to occur while a cold sore is actively present, it may still be possible to spread the virus while it is dormant. If this is of concern, antiviral medications such as Acyclovir (Zovirax), Famciclovir (Famvir) or Valacyclovir (Valtrex) taken on a daily basis may help reduce the risk of transmission.
Disclaimer: This is not medical advice. You and your physician will determine if and how you should take any medication prescribed to you following a medical consultation.
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