How to get rid of cold sores

Cold sores are small blisters that typically develop around the lips or mouth. They are caused by the herpes simplex virus type 1 (HSV 1). Half of the world’s population (around 3.7 billion people) are carriers of HSV 1, making it one of the most common viral infections globally.

What is a cold sore?

Cold sores (or fever blisters) often start out as a red patch around your mouth. Within a few weeks, they will begin to blister and turn white. After 1 to 2 weeks, you may notice a yellow crust forming on top of the blisters which is a sign that they are healing.  

Cold sores aren’t dangerous and usually resolve without treatment, but they can cause discomfort and make you feel self conscious as well. You may also notice other symptoms such as fever, swollen lymph nodes, and fatigue, especially during the initial infection.

Not everyone who carries the HSV 1 virus will have cold sores. Some carriers may never experience a single outbreak or cold sore.

Less often, herpes sores can show up anywhere on the body, including arms, legs and torso.  If you develop a herpes sore in or around the eye, you may require urgent treatment to prevent damage to your sight.

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Canker sore vs cold sore

It’s easy to mistake canker sores for cold sores, but they are not the same. Canker sores occur only inside the mouth and are not the result of an infection. Cold sores can occur inside or outside the month and are, as mentioned, caused by a virus.

What causes cold sores?

Cold sores are mostly caused by HSV 1, but herpes simplex type 2 (HSV 2) can also lead to open sores and blisters around the mouth as well as on the genitals. HSV 2 remains the dominant cause of genital herpes, but recent studies show that people can get cold sores around the mouth when performing oral sex with an HSV 2-infected partner.

Cold sore outbreaks due to HSV are more likely during times when your immune system is compromised or sressed, e.g. when you have a cold or flu.

Cold sore prevention

What causes cold sores to flare up will be different from individual to individual. But, if you suffer from frequent outbreaks, it’s best to try and prevent them. There are a couple of measures you can take that do not involve medication.

Avoid

• Exposure to sunlight or tanning beds
• Extreme temperatures (hot or cold)
• Stress
• Cracked lips

You can wear sunscreen and apply lip balm to keep the skin on or around your lips intact and avoid direct exposure to sun.

Regular exercise and a helathy diet can help maintain your immune system.

If you currently have cold sores, it is imprtnat to avoid spreading the virus to others. 

Measures you can take to avoid transmission include:

• Not coming into direct contact with others until the sores have completely healed.  Avoid kissing, for example.
• Not sharing cutlery, toothbrushes or towels
• Disinfecting your hands after touching your lips
• Avoiding oral sex
• Parents of newborns should not kiss their babies because their immune system has not fully developed.

Cold sore treatments

Cold sores tend to clear up without treatment after 2 weeks. But if your symptoms are painful or you are looking to get rid of a cold sore fast, here’s what you can do:

The fastest way to get rid of a cold sore is by treating it as soon as you notice any symptoms. You can apply an antiviral ointment 2 to 5 times a day. They are available over-the-counter at your local pharmacy or supermarket.

• Acyclovir (Zovirax)
• Penciclovir (Denavir)

You can also take antiviral oral tablets such as:

• Famciclovir (a dose of 1.5 g once)
• Valacyclovir (Valtrex) (take 2 g twice for one day, 12 hours apart)

Antiviral ointments do not prevent cold sores from recurring in the future even if you apply them every day.

If you get cold sores often and are in a relationship, long-term suppression therapy with valacyclovir has been shown to be effective in preventing cold sore outbreaks, and lowering your risk of spreading HSV to your partner.   

Unfortunately, there are no miracle cures for fever blisters. Although antiviral remedies work fast, none of them work in just 24 hours. Once you’ve developed blisters, they will take at least a few days to heal completely.

However, there are a few home remedies you can try to reduce the severity or duration of a cold sore:

• Support your immune system. As mentioned, eating well and execising regularly can help optimize immune function.
• Kanuka honey. Applied five times a day, this honey from New Zealand has been shown to be just as effective as acyclovir cream in reducing cold sores.
• Propolis. Propolis is a component of bee pollen that may have antiviral properties. It is available as a supplement or as an ingredient in some cold sore creams.
• Lemon balm. There is some evidence that lemon balm ointment could be beneficial in speeding up the healing process.
• Lysine. Some research suggests that taking lysine regularly may result in fewer cold sore outbreaks. 
• Zinc cream. There is evidence that zinc inhibits HSV 1 and HSV 2 virus from spreading.

Should I pop a cold sore?

It can be tempting to touch or pick at scabs and cold sores but doing so usually slows down the healing process. Try to avoid touching, popping or picking at a cold sore or scab. Avoid direct contact with acidic or spicy food which can further irritate the skin.

If you do have cold sores very often or develop them near your eyes, consult a doctor ASAP.

References

1. World Health Organization: WHO. (2015, October 28). Globally, an estimated two-thirds of the population under 50 are infected with herpes simplex virus type 1. Retrieved from Who.int website: https://www.who.int/news-room/detail/28-10-2015-globally-an-estimated-two-thirds-of-the-population-under-50-are-infected-with-herpes-simplex-virus-type-1
2. InformedHealth.org [Internet]. Cologne, Germany: Institute for Quality and Efficiency in Health Care (IQWiG); 2006-. Cold sores: Overview. 2018 Jul 12. Available from: https://www.ncbi.nlm.nih.gov/books/NBK525782/
3. Famvir. (2019, January 4). Retrieved November 5, 2019, from RxList website: https://www.rxlist.com/famvir-drug.htm#clinpharm
4. Valtrex. (2018, October 25). Retrieved November 5, 2019, from RxList website: https://www.rxlist.com/valtrex-drug.htm#indications
5. Chi, C.-C., Wang, S.-H., Delamere, F. M., Wojnarowska, F., Peters, M. C., & Kanjirath, P. P. (2015). Interventions for prevention of herpes simplex labialis (cold sores on the lips). Cochrane Database of Systematic Reviews. https://doi.org/10.1002/14651858.cd010095.pub2
6. Semprini, A., Singer, J., Braithwaite, I., Shortt, N., Thayabaran, D., McConnell, M., … Beasley, R. (2019). Kanuka honey versus aciclovir for the topical treatment of herpes simplex labialis: a randomised controlled trial. BMJ Open, 9(5), e026201. https://doi.org/10.1136/bmjopen-2018-026201
7. Bankova, V., Galabov, A. S., Antonova, D., Vilhelmova, N., & Di Perri, B. (2014). Chemical composition of Propolis Extract ACF® and activity against herpes simplex virus. Phytomedicine, 21(11), 1432–1438. https://doi.org/10.1016/j.phymed.2014.04.026
8. Mazzanti, G., Battinelli, L., Pompeo, C., Serrilli, A. M., Rossi, R., Sauzullo, I., … Vullo, V. (2008). Inhibitory activity ofMelissa officinalisL. extract onHerpes simplexvirus type 2 replication. Natural Product Research, 22(16), 1433–1440. https://doi.org/10.1080/14786410802075939
9. Gaby AR. Natural remedies for Herpes simplex. Altern Med Rev. 2006 Jun;11(2):93–101

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