Overview of cold sores
Synonyms: Fever blisters, oral herpes
Cold sores or herpes labialis is a mild selflimiting infection with herpes simplex virus type 1. Approximately, 20–40% of the population will experience labial or perioral outbreaks of cold sore.1 It leads to the development of small and painful blisters on the skin of lips and perioral area, associated with fever. The infection is mostoften acquired in childhood, but the incidence increases withage.
Causes and Risk Factors of cold sores
After the primary infection, which usually occurs in childhood, the virus remains latent in the trigeminal ganglion (nerve tissue of the face). Factors such as exposure to bright sunlight, fatigue or psychological stress can precipitate recurrences, which are usually in the same area. Herpes viruses are contagious. Contact may occur directly or through infected razors, towels, dishes and other shared articles. Occasionally, oral-to-genital contact may spread oral herpes to the genitals (and vice versa).
Presentation and Diagnosis of cold sores
Prodrome—localized tingling, itching or burning around the lips, mouth and gums.
Appearance of small blisters filled with clear yellowish fluid.
Ulceration of blisters.
Blisters break, ooze and form crusts.
Crusts slough to reveal pink, healing skin
The diagnosis is made on the basis of the appearance or culture of the lesion. Examination may also show enlarged lymph nodes in the neck or groin.
Management of cold sores
The aim of treatment is to reduce pain, to speed healing of lesions and to reduce the frequency and severity of recurrent attacks, with minimal adverse effects. Recent evidence suggests that early application of topical 5% acyclovir may reduce the duration of lesions.3 Further the spread of the virus to other areas of skin can be minimized by washing the blisters gently with soap and water. An antiseptic soap may be recommended. Applying ice or warmth to the area may reduce the pain.
For recurrent herpes labialis, both topical and oral episodic antiviral treatments are effective at reducing the duration of signs and symptoms. Studies with high-dose, short-course valaciclovir suggest that maximum benefit from antiviral therapy may be achieved with as little as 1 day of treatment. Topical steroids may be useful in combination with an antiviral agent.1
Life style changes to overcome cold sores
Written by: Healthplus24 team
Date last updated: September 10, 2012