What are Cold Sores?
Cold sores form as a cluster of small blisters on the lips, around the corners of the mouth, or sometimes inside the nose. They are also referred to as fever blisters, and the medical term for them is recurrent herpes labialis.
Once the cold sores develop, the blisters are more obvious and clearly recognizable. When the blisters break, an extremely painful, moist sore develops. Thereafter, a crust or scab forms over the sore.
Cold sores are caused by a highly contagious viral infection, the herpes simplex virus-1 (HSV-1). If you are exposed and infected with the herpes virus, it may stay dormant in your system forever, with occasional bouts of activity and infection.
Types of HSV infections
There are two types of HSV infections – HSV type 1 and HSV type 2.
- HSV type 1 usually only infects those body tissues that lie above the waistline and is the most common cause of cold sores. Children often develop the HSV-1 virus, becoming infected from a sibling or parent.
- HSV type 2 generally infects those body tissues that lie below the waistline, and is more common in the genital area. However, it is also responsible for approximately 10% of cold sores in adults.
Diagnosing Cold Sores
Although most cold sores are self-diagnosed and cared for at home, there are definitive diagnostic methods available. The diagnosis is based on the medical history of the patient, physical symptoms, as well as examination of the skin. A viral culture will confirm whether the diagnosis of a cold sore is accurate. Cell scrapings from the blister will also be able to detect whether you have herpes type 1 or 2.
What Causes Cold Sores?
The most common way the virus is spread is through physical contact, such as kissing. Washing your hands thoroughly after touching the affected area will help prevent spreading the virus to other parts of your body or another person.
A cold sore infection occurs when latent herpes simplex virus particles become reactivated. It is not a sign of a recently acquired herpes simplex infection. Also known as primary herpetic stomatitis, the initial herpes simplex virus infection usually does not take the form of a cold sore. It is for this reason that a person may not associate their initial exposure to the herpes virus with their current outbreak.
With initial infection, the virus penetrates small breaks in the skin caused through injury or trauma, and then travels to the nerve roots on the spinal cord, where it lies dormant. Whenever our immune systems are low, the virus travels through the body down to the sensory nerves to the skin. When the virus reaches the cells of the skin, it multiplies and damages the skin cells, resulting in blisters. Eventually a cold sore develops.
Whether a cold sore is visible or not, this virus is always seeking new cells to infect. This process is called viral shedding. Because there are large numbers of herpes particles being shed or released, it is extremely easy to expose or even infect others.
The eyes seldom become infected, but it would be wise to protect them from the virus, since it can potentially cause eye problems and, in extreme cases, blindness. Managing your stress levels and avoiding excessive sunlight can help to reduce outbreaks.
Contributing Factors that May Trigger an Outbreak
- Colds, the flu and other upper respiratory tract infections
- Excessive exposure to the sun and wind
- Hormonal changes during menstruation
- Dry, cracked lips and injuries as a result of cosmetic surgery, laser therapy, or chemical peels
- Physical and emotional stress lower the immune system (thus allowing the virus to reactivate)
Warning Signs and Symptoms of a Potential Cold Sore Outbreak
These types of signs are referred to as the prodrome or prodromal symptoms and include:
- A sense of fatigue, irritability, headache, tingling, numbness, swelling, fever, or pain may be felt prior to the outbreak of a cold sore
- Localized redness and swelling (inflammation) may occur even though the skin may appear normal
- Mouth becomes painful and gums are intensely inflamed, usually after the first signs of infection
- Small blisters may have formed that do not look like blisters as yet, but rather look like tiny red bumps
Help for Cold Sores
Cold sores treatment should begin as soon as the symptoms first appear. There are a variety of topical creams such as skin protectants and oral analgesics that are available over-the-counter that can provide temporary relief. There are also prescription medications available; but as with other drug treatment, they carry the risk of side effects. Most cold sores usually clear within 7-10 days.
A more natural alternative to treating cold sores is the use of herbal and homeopathic remedies. These remedies are gentle to use, and also address your overall health and well-being without harsh side effects. Herbs such as Echinacea and Viscum album can provide a natural immune system boost. Astralagus membranaceus is a potent Chinese remedy with a variety of benefits as a convalescent and rejuvenating tonic. Olea europea (extract of olive leaf) contains a compound called oleuropein acid, which is effective against numerous viruses, bacteria, and fungi.