What causes cold sores and how do you get rid of them?

photo: howtogetridofthis.com

Q: I get cold sores on my mouth a lot. What causes them and how can I get rid of them?

A: Cold sores are caused by the herpes simplex virus (HSV), a stinker of a bug that establishes permanent residence in your nervous system once it infects you.  Fortunately, most of the time the virus lies around doing nothing, but it can be “reactivated” by any number of things: stress, fever or sickness, menstrual cycle, burns and damage to the skin by sun or wind.

When the virus becomes active, there is usually some numbness or tingling in the area where a cold sore will form. About two days later, painful blisters called “vesicles” develop, which then pop and ooze. The sores usually take 7-10 days to completely heal, although in general the pain is the worst the first day or two. Cold sores usually develop on the lips, but can occur anywhere in the mouth.

Unfortunately, there is no cure for cold sores.  There are, however, some things you can do to make the virus less likely to re-activate and treat it if it does:

  • Avoid stress! (Isn’t that an obnoxious thing to say during fall quarter?) Get enough sleep; eat right and use sunscreen if you’re outside.
  • Antiviral medications can make the cold sores less severe and go away a little faster, but they have their limitations: they are expensive, must be started within a few hours of symptom onset to be effective, and don’t all work fabulously well.
  • There are a variety of medications that can minimize the symptoms.
  • Suppressive therapy (medicines taken daily even when there is no active cold sore) can be helpful for patients with frequent reactivation.

If you have a cold sore, wash your hands frequently to avoid spreading the virus to other people or other parts of your body.  It is especially important to wash your hands before touching your eyes or genitals, as these areas are particularly susceptible to the virus. Herpes simplex virus infections of the eye can lead to permanent visual impairment.

If you experience cold sores with eye irritation, cold sores that recur frequently, or cold sores bigger than a toy poodle, be sure to schedule an appointment with your health care provider.

John A. Vaughn, MD
Student Health Services
The Ohio State University

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