The Cold Sore

Many people in time of stress will develop small, painful, bumpy lesions on their lips, or just under the nose or around the mouth or develop severely chapped lips. In the mouth the sores may be fleshy or may be shallow ulcers that are painful. The triggering stress could be a cold or other acute illness, a job or family stress, a sunburn, exhaustion, another illness such as cancer or diabetes to mention a few. These "cold sores" show up at the most inconvenient times: a wedding, an important job interview, the arrival of the grandchildren for a few days. The heat of summer seems to allow cold sores to bloom and bloom.

Cold sores are really a Herpes Simplex virus. It is not a sexually transmitted disease as such, but it is contagious. The word Herpes comes for the Greek meaning "to creep", describing how the lesions would spread on the body. Kissing another person, especially when there are lesions visible, places that loved one at risk for picking up the virus. A kiss on the lips to express our devotion could mean a new case of Herpes! The infection takes place locally, on or about the mouth or even in the mouth. You may hear the doctor call the infection stomatitis: inflammation of the mouth.

When a child or elderly person, or immune compromised person gets a first time infection, the illness can become very intense. Sometimes it is important that the patient be hospitalized and given IV fluids and IV antiviral medicine such as acyclovir. Sometimes the infection can cause meningitis and encephalitis. A child may seem confused or walk off balance. Most of the time the illness just runs its course and even the mild meningitis quickly resolves. However, for a few it can be a very serious disease. The mouth sores may become so painful that an affected child or adult could become dehydrated and very weak. Topical pain medicines such as teething gels or viscous lidocaine may help. Starting antiviral medicine early can help block a serious turn of the illness. The same medicine used to treat genital herpes (you have seen the ads on TV) will help in this Type I Herpes: Acyclovir, Valtrex, Famvir. There are topical medicines for symptoms of mild recurring disease. These require many applications: Zovirax an Denavir are examples.

Kissing on the cheek, or pretend kissing (without actual contact) helps reduce the transfer of the virus. A good hug could substitute for a kiss. When a person is congested, even a hug may increase risk of sharing an illness. One major caveat: the temptation to touch one’s cold sore often seems impossible to resist. Resist. If the cold sore is touched, then washing the hands with soap and water and drying with a paper towel instead of a family bathroom towel will help control sharing the infection. Routine washing of shared surfaces: tables, desks, telephones and computer keyboards is also an aid in controlling all infections. Refrain from sharing drinking containers and from eating off of another’s plate or using their utensils. Never borrow another’s used toothbrush. During a flare change the pillowcase every couple days to reduce spread of the virus. Avoid getting a sunburn. If a child has had recent vaccinations against viral illnesses, including chicken pox which is a herpes virus, it may be wise to avoid time in the sun for several days so there will be fewer skin reactions and less toxicity. Do not use aspirin during a herpetic illness. Until the age of 22 it is advised there be no use of aspirin for fever care to reduce the risk of the rare but very serious Reyes Syndrome.

Cold sores are usually mild, irksome, recurring uncomfortable inconveniences. Occasionally this Herpes virus can cause some serious illness. Good general hygiene can minimize the risk of spread. There are medicines that can help. We work together towards Health.