cold sore

They are mean, nasty, painful and unsightly.  If you are a fellow sufferer you know exactly what I am talking about!

They can be predictable.  For instance, after too much sun or wind, a fever, stress or anything taxing on your system.  But they can also be unpredictable, coming on out of no where for no apparent reason,  leaving your lips looking swollen, sore and uninviting.

Cold sores (or fever blisters) are  caused by HSV (herpes simplex virus)  type I.  Genital sores are generally caused by HSV type II.  However, both can occur in either location.  Transmission is through intimate contact, such as kissing or oral sex.  An oral lesion can be transmitted to the genitals and vice versa.  A lesion is contagious until it completely crusts over or heals.  Once infected, outbreaks are  frequently associated with stress, certain foods or a womans menstrual cycle.  Between outbreaks the virus lays dormant in the nerve cells until it is activated.  Most individuals report feeling  itching or sensitivity right before an outbreak.  Ideally, this is when treatment is initiated  in order to reduce the severity of an outbreak.  The sooner anti-virals are introduced the better.

There are numerous anti-virals to treat HSV I or II.  Acyclovir (Zovirax), Penciclovir (Denavir) and Valacyclovir (Valtrex) are commonly prescribed.  Abreva® (docosanol) can also be applied topically to help to reduce the severity of an outbreak by preventing the virus from replicating.  Ideally, if you suffer from cold sores frequently enough, you have a supply of your medication of choice available at all times.


I find these single dose ampules very helpful as well.  They are a combination of an numbing agent and alcohol.  If a cold sore gets to the blistering stage these really dry it out and reduce the healing time in addition to numbing the area slightly.  I find having a small bag with a dose of Valtrex,(my medication of choice) an ampule of Orajel™ and Abreva® in my purse to be the most proactive way to deal with cold sores.

In my line of work we frequently put patients with a history of cold sores on antivirals prior to treatments that can induce an outbreak.  For instance, IPL’s, laser treatments, chemical peels or lip injections. Prevention or prophylactic treatment seems to be the best approach.

Also, sunscreen can be very helpful in the prevention of UVA/UVB induced outbreaks.  I love elta MD® UV lip balm.  It has transparent zinc oxide, is water resistant and has a nice minty taste.

Elta Lip

There are other dietary supplements that can be helpful, for instance the amino acid Lysine.  Although it is not well studied and in high doses over time can create complications, such as kidney problems.

Ultimately, each individual learns there own triggers and can plan accordingly.  Some people have an initial outbreak and then never have a reoccurrence.  (lucky ones)

Hopefully this quick synopsis helps my fellow sufferers!

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