Cold Sores

Cold sore is a viral disease that we encounter frequently. Cold sores (fever blisters) usually start on the lips and present with blisters filled with fluid. They usually cause pain, but not every cold sore is painful. And unlike canker sores cold sores are contagious and often occur on the outside of the mouth.

The most common places where cold sores occur on the face are the edges of the lips and around the mouth. But they can also spread to the edges or inside the mouth. However, primary infection with the virus usually occurs in areas that are frequently irritated and traumatized. These are the corners of the lips, the edges of the nose, and sometimes around the eyes, respectively.

Causes of Cold Sores

Herpes simplex (herpes virus) is a member of the herpesviruses family. Herpes simplex virus is transmitted through contact (kissing, sexual intercourse, sharing objects, and others). There are viruses in small blisters filled with fluid in cold sores around the mouth. If the bubble bursts during contact (especially kissing) the virus comes out. In that case, one can also transmit it to the other person.

The first transmission of the virus is usually in childhood. It causes cold sores in the form of small blisters in the mouth, nose, throat, palate, and tongue in children. This situation passes easily in 3-5 days with a little fever. The virus usually doesn’t do this again after that. Once the herpes simplex virus enters the body and causes illness, it does not leave. It becomes inactive (latent) by settling in nerve cells, especially nerve endings in front of the ear.

It is the immune system of our body that ensures that herpes simplex remains latent and does not become active and cause disease. As the age progresses, the virus reactivates under suitable conditions and creates cold sores on the lip, especially on the lip-skin junction line. However, cold sores are not limited to the lip margins, we can also see them in the mouth.

Cold Sore Symptoms

Cold sores cause complaints such as itching, burning, and stinging. As cold sores heal, they form yellow-white crusts and then fall off. In terms of signs and symptoms, we can divide cold sores into primary and secondary ones.

Primary Cold Sore Infection

When a person encounters the herpes virus for the first time in his life, the virus enters the skin from the first contact and settles in that area. It passes directly to the inactive (latent) form without any symptoms at a rate of % 99. Over time, depending on the decrease in body resistance, it comes to the first place it entered and creates a cold sore there. Although these cold sores occur in % 1, they are very painful and disseminated. They can appear around the mouth, on the face, or in the genital area.

Secondary Cold Sore Infection

Secondary cold sores are more common. In this case, the virus comes back to the area where it first entered the body with a decrease in body resistance. There it forms small fluid-collecting bubbles on a reddish ground. Before these fluid-filled blisters form, the patient feels burning and pain in that area. We call this hyperesthesia. This burning and pain can last for several days. The blisters, filled with fluid, burst after about 5-6 days and turn into yellow-white crusts. These crusts heal by shedding in a few days. If no additional infection other than herpes virus occurs at the wound site, the cold sore heals completely within 7-10 days without leaving any traces on the skin.

Cold Sore Recurrence Factors

We can group some factors that reactivate the herpes simplex virus and cause cold sores to recur as follows.

Stress

Conditions such as stress, fatigue, insomnia, sadness, pain, and nightmares trigger cold sores. In particular, they are common in students due to stress before exams. Apart from these, cold sores can recur in the autumn and winter seasons due to the negative effects of physical conditions on psychology.

Sunlight

The sun is one of the most important causes of cold sores. Staying in the sun too long can cause lip inflammation. In these cases, cold sores may occur in the lip area. Cold sores can recur very easily in those with sun-induced lip inflammation. Lip balms contain a sunscreen factor that will be useful in these cases. The sun is another reason for the increase in viral diseases in summer.

Local trauma

Movements such as hitting and impact cause damage to the skin and deterioration of skin integrity. The skin integrity of the lip is very important in terms of preventing the recurrence of cold sores on the lip. In other words, if there is trauma such as an abrasion or crack on the lip, we may encounter cold sores frequently. Epithelial creams that create a suitable barrier to the lip and provide the general skin integrity of the lip will be useful in these cases.

Weakened immunity

Cold sores can easily recur in colds, flu, febrile diseases, chronic diseases, cancer, chemotherapy, immunosuppressive treatments, HIV positivity, and other such conditions that weaken the immune system. In addition, they may recur frequently in cases of anemia, iron deficiency, vitamin B12 deficiency, and folic acid deficiency.

Other factors

Due to hormonal reasons, cold sores may occur especially in women during the menstrual period and pregnancy. In addition, nutritional disorders and gastrointestinal changes also facilitate the recurrence of them.

Treatment of Cold Sores

Revealing the factor that triggers the formation of cold sores is very important for its treatment. This factor can be illness, stress, or a blow. Eliminating the factor is the first step of treatment.

The second step is to treat cold sores with creams, ointments, or pain relievers, depending on the situation. Some natural products (such as propolis, echinacea, and beta-glucan) that strengthen the immune system can also be added to the treatment. Apart from this, as in other viral diseases, the patient must eat very well, take adequate fluids, and rest.

It is not abnormal if a cold sore recurs less than 6 times a year. In these cases, they are treated with simple rub-on medications. If a cold sore recurs more than 6 times a year, it means that this condition has become chronic. Patients often consult doctors in these situations.

If a cold sore causes pain frequently, recurs, is in a visible area or disturbs the patient in terms of appearance, an antiviral treatment method lasting 6-12 months can be chosen. It should be noted that antiviral treatments do not eliminate herpes viruses, they only prevent the frequent recurrence and spread of the disease.

Cold Sore Remedies

There is currently no treatment method that will destroy the herpes virus in the body. But we can take advantage of some products that can be found in every home, which make the wound heal faster and have a partial antiviral effect. For example, alcohol is one of the substances that are effective against the virus. If there is no alcohol, we can also use iodine. Because iodine is also a substance with antiviral and antibacterial effects. Apart from these, we can also benefit from sprays containing chloroform and chloroethyl. Pain relievers (eg, ADA-approved; Kank-A Mouth Pain Liquid, Benzodent Maximum Strength Pain Relieving Cream, etc.) are also a good solution for patient relief. If all these are not helpful, it would be healthier to consult a doctor.

Cold Sore Prevention

Kissing, sexual intercourse, and using the same items with the patient are the most important factors that lead to the transmission of the herpes virus. The period when blisters filled with fluid are formed is the period when the probability of herpes transmission is highest. The most important mode of transmission of the herpes virus is contact. Therefore, not being in close contact with sick people and not touching the items they use is the safest method of protection.

Frequent cold sores are an important sign that the body’s resistance has decreased. The occurrence of fever blisters more than four times a year, the width of the affected surface, and the resistance of the disease to treatment require investigation of the patient’s immune system. In addition, it will be useful to eat a balanced diet, exercise regularly, get enough sleep, and stay away from stress, smoking, and alcohol. Apart from this, people with suppressed immune systems should take vitamin and mineral supplements under the control of a doctor when necessary.