Doris Obinna
Sunscreen and good lip care can protect your lips from potential cold sores also known as fever blisters triggers like sunlight and cracked lips. There is a lack of good research on whether medication for the prevention of cold sores (blisters) helps in people with a healthy immune system.
Some people keep getting cold sores/blisters. It is estimated that 5 to 10 out of 100 people who have cold sores get them more than five times a year. Avoiding potential triggers may help to prevent them.
According to study, if someone often has cold sores that really affect them in everyday life, preventive treatment with antiviral tablets may be considered. But these tablets have only been approved for the prevention of other types of herpes infections. If they are used for the treatment of cold sores, it is considered to be non-approved (“off-label”) use, for which special regulations apply.
Herpes is the name of a group of viruses that cause painful blisters and sores. One kind of herpes simplex causes both cold sores around the mouth and genital herpes (herpes around the sexual organs). Herpes zoster, another kind of herpes, causes chickenpox and shingles.
Herpes are bubbles that pop up when fluid collects in pockets under the top layer of your skin. They can be filled with pus, blood, or the clear, watery part of your blood called serum. Most are shaped like circles. Depending on the cause, your blister could itch or hurt a lot or a little. They can appear as a single bubble or in clusters.
In Nigeria, patients who developed fever blisters on their lips or by the side of the mouth usually assume that they have malaria fever. Most of them even inform the doctor that they have started taking anti-malaria drug. But research shows that fever blister, medically referred to as herpes labialis and generally known as lip blister or cold sore, have little or no association with malaria.
In a particular malaria study done by a group of clinicians, the only groups of people with blisters, or sores, are old people. This also shows that blisters are associated with low immunity, which is linked to herpes infection.
Only time will tell. A cold sore on a person’s lip, tongue, or mouth is an outbreak or oral herpes. Oral herpes is most often caused by a virus called herpes simplex virus type 1. Up to 8 out of 10 American adults have oral herpes. Genital herpes is most often caused herpes simplex virus type 2. Both types, however, can cause oral or genital infections. Both are very contagious when sores are present, open, moist, or leaking fluid. Both are also contagious when there are no sores. And both can be spread by touching, kissing, or any other skin-to-skin contact. Even brief skin-to-skin contact is enough to spread either kind of herpes virus.
If you’ve ever had a cold sore, you know the signs. It starts with the tingling, and then the edge of your lip or the corner of your mouth begins to burn. Then the outbreak: An ugly red sore appears. A few days later it breaks open and crusts over.
Cold sores, or fever blisters, are a bother in more ways than one. They are not only painful; they can ruin your smile. When you feel one budding, you want to get rid of it, fast.
But you probably don’t need a doctor. There are things that you can do at home to soothe the pain and make cold sores look nicer as they heal.
According to a Medical Practitioner, William Cole, cold sores or blisters are no fun; they’re painful, itchy, and embarrassing. “But if it’s any consolation, if you struggle with cold sores, you’re definitely not alone. In fact, there are over 3 million cases every year in the United states alone, and 90 per cent of us get at least one cold sore in our lifetime, with 40 per cent of us having recurring chronic cold sore infections. So what are they exactly, and more importantly, what can you do about them?”
He said: “Cold sores, also known as fever blisters, are painful infections that show up as blisters mainly on the lips (not to be confused with canker sores, which are only on the inside of your mouth). These nasty little guys are caused by the herpes simplex virus (HSV-1). For context, HSV-2 is what causes the STD genital herpes outbreaks. Cold sores are also very contagious and can spread to other parts of the body such as the lips, cheeks, eyes, and, yes, the genitals.
“So far, there are actually eight identified members of the human herpes virus family recognised by mainstream medicine. And interestingly, it’s the same group of viruses that cause mono, chronic fatigue (Epstein-Barr virus), chickenpox, and shingles! Herpes is one rough family. The name herpes comes from the Greek word “herpein,” or “to creep” and that’s exactly what these suckers do. They can stay dormant for years until an opportunity to strike occurs. The great news is that there is so much you can do naturally to knock out cold sores for good.”
Also, according to a medical practitioner, Dr Sunday Olalekan, most people are first infected by the virus that causes cold sores before they are 10 years old. After this first infection, the virus remains dormant (inactive) in the nerves of the face. In some people, the virus becomes active again from time to time. When this happens, cold sores appear. HSV-1 can get active again because of a cold or fever.
“Stress also can lead to a cold sore outbreak. This includes mental and emotional stress, as well as dental treatment, illness, trauma to the lips or sun exposure. HSV-1 also can infect the eyes, the skin of the fingers and the genitals. Most genital herpes infections are caused by herpes simplex type 2 (HSV-2), however.
“HSV-1 can cause serious illness in people who have other health problems. The virus also can cause serious illness in people whose immune systems are weakened by either illness or medicines they are taking.”
Causes
The herpes simplex virus (HSV) causes cold sores. HSV-1 and HSV-2 are highly contagious viruses that can be transmitted easily as a result of close contact.
According to Cole, cold sores are caused by a common virus called herpes simplex. Most people get exposed to the virus when they’re babies or children. There’s no cure for it. Once you have been exposed to it, it’s always in your system, even if it doesn’t often cause cold sores or other symptoms.
“Herpes simplex or HSV is spread by close contact. If you kiss someone with a cold sore, or you touch his face and then touch your own face, you can catch the virus. You can also get herpes simplex by sharing lip balm, a fork, a mug or a razor with someone who has it. You’re most likely to get the virus from someone who has an active cold sore, but it’s also possible to contract it from someone who doesn’t have a sore or blister showing.”
Signs and symptoms
People infected with HSV-1 for the first time may have fever, headache, nausea and vomiting. They may have painful swelling and open sores in the mouth. Some people have a sore throat. According to experts, these symptoms usually begin about a week after someone is exposed to HSV-1.
Cold sores appear when HSV-1 is reactivated later in life. They may occur after a period of illness or stress, poor nutrition or sunlight exposure. Sometimes there’s no known reason.
Dental procedures that stretch the lip may occasionally trigger the virus.
Explaining further, Olalekan said the border of the lip is the most common place that these sores appear. They may occasionally occur inside the mouth, too. This is more likely in people who have weakened immune systems or other medical problems.
“The first sign of a cold sore is a tingling, burning or itching. This is followed by swelling and redness. Within 24 to 48 hours, one or more tiny blisters (“fever blisters”) appear. These blisters pop and form painful sores (“cold sores”). The sores eventually are covered by crusts, which look like scabs. The crusts are shed and form again while the sore heals.”
It is important to note that when you are first infected with HSV-1, symptoms can last for 7 to 14 days. Cold sores usually crust within 4 days and heal completely within 8 to 10 days.
Diagnosis
Olalekan said: “Your dentist or physician usually can diagnose cold sores by asking you about your medical history and examining you. If you have other medical conditions, your physician may do other tests to diagnose cold sores. These tests are usually not necessary in healthy people.
“Those with previous experience of a cold sore outbreak will easily recognize a recurrence. People, who suspect that they or their child may have a primary infection, especially if the sore has not healed within a week or so, should see their doctor.
“The signs and symptoms are usually clear enough for a doctor to make a diagnosis, but they may also order a blood test. In some cases, the doctor may take a sample of the fluid scraped from the cold sore to detect the presence of the virus. This is usually done only on patients with weak immune systems, such as those undergoing chemotherapy, or people with HIV or AIDS.”
Treatment
Some medicines can help cold sores heal faster. They also relieve pain and discomfort. The medicines are acyclovir (Zovirax), famciclovir (Famvir) and valacyclovir (Valtrex). These drugs cannot get rid of the virus. You need to take them each time you can feel a cold sore coming on.
Once you have blisters on your lip, the medicines will not help much.
These drugs also can stop cold sores from popping up in the first place. Some people take them when they know they will be under stress.
Keep the area clean and apply lip balm. Try not to touch the area. Do not pick at the crusts over the sores. Avoid kissing anyone while you have blisters and sores.
Cold sores can spread through kissing and by sharing things that touch the lips and the skin around them, such as spoons, forks, glasses and towels.
“Cold sores are common. They usually are not dangerous. If you have a weakened immune system (because of a disease, or because of medicines you take), HSV-1 can cause a serious illness. Call your dentist or physician right away if lip or mouth sores persist longer than one week, the sores make it hard for you to talk or swallow or you develop a fever,” advised Cole.
Also, some over the counter (OTC) creams are available that do not contain antiviral medication. Examples are bonjela, blistex, or cymex. These may reduce discomfort.
These treatments do not speed up the healing process, but they may help if the cold sores are dry, itchy, or painful.
Patients should dab these creams onto the sores without rubbing, then wash their hands. People with cold sores should not share creams.
Painkillers
Ibuprofen or Tylenol, containing paracetamol, may help alleviate pain. These are available in liquid form for younger patients.
Pregnant women who have cold sores should discuss their treatment options with their doctor.
Patients with weakened immune systems
Patients who have, for example, HIV or AIDS or who are undergoing chemotherapy may face complications, because their immune system is compromised.
The infection may spread to other parts of the body, including the eye, and there is also a risk or swelling of the brain, referred to as encephalitis.
Such patients may be prescribed antiviral tablets. They may need to see a specialist. However, treatment depends on the severity of symptoms, and the patient’s medical condition.
Prevention
To help to prevent a first herpes infection especially in children do not let them be kissed by anyone who has cold sores, fever blisters or signs of a first herpes infection. However, HSV-1 is very common. Most children will be infected by the time they reach adulthood. Several different vaccines are being developed against HSV (types 1 and 2), but these appear to protect only people who have never been infected.
There is evidence that using sunscreen on your lips will prevent cold sores caused by sun exposure. Antiviral medicines may prevent cold sores from forming. In certain situations, your dentist or physician may prescribe these medicines. If you expect to encounter a known trigger, a medicine taken in advance can decrease the chance of a cold sore.
Facts on cold sores
• Cold sores are tiny blisters that develop on the lips or around the mouth.
• The herpes simplex virus strain HSV-1 normally causes them.
• They usually clear within 7 to 10 days without treatment.
• The virus is highly contagious and can be passed on through close direct contact.
• After someone has contracted the “cold sore virus,” it remains inactive for most of the time, but triggers such as fatigue and injury can activate it.