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Cold sores are a pain in the mouth

What is a cold sore?
Cold sores are annoying, unsightly, painful outbreaks generally found on the lips or in the corners of the mouth. Many people are affected by them and suffer with this condition on a repetitive basis. There are things that can be done to treat outbreaks and things that can be done to avoid transmission to others. If you are plagued by cold sores, learn about what you can and should do to keep the condition under control.

What causes cold sores?
Cold sores are caused by the Herpes Simplex virus (HSV). There are two types of this virus. HSV-1 typically causes oral herpes, or cold sores. HSV-2 typically causes genital herpes. It is possible to transmit type 1 to genital surfaces and type 2 to oral surfaces. Generally, if you have one of these viruses, you will likely get outbreaks throughout your lifetime. This article will primarily discuss HSV-1 and how it affects oral surfaces. Outbreaks are often brought on by stress, sun exposure, fever, trauma, or menstrual cycles. Individuals who are immunocompromised, such as those undergoing chemotherapy for cancer or taking immune suppressing drugs, are at higher risk of having outbreaks. You have to carry one of the two HSV viruses in order to develop a true "cold sore." Often, individuals will mistake aphthous ulcers (canker sores in the mouth) or acne outbreaks for cold sores, so talk to your doctor if you are concerned.

How do these sores present?
The initial outbreak when you are first infected with HSV can be quite severe and can involve more than just the lips. It often occurs in childhood and includes ulcerations and blister formation in the mouth, throat, gums, lips, and cheeks. It is often quite painful and can be difficult to treat and recognize. Subsequent reactions can occur at any time in the future. HSV is a virus so once you are infected with it, there is no medication that will "cure" the disease or remove the virus from your body. Generally, 24 to 48 hours prior to any outbreak, individuals will experience burning pain and/or itching that may last until the sores resolve. Then a blister-type rash will start, usually on the lips, lasting 8 to 10 days. If you wish to seek treatment for these outbreaks, it is wise to talk to your doctor during the painful phase prior to the blisters forming.

What should I do if I get a cold sore?
It is important to note that in most otherwise healthy individuals, cold sores are self-limited and they will likely resolve on their own within 8 to 10 days. There are medications available that will make the cold sores go away faster. If you have an immunocompromising condition or have never had a sore that you can recall, evaluation and treatment is necessary. Your primary care provider will do a physical exam and may run some tests including culture of the contents of the blisters and/or blood tests.

Treatment is most effective when started within 48 to 72 hours of the symptoms, including any amount of time pain was present before blisters began. By treating promptly, the duration of the outbreak is decreased significantly. Medications of choice are usually oral antiviral drugs, but there are some topical antiviral drugs that are very useful in small, localized outbreaks. During an active outbreak, the virus is being shed and it is contagious. It is recommended that you refrain from kissing, sharing drinks or any skin-to-skin contact of the affected area until the area is well-healed. It is possible to spread the virus when an active outbreak is not occurring but less likely.

Cold sores are a pain in the mouth! If you suspect that you have one or may be developing one, seek care and treatment from your medical provider. Although there is no way to rid your body of the virus and cure the disease, symptom treatment is available and helpful. Call your primary care provider with questions today and start getting help for those annoying cold sores.

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