Cold Sores -- Embarrassing Health Problem Fix

woman with cold sore
Flickr photo by Vanessa Roanhorse
Periodically we'll talk to a doc about an everyday health problem you'd never dream of discussing at the coffee shop. Email if you want yours featured. (We'll keep it between us.)

Cold Sores

All you have to do is say the word "herpes" and people go running. Or at least say "ewww" in their heads. Funny how it makes us immediately think of a sexual disease. But anyone can get the Herpes Simplex Virus-1, simply by kissing or even just everyday casual contact.

The first time someone gets a cold sore (or "fever blister") they can either have minimal symptoms or they can be sick with a fever and more extensive rash. The virus then "hides" in the body's nerve cells and can be triggered to show up again with the "cold sore."

After the first outbreak, outbreaks are usually less symptomatic and usually just a few blisters grouped together. But oh how annoying.

Dr. Margaret E. Parsons, MD, assistant clinical professor of dermatology at the University of California, Davis, knows all about cold sores and tells us how to ...

Hide it:

The skin will heal the best covered in a thin layer of petroleum jelly or Aquaphor, so that is my first choice. It is okay to put make-up on if you wish, just be sure to use a Q-tip and not your make-up brush or sponge to avoid spreading the virus.

Treat it:

Cold sores are best treated by oral prescription medication: acyclovir, valacyclovir, or famcyclovir. Quite frankly, the over the counter topicals just don't work very well. Even the prescription topicals aren't that effective. The one topical ingredient that studies have shown to be effective is topical tetracaine (not lidocaine) that is hard to find as an OTC now. Compounding pharmacies can mix it up if ordered by a physician.

Prevent it:

The majority of the population will be exposed at some point. The virus is spread by contact of active lesions to skin/lips/mouth of someone who has not had it. Once someone has had it, recurrences can be minimized. HSV flares with stress, UV-exposure, and when ill. So sun protection (not only sunscreen and hats, also a product just for lips), stress management and trying to stay healthy can all help.
And remember, the virus is contained in the blister, so avoid contact when the blisters are present and until fully crusted over.

This is just general advice -- consult your own doctor for the best treatment for you.

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