What Are Cold Sores?

Cold sores, or herpes, are extremely common. It is caused by an infection by the herpes simplex virus. It is estimated that more than half of people are infected with the virus which causes cold sores by the time they become adults.

There are two types of the herpes simplex virus– herpes simplex virus type 1 (HSV-1) and herpes simplex virus type 2 (HSV-2). In children, HSV-1 is usually responsible for causing cold sores around the mouth. Classically, HSV-2 is thought to be the cause of genital herpes. However, both HSV-1 and HSV-2 can cause blisters and sores on any parts of the body.

How Are Cold Sores Transmitted?

Cold sores are highly contagious. The virus can spread through saliva, skin-to-skin contact, or by touching an object handled by someone infected with the virus. Although transmission is most likely when the infected person has an active sore, the virus can also be passed on even if the infected person is asymptomatic.

Simple measures to decrease the spread of the virus include:

• Don’t share food, beverages, or eating utensils.
• Don’t share personal items like lip balms, razors, and towels.
• Wash your hands frequently throughout the day.
• Do not touch any of the blisters or sores of an infected person.
• Avoid kissing or skin-to-skin contact with people while blisters are present.

Diagnosing A Cold Sore

During an active outbreak, a dermatologist is often able to diagnose herpes simplex infection by examining the affected areas. Confirmation of the diagnosis can be done by taking a swab from the sore and sending it to a laboratory to detect the presence of HSV-1 and/or HSV-2. If you do not have an active outbreak, your provider may perform blood work looking for past infection with HSV-1
or HSV-2.

Treatment for Cold Sores in New York City

Infection with the herpes simplex virus is life-long. While there is no cure, treatments are available to speed the healing and control the outbreaks. Antiviral medications are available both as topical creams and oral pills. Examples include: acyclovir, valacyclovir, famciclovir, and penciclovir. In general, the oral pills are more effective at treating cold sore than the topical creams. Depending on the frequency and severity of the condition, the oral medications can be taken episodically (at the first sign of an outbreak) or daily to suppress future breakouts.

Home remedies and over the counter treatments are also available to treat the uncomfortable symptoms of a cold sore. Examples include:

• Applying ice or warm compresses to the site to ease discomfort
• Applying petroleum jelly to the open sores
• Avoiding foods that cause pain and discomfort such as acidic foods, citrus fruits, salty foods, or spicy foods
• OTC pain medications such as acetaminophen or ibuprofen
• It is also helpful to try to avoid and limit triggers that cause flares. Examples include wearing sunscreen and considering pre-medication with an oral medication before dental work and procedures.

Complications of Cold Sores

Cold sores seldom lead to complications. In most cases, cold sores resolve on their own even without treatment. There are certain circumstances where the infection can have more serious consequences and require prompt medical attention. Examples include:

• Infections near the eye. Herpes infections can spread to the eyes which causes HSV keratitis.
• Infections in babies under 6 months of age. Young babies do not have well-developed immune systems and can be susceptible to more serious infections.
• Infections in people with poorly controlled eczema.
• People who suffer from eczema can have tiny breaks and cracks in their skin. These tiny breaks and cracks in the skin can become easy entry points for the herpes simplex virus, thereby causing severe, widespread infections.

Contact Dermatology & Surgery Associates to learn more about cold sores.