Cold Sores



What are Cold Sores?

Cold sores have nothing to with either cold weather or the common cold. In recent years we have learnt about this strange virus-caused disorder.

The oral region is the most common place. But it can also infect the vaginal area and the outer parts of the vulva. Sometimes the upper parts of the face are involved and even the eyes are affected. Much more rarely, but seriously, the virus can travel to the brain, causing a serious viral encephalitis.



Cold Sore Symptoms

Often it commences gradually, with a big fever that may climb from 37.8° to 104°F. The patient often has a sore throat. Then an outcrop of blisters occurs, often on the lips and surrounding parts of the face, and commonly on the gums, tongue and roof of the mouth. These may break down, leaving a very painful, yellowish colored ulcer. There is often an unpleasant breath, eating becomes difficult and painful. The fever will often reduce within a week, but in severe cases the sores in the mouth may persist for a couple of weeks. This is one of the most common causes of sore gums and mouth in children under the age of five years.

It may occur in newborn babies and usually means baby is infected during birth from its mother, who has a vaginal infection. This may produce a very serious form of the disease in babies.



Cold Sore Treatment

In mild cases it is worth trying some of the simple measures. For severe recurring cases, the antiviral antibiotic acyclovir may be ordered by the doctor, for this rapidly kills the virus even though recurrences are likely throughout life. Idoxuridine, usually in the form of a cream or cold sore ointment, will often reduce blister formation if applied early enough. After one attack, mother and child can frequently predict the onset of another one by a tingling sensation. Applied at this time, it may be effective. Also, the application of an icepack (for 60 to 90 minutes) is frequently found to be effective, but it must be maintained for at least this period of time. It is useful only in the early stages.

Simple measures include painting on mentholated spirits or alcohol. This probably helps a little by drying them out a little earlier. Betadine lotion is also effective. Spirit of camphor or 10 percent camphor in alcohol or BFI powder marginally helps skin blisters. For sores in the mouth, simple, warm salty-water rinses give some relief. Analgesics (paracetamol elixir) relieve pain, but do not hasten a cure. Some Western doctors are practicing the ancient skill of acupuncture and report good results with herpes.



Avoiding excessive exposure to bright sunlight may help protect, especially at the start of the hot season. Allergies and psychological upsets also seem to play a part in recurrences. Acyclovir cream is available for herpes infections of the eye.