Cold sores are common viral infections that cause discomfort and embarrassment, but there are treatments that can help.
We talked to Whitney Striha, Pharmacy Manager at Moose Jaw Co-op in Moose Jaw, Sask., about how to spot a cold sore and the best way to treat it.
What are cold sores?
A cold sore, also known as a fever blister or herpes labialis, is a viral infection that causes small fluid-filled blisters to form on or around the lips, mouth or nose. Cold sores can last from a few days to weeks and are usually quite painful.
Striha told us that unlike most viral infections, the cold sore virus—herpes simplex virus (HSV) 1 or 2—is not eliminated by the body’s defenses, so cold sores often recur.
How do you recognize a cold sore?
A cold sore normally goes through five stages:
- Prodromal stage - Itching and tingling two to 24 hours before the cold sore appears.
- Blister stage - Affected area forms blisters that fill with clear, infectious fluid.
- Ulcer stage - Blisters burst, and shallow ulcers form. The sore is usually surrounded by a red, inflamed ring. This is usually the most painful and infectious stage.
- Scabbing stage - The contagious fluid begins to dry, forming a crust. The affected area might burn or feel itchy as it starts to heal.
- Healing stage – The crust begins to scab and fall away.
Some patients may develop painful gums, sore throat, headache, muscle aches, fever and/or swollen lymph nodes. These symptoms are not as common and may require further investigation by a physician to rule out other causes.
What factors increase your risk for developing cold sores?
Many factors can increase your risk of developing cold sores. White females over 65 years old are at increased risk. In addition, stress, fever, extreme temperatures, physical trauma, sun, respiratory infections, hormonal changes and immunocompetency can affect your risk.
You can prevent cold sores from spreading in a number of ways:
- Use cold and warm compresses and soap and water to clean the area.
- Avoid touching your cold sores unless you are applying a cream. Dab creams on gently instead of rubbing them in to avoid damaging your skin further.
- Use proper hand hygiene. Always wash your hands before and after applying cream and after touching the affected area.
- Do not share items such as cutlery, lipstick or lip balm, towels, cosmetics and creams.
- Avoid kissing and intimacy until your cold sores have completely healed.
How are cold sores treated?
Striha told us about some over-the-counter options to help manage the symptoms if your cold sore is already present. Protectants prevent drying and cracking, and local anesthetics provide relief from pain and itching. Abreva blocks viral entry, and Lipactin decreases pain and aids in healing. Be sure to talk to your pharmacist to help you choose the best option.
The most effective option in the treatment of cold sores is prescription antiviral medication. It works best if started one to two hours after symptoms start and decreases the severity and length of symptoms by one-half to two days.
“If you have recurrent cold sores with more than six episodes per year, chronic daily suppression with an antiviral is an option worth considering,” said Striha.
Your pharmacist can also prescribe a preventative medication for the duration of exposure to an anticipated trigger. Talk to your pharmacist for options that will decrease the duration of or prevent your next cold sore.