COLD sores, sometimes called fever blisters, are groups of small blisters on the lip and around the mouth.

The skin around the blisters is often red, swollen and sore. The blisters may break open, leak a clear fluid, and then scab over after a few days. They usually heal after several days to two weeks.

Cold sores are caused by the herpes simplex virus (HSV). There are two types of herpes simplex virus: HSV-1 and HSV-2. Both virus types can cause sores around the mouth (herpes labialis) and on the genitals (genital herpes).

The herpes simplex virus usually enters the body through a break in the skin around or inside the mouth. It is usually spread when a person touches a cold sore or touches infected fluid, such as from sharing eating utensils or razors, kissing an infected person, or touching that person’s saliva. A parent who has a cold sore often spreads the infection to his or her child in this way. Cold sores can also be spread to other areas of the body.

When someone gets infected with HSV-1, the virus makes its way through the skin and into a group of nerve cells called a ganglion (pronounced: GANG-glee-in). The virus moves in here, takes a long snooze, and every now and then decides to cause a cold sore. But, not everyone who gets the herpes simplex virus develops cold sores. In some people, the virus stays dormant permanently.

SYMPTOMS OF COLD SORES

A cold sore usually passes through several stages:

1. Tingling and itching: Many people feel an itching, burning or tingling sensation around their lips for a day or so before a small, hard, painful spot appears and blisters erupt.

2. Blisters: Small fluid-filled blisters typically break out along the border where the outside edge of the lips meets the skin of the face. Cold sores can also occur around the nose or on the cheeks.

3. Oozing and crusting: The small blisters may merge and then burst, leaving shallow open sores that will ooze fluid and then crust over.

Signs and symptoms vary depending on whether it is the first outbreak or a recurrence. They can last several days, and the blisters can take two to four weeks to heal completely. Recurrences typically appear at the same spot each time and tend to be less severe than the first outbreak.

During first-time outbreaks, some people also experience: fever; painful eroded gums, sore throat, headache, muscle aches, and swollen lymph nodes.

Cold sores appear when HSV-1 is reactivated later in life. They may occur after a period of illness or stress, poor nutrition or sunlight exposure. Sometimes there’s no known reason.

Dental procedures that stretch the lip may occasionally trigger the virus. The border of the lip is the most common place that these sores appear. They may occasionally occur inside the mouth, too. This is more likely in people who have weakened immune systems or other medical problems.

Children under five years old may have cold sores inside their mouths and the lesions are commonly mistaken for canker sores. Canker sores involve only the mucous membrane and aren’t caused by the herpes simplex virus.

TREATING COLD SORES

Cold sores usually clear up by themselves without treatment within seven to 10 days.

However, antiviral creams are available over the counter from pharmacies without a prescription. If used correctly, these can help ease your symptoms and speed up the healing time.

To be effective, these treatments should be applied as soon as the first signs of a cold sore appear (when you feel a tingling, itching or burning sensation around your mouth). Using an antiviral cream after this initial period is unlikely to have much of an effect.

Cold sore patches are also available that contain hydrocolloid gel, which is an effective treatment for skin wounds. The patch is placed over the cold sore while it heals.

Antiviral tablets may be prescribed for severe cases. Examples include Acyclovir (Xerese, Zovirax); Valacyclovir (Valtrex); Famciclovir (Famvir); and Penciclovir (Denavir).

Cold sores are common. They are usually not dangerous. If you have a weakened immune system, HSV-1 can cause a serious illness.

Call your dentist or physician right away if:

• Lip or mouth sores persist longer than one week;

• The sores make it hard for you to talk or swallow;

• You develop a fever, and/or

• You have a second outbreak of blisters.

Dr Sharon Robinson DDS has offices at the Dental Place Cosmetix Spa located at Shop #5, Winchester Business Centre, 15 Hope Road, Kingston 10. Dr Robinson is an adjunct lecturer at the University of Technology, Jamaica, School of Oral Health Sciences. She may be contacted at 630-4710 or visit the website www.dentalplace4u.com