About 1 in 5 people have recurrent cold sores. They are small blisters that develop on the lips or around the mouth caused by the herpes simplex virus. They usually resolve without treatment in 7-10 days.

Cold sores often start with an itching, burning or tingling sensation around the mouth. Small fluid-filled sores will then appear, most commonly on the edges of your lower lip. The blisters may weep and take several days to form scabs. The fluid in these sores contains the herpes simplex virus and therefore until the cold sore has healed and disappeared, the cold sore is very infectious and can be spread to other people. If you have unhealed cold sores, it is particularly important to avoid close contact with people with weakened immune systems such as new-born babies, people with HIV or those receiving treatment that weakens the immune system such as chemotherapy.

Causes

The first infection with herpes simplex usually occurs in childhood without any symptoms. The virus travels up the nerves where it lies dormant (inactive). From time to time the virus may become active, multiply and travel down the nerve to cause cold sore blisters around the mouth.

Factors thought to trigger outbreaks of cold sores include:

  • having another infection
  • having a high temperature (fever)
  • emotional upset or psychological stress
  • tiredness and fatigue
  • an injury to the affected area
  • menstruation (periods)
  • strong sunlight

Treatment

Antiviral creams e.g., Zovirax, Acic

These creams contain a medicine called Aciclovir which may speed up the healing time of a recurrent cold sore infection. They are most effective if you apply them as soon as the first signs of a cold sore, usually a tingling sensation, as they do not kill the virus, but stop it from replicating. They must be applied five times a day for five days.

Cold sore patches

These contain a special gel called hydrocolloid. They are placed over the cold sore to help healing and to reduce the risk of spread of the cold sore.

Antiviral tablets

These can be prescribed by your doctor for more severe infections, in newborn babies or in immunocompromised patients.

Tully’s totalhealth Pharmacists Advice

  • Avoid touching cold sores unless you are applying cold sore cream
  • Creams should be dabbed on rather than rubbed in to prevent damage to the blisters and spread of the infection
  • Always wash your hands before and after applying cold sore cream and after touching the affected area
  • Do not share items that come into contact with the affected area, such as lipsticks or cutlery
  • Pain caused by cold sores can be managed using paracetamol or ibuprofen
  • Using a lip balm with SPF 15 or higher can prevent some outbreaks triggered by direct sunlight