What You Need to Know About Cold Sores

Yvette C. Terrie, BSPharm, RPh
Published Online: Friday, December 1, 2006

Brought to you by Merix Pharmaceutical Corp, the makers of Releev

More than 150 million Americans experience the pain, discomfort, and embarrassment associated with cold sores. Cold sores, also called fever blisters, are primarily caused by the herpes simplex virus 1. The herpes simplex virus 2 is typically responsible for genital herpes, although both virus types can cause cold sores or genital herpes. The virus is highly contagious and can be easily spread from one individual to another by both direct and indirect contact. It is important for you to thoroughly understand how to treat a cold sore outbreak and how to prevent or reduce the chance of further complications.

What Can Cause a Cold Sore Outbreak?

There is no cure yet for the cold sore virus—from the time of infection on, you will have periods when the virus is not active and periods when you will have an outbreak of cold sores. Certain situations called risk factors can increase the chances that you will have an outbreak.

Common triggers for cold sore outbreaks are as follows:

  • Stress/fatigue
  • Ultraviolet radiation/extreme exposure to the sun
  • Exposure to cold weather
  • Fever and upper respiratory infections
  • Trauma due to recent dental work
  • Infectious diseases
  • Menstruation or other hormonal changes
  • Factors that may compromise the immune system (chemotherapy, immunosuppressant agents)
  • Certain foods such as chocolate and others with a high content of the amino acid arginine

What Are the Signs and Symptoms of Cold Sores?

Cold sores usually appear on your lips or in adjacent areas around your lips and sometimes on your nose. You may first feel pain and tingling 1 or 2 days before a cold sore forms. Some people may also experience mouth soreness, fever, or swelling of lymph glands. Cold sores appear as small raised blisters filled with a clear fluid and can cause redness in the affected area as well as pain and discomfort. In general, cold sores heal in 10 to 14 days.

How Are Cold Sores Spread?

If you have a cold sore, it is very easy to infect another person through direct contact, such as kissing. It can also be spread if a person touches the cold sore and touches any mucous membranes, such as your nose, eyes, and mouth. If you touch your cold sore, always wash your hands with warm soapy water. Infection may also occur through indirect contact with the virus such as by sharing personal items such as razors or drinking out of the same glass.

Treatments for Cold Sores

A cure for cold sores has not been found, but many treatment options are available. You can discuss these options with your pharmacist or primary health care provider to determine which one is best for you. For example, if you have many outbreaks of cold sores, your doctor may prescribe a prescription product for the treatment of cold sores.

A New Product

A new product has recently entered the market as a treatment for cold sores. It is called RELEEV 1-Day Cold Sore Symptom Treatment. RELEEV is designed to aid healing and reduce the duration of an outbreak. RELEEV has been shown to relieve the symptoms of cold sores, including pain, itching, tingling, burning, and throbbing within 24 hours of initial use. RELEEV is a topical microbicide that is a proprietary blend of benzalkonium chloride 0.13% and phytochemicals primarily derived from the Asteraceae family. RELEEV is a nontoxic botanical product and should be applied 3 to 4 times a day. It can be used safely in adults and children 2 years of age or older and is nonirritating. It is best used at the first sign of an outbreak but can be applied at any time to relieve symptoms. It may be used as an antiseptic to help cleanse or dry cold sores and to help in preventing secondary infections. RELEEV also may be used on sores on the inside of the lips and on oral mucosa. RELEEV should not be used if an individual has an allergy to the Asteraceae (daisy) family of flowers.

Other Products

Another nonprescription topical product available for the treatment of cold sores is Abreva. In addition, a variety of medications are available to help with the discomfort and pain associated with cold sores. These products include skin protectants such as lip balms and moisturizers that provide protection for the lip area. Other products can provide relief of pain and burning. Examples of these products include Blistex, Campho-Phenique, and Zilactin.

Preventing and Managing Cold Sore Outbreaks

The virus that is responsible for cold sores is very contagious. To reduce or prevent cold sore recurrences and to prevent the spread of cold sores to others, you should take the following steps:

  • Avoid sharing items such as towels, razors, and eating utensils.
  • Avoid close or direct contact with others when cold sores are present.
  • Avoid things that may trigger cold sores, such as stress, fatigue, and excess sun exposure.
  • Clean cold sores with warm water and a nonprotein soap frequently, and keep them dry.
  • Avoid touching cold sores to reduce the chance of spreading them to other parts of your body.
  • Wash your hands frequently and thoroughly to help prevent the spread of cold sores.
  • Use topical skin protectants to prevent infection in cold sores that can result from drying and cracking.
  • Use lip balm or moisturizers to keep the lips moist.
  • Avoid foods high in the amino acid arginine such as chocolate during an outbreak.
  • Avoid drinking alcoholic beverages, because they may hinder the immune system from fighting the outbreak.

When to Seek Medical Advice

Consult your physician if:

  • Cold sores do not heal within 1 to 2 weeks or worsen.
  • You experience frequent episodes of cold sores (more than 6 per year).
  • You have any health conditions affecting your immune system.
  • Your cold sore shows signs of secondary infection, such as unusual redness, swelling, or discolored discharge.

Ms. Terrie is a clinical pharmacy writer based in Haymarket,Va.




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