Cold sores
I get a cold sore on my top lip about every two months. These are painful, look awful, and usually last a week. What is the best way to treat them? Why do they keep coming back in the same place? Can they be cured?
Answer:
Cold sores around the mouth are caused by the herpes simplex virus (HSV). Most people who get them have been infected before the age of five. I’m afraid that, once infected with HSV, it stays with you for the rest of your life. In the first attack, the virus migrates along the nerve supplying the area where the sore appears, to the root of that nerve near the spinal cord. There it settles, most of the time in an inactive (latent) state which causes no problems. Recurrent attacks occur when the virus becomes awakened from this latent state and starts to multiply in the nerve root. Viruses may then travel back down the nerve to the skin, to cause another out-break in the same area. Recurrences, which may be weeks, months or years apart, are more likely when resistance to illness in general, or to HSV, is low. Some immunity to the virus develops during the first and each subsequent attack, but this wanes with time.
Recurrences can be triggered by windburn or sunburn, by biting your lip, being run down, under stress, having a cold or any other general illness - hence “cold sores” or “fever blisters”. Sometimes there is no obvious explanation.
You can reduce the frequency of recurrences by avoiding sunburn and exposure to cold winds, but it’s not always easy to avoid getting colds or being under stress. However, anything you do to keep yourself as healthy as possible (such as making sure that you have good nourishment, enough rest and exercise, and having a positive attitude towards being healthy) will improve your resistance to all infections, including cold sores.
So far, there is no known cure for HSV or any other virus. That is, there is no way to get rid of the virus from the nerve root and prevent recurrences forever. However, because some people can go for years without an outbreak, any treatment last tried will get the reputation of a cure at least until the next recurrence occurs! These folk cures include: dabbing the sore with cut lemon, eau de cologne or a used tea bag; applying starch poultices; dieting (the Russians and Irish recommend lots of potatoes); vitamin and mineral supplements; smallpox vaccination; meditation, etc. None will do you harm, but nor will they cure you.
The best way to relieve the pain of a cold sore is to apply ice, or a local anaesthetic cream or gel, and take aspirin or paracetamol. Some people find that it helps to dab the sore with a mild astringent, such as witch-hazel. Try not to lick, bite or scratch a sore. Cream containing the antiviral drug acylovir, which slows down multiplication of the virus, is claimed to speed up recovery in an attack. This preparation is expensive, and needs a prescription, but is worth a try. HSV is passed on by direct contact with a sore, so during an attack, take care not to infect others - especially infants and small children.
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Jan 12th 2008 at 10:21 am
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Feb 7th 2008 at 5:45 pm
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