Cold sores (Herpes Labialis) are a common condition that are caused by an infection with, or later with the reactivation of the herpes simplex virus. Commonly located on the lips, (occasionally not on the lip, but in the area around). Cold sores occur in the same location, with intense ones leaving scars. Symptoms include:
- Initially a burning/tingling sensation that becomes more painful as the cold sore develops
- Painful red blisters
- Occasionally a low grade fever, or feeling fatigued
The virus is spread via contact with infected secretions of saliva. The virus is more contagious when there is an active cold sore. Once a person has the virus it remains in a latent or dormant state within a nerve. It is inactive until a trigger allows it to resurface. Common triggers include:
- Sun or wind burn
- Accidental “biting” or scratching of the lip
- Other infections that weaken the immune system and allow virus to “break through”
- Emotional or physical stressors
- Procedures performed on the face (chemical peels, laser treatment, microdermabrasion, micro needling, fillers, blue light etc.)
Cold Sore Treatments
The best way to treat a cold sore is to start taking an antiviral pill when you FIRST FEEL the symptoms coming on. Oral treatment is by far the most effective way to treat cold sores (leagues more effective than topical creams, Lysine or Abreva). Although much less potent, there are topical products available that can help diminish symptoms. A summary of common treatments:
- Valacyclovir (Valtrex): Take 2 (1 gram) tablets at first sign of cold sore. Repeat (take 2 pills) in 12 hours and that’s it! If the medicine is taken early enough(at the first sign of any stinging, burning feeling) patients typically won’t even get a cold sore. Occasionally an additional dose of 2 (1 gram) tablets may be taken after another 12 hour (So 6 grams total over 24 hours) if the cold sore has already broken out.
- Acyclovir (Zovirax) pills are another very effective oral medication similar to Valacyclovir
- Prescription creams are stronger than OTC creams and include: acyclovir cream (Zovirax), Penciclovir (Denavir), or Xerese (a combination of hydrocortisone and acyclovir cream). Apply to the cold sore 5 x a day for 5 days.
- Oral lysine, a popular supplement, and Abreva (Docosanol) an non prescription solution are both significantly weaker than prescription medicine, but each may decrease symptoms by a day or so.