Cold sore: Facts about Oral Herpes

This post was written by Margaret Ojeniyi and edited by Lani Sodunke.

If you are in Nigeria, you’ve probably had a tiny fluid-filled blister (cold sore or oral herpes) around your mouth or seen someone with the blisters. The general belief is that the blister is a result of malaria. However, fever blisters are caused by herpes simplex virus type 1 (HSV-1) to debunk this belief. It is possible to get it from type 2 (HVS-2) too, but it is rare.

The sores are usually clumped together and can last a week or longer. Cold sores can be highly contagious, especially when you burst it. They can spread through infected saliva, sharing infected cutleries/ objects, or kissing, and can appear on the lips or anywhere around the face.

Cold sores do not have any cure, but antiviral medications can manage the symptoms. Regardless of age, anyone can get infected with a cold sore.

Facts about cold sores

• HSV infection is for life, meaning there is no cure.
• It is commonly spread through oral contact.
• You will have a recurrent virus if your immune system is compromised.
• Blisters during recurrent episodes usually heal after several days.
• Cold sore caused by herpes simplex virus type1 (HSV-1) can be transmitted through contact.
• The virus can spread from the mouth to other parts of the skin.
• You can infect people even without having a cold sore outbreak.

Stages and symptoms of cold sores

1. Itching stage: This starts in a day or less before the sores or blisters appear. You would mostly feel an itching or tingling sensation on your lips.

2. Fluid-filled blisters: This is when herpes sores or blisters appear on the lips or the areas surrounding the mouth.

3. Crusting stage: At this stage, the sores would break open and ooze out, after which it begins to crust and crack. The sore is most contagious when it is open.

4. Healing stage: This is when the sores begin to heal, and the scabs fall off.

People who show symptoms of cold sores might experience these common symptoms of labial herpes:

• Tingling or burning sensation
• Itchy lips
• Painful red blisters
• Fever
• Body aches
• Tiredness
• Loss of appetite
• Sore throat
• Swollen lymph nodes
• Children can also have cold sores inside their mouths.

If you have any eye symptoms, you should see a doctor immediately as it can lead to permanent vision loss if not treated immediately.

Causes or risk factor of recurrent cold sores

Cold sore is mainly caused by direct contact with someone with herpes. Direct contact includes:

• Oral sex

You can have cold sores if you engage in oral sex with someone with genital herpes. Oral sex can spread to spread both cold sores and genital herpes.

• Kissing

You can also get infected with cold sores when you kiss someone with infected saliva or open sores.

• Sharing of infected objects

Getting infected through objects is low because the virus can only live outside the body for a few hours. However, drinking from the same glass or bottle of someone with cold sores may get you infected with herpes. You can also get infected by sharing lip balm, toothbrushes, or other objects.

After the initial infection, the virus lies dormant and may re-emerge at the same place at any time. When the sore reappears, the virus also reactivates. The risk factors that play a role in recurring cold sores include:

• Stress (physical and emotional)
• Illness
• Fever or viral infection
• Fatigue
• Surgery
• Upper respiratory infection
• Injury
• Hormonal change, as related to menstrual periods
• Long exposure to Sun
• Eczema (Atopic dermatitis)
• The weakened immune system as a result of a long illness like cancer or HIV
• Chemotherapy 
• Severe skin burns
• Dental work

Complications of Oral Herpes

Possible complications of cold sores, especially in people with a weak immune system, include:

• Herpetic whitlow: This complicated condition caused by HSV-1, where small painful blisters form on the finger.
• Dehydration: Dehydration can happen when the pain from the sores makes it difficult to drink.
• Encephalitis: Encephalitis is a life-threatening condition that causes the swelling of the brain. This happens when the infection spreads, making the immune system attack the brain.
• Herpetic keratoconjunctivitis: This is the infection of the cornea. It causes swelling and irritation of the eyes.

How to diagnose cold sores

Oral herpes can be misdiagnosed for other infections like allergic reactions. It can be diagnosed through physical examination of the blisters or sores on the lips. 

In some cases, a culture of the fluids from the sores might be sent to the laboratory for testing. A blood sample of an asymptomatic patient can also be taken for testing. You can also use an at-home test kit to test yourself for HSV antibodies.

How to treat cold sores

Taking medication can manage the outbreak of oral herpes and lessen the pain or discomfort. However, due to the nature of the virus and its ability to hide in the nerve, oral herpes has no cure. Major cold sore treatments include:

1. Antiviral medications

Antiviral medications ensure you do not spread the virus, especially when you do not have the symptoms. Getting prescriptions form an expert medical practitioner if you experience severe outbreaks can lessen the severity of your pain and symptoms. Examples of these medication include:

• Acyclovir (Zovirax)
• Famciclovir (Famvir)
• Valacyclovir (Valtrex)

2. Pain relieving ointments or gel

you can use an over-the-counter pain reliever that contains Benzocaine or Lidocaine to reduce the pain and itching. They include:

• Cymex
• Blistex
• Orajel
• Anbesol
• Dimethicone
• Docosanol
• Benzyl alcohol

3. Using Pain-relieving pills such as ibuprofen and acetaminophen.

4. Use a sunblock with zinc oxide on your lips to prevent a recurrence.

Home remedies for Cold Sore

There are varieties of home remedies to ease the pain of cold sores or labial herpes. You can try any of the following;

• Make a paste out of corn starch or baking powder and water, then put it on the sore. It would have a soothing effect on your sores.
• Put a warm or cold compress on the sores.
• You can suck on ice or popsicles to ease your discomfort momentarily.
• You can put diluted essential oils like tea tree or peppermint oil.
• Apply petroleum jelly or Shea butter to prevent cracking.
• Apply aloe Vera to the cold sores. Aloe Vera can help calm or relieve the pain.
• You can apply raw honey to your lips to fasten the healing.
• Apply crushed garlic mixed with olive oil on your sores. Garlic has antiviral properties.
• Include foods rich in vitamin C, B complex, and zinc. They would help boost your immune system, reducing the number of outbreaks.

What to avoid if you have a cold sore

• Avoid acidic food – They can break open the cold sore or cause a burning sensation on the sore.
• Do not touch an open sore. If you do, you run the risk of spreading it to someone else.
• Avoid oral sex if you have a cold sore
• Avoid picking at the scab. It might leave a scar if you do.
• Do not attempt to bust the sore. If you pop the sore, the fluid can get on your skin, making you spread the virus unintentionally.
• Avoid sharing cold sore gel/ cream with anyone.
• Avoid processed food; they may contribute to oxidative stress.
• Avoid high consumption of alcohol; it can weaken the immune system.

Conditions that can be confused for cold sores (oral herpes) 

These conditions look like oral herpes and can be mistaken for it. They include:

• Impetigo
• Canker sores
• Pimples
• Scrapes
• Angular stomatitis

Takeaway

Though a cold sore is not a life-threatening health concern it can cause discomfort and pain for a long time. Knowing the early signs like itching and tingling would serve as an early warning, making you prepare yourself with the proper treatment.

IF you notice any of its symptoms and feel uncomfortable, contact an expert doctor as soon as possible.