Category: Viruses
Posted by Dr. Molly OShea on Tue, Nov 3, 2009 at 10:16 AMCold sores: causes, symptoms, strategies to prevent recurrence
Cold sores are a pain in more ways than one. They are ugly, of course, but for many they are numerous enough inside the mouth to cause difficulty eating and sleeping.
Cold sores are actually a viral eruption caused by herpes simplex - yep, that herpes, the one that can cause problems on any mucus membrane including the genitals and mouth. There are two strains of the herpes simplex virus. For a long time we thought type 1 infected the mouth and type 2 the genitals, but in truth both are found in both places.
The first time a person experiences cold sores, they are often accompanied by fever, headache and body aches. Once the virus infects the nerves cells of the mucus membrane once, it lives there forever, dormant and waiting to resurface. Cold sores pop up in the same places because the virus lives in specific nerves and erupts in that nerve's location again and again.
The first symptoms of cold sores are tingling and a sense of swelling that can't be seen. Within a day or two, the characteristic blisters appear on the lips or ulcers appear in the mouth. The blisters and ulcers last about 10-14 days before the body beats back the virus into submission and it returns to its dormant state.
Things that stress the immune system or local trauma can cause the virus to reappear. Incidents such as illness, sunburn on the lips, fever and emotional stress can focus the immune system in other places or weaken it to the point that the virus can come out of its dormancy and cause cold sores.
It makes sense that the best ways to prevent cold sore from recurring is to do things that boost the body's immune system, limit emotional stress and diminish trauma to the lips and mouth.
L-lysine is an amino acid that can boost immune system function and improve the strength and resiliency of the mucus membranes, thereby reducing recurrences. Anyone, including children, can safely take L-lysine and kids who take 500 mg daily and adults who take 1,000 mg each day have significantly fewer outbreaks than those who don't. In addition, if at the first sign of tingling you increase the dose to 2,000 mg daily for kids and 3,000 mg daily for adults, the duration and severity of the outbreak is much less. Zinc and vitamin C also play important roles in mucus membrane health and Vitamin D3 is important in maintaining immune function. So in addition to L-lysine, a multivitamin with these micronutrients should keep your immune system as strong as possible.
Exercising, eating well, getting adequate sleep and encouraging a healthy balance between work and family life along with nurturing yourself can also help decrease the likelihood stress will play a role in cold sore outbreaks.
Lastly, using sunscreen on your lips summer and winter when outdoors for prolonged periods can help minimize sunburn trauma to the lips - a known trigger for cold sore outbreaks.
If you have an active cold sore, avoid kissing, sharing towels, drinking glasses, toothbrushe, and eating utensils to minimize spread to others. You can use topical ointments that are available over the counter to decrease symptoms, but if the outbreak is severe or the recurrences are frequent despite the natural strategies outlined above, you should talk to your doctor about the possibility of going on a low dose of acyclovir, an antiviral medication, that can diminish the frequency and severity of attacks. Kids with braces and cold sores often need to do this because the metal in their mouths is causing constant minor trauma.
