COLD SORES TREATABLE NOW; MAY BE PREVENTABLE IN FUTURE

Question: I am 20 years old, and I have gotten cold sores all of my life. While I know they are no big deal, they are annoying, not to mention ugly. Will I ever outgrow these? Why did I start getting them in the first place? My friends don’t seem to have them. Is there any treatment for them?

Answer: Cold sores, also called “fever blisters” are a common viral skin eruption that affects about 50 percent of the national population. This virus, called “herpes simplex type I,” often infects the mouth in childhood. Once this initial infection has occurred, the virus remains in your system, but usually in a dormant, or inactive form. Any time the virus reactivates, it causes another cold sore.

Reactivation of this virus can be triggered by stress, illness, fever, sun exposure, menstruation and other causes. When the reactivation occurs, a lesion-like blister appears, usually on the lip. Without treatment, it generally takes about seven to 10 days from the initial outbreak until the sore is completely healed and gone. Many people also notice pain or sensations of itching, tingling or burning on the lip while the blister is there, and even up to two days before the cold sore actually appears. If you do notice pre-blister lip pain, that is the optimal time to treat the cold sore.

There are several over-the-counter topical medications available at drug stores, but more recently prescription antiviral medications -- both oral and topical -- have proven very effective in shortening the course of cold sore outbreaks. Researchers are developing a promising vaccine, but the studies are still in early stages, so the vaccine has not yet been approved for the general public. Also under development is a potential oral antiviral medication that might help prevent cold sore outbreaks.

For people who get cold sores due to sun exposure, the use of sunscreen on the lips can dramatically reduce their frequency. The bad news is that, so far, this is the only known preventive method for cold sores, and it only applies to sun-induced outbreaks. The good news is that, as I mentioned above, coming years may see a vaccine or preventive medication.

The herpes simplex type I virus can be spread by direct contact any time between the beginning of the pre-blister phase to when the sore is completely healed. Avoid kissing someone who has an active cold sore, and if you have a cold sore, avoid touching the blister.

Most people with cold sores get about six outbreaks per year. After the age of 35, the recurrences do become less frequent, and the lesions tend resolve a bit faster. So while you will never completely outgrow this condition, it will improve as you get older –- and hopefully, so will the treatment options.