Cold Sores (herpes labialis)

Herpes Labialis, or cold sores, is a very common viral infection that presents with painful water blisters on the infected skin. There are two main types of herpes virus: herpes simplex virus type 1 (HSV1) and herpes simplex virus type 2 (HSV2). HSV1 is the main cause of cold sores or fever blisters on the lips or face, and HSV2 is more commonly associated with genital herpes on penis and vagina. However, either HSV1 or HSV2 can cause sores on either face or genitals. After initial infection, the herpes simplex virus continues to live in the nerves that are responsible for sensation to the infected skin. During an active flare, the virus travels down the nerves and onto the skin to causes herpes lesions on lips, mouth and genitals. Once the outbreak is over, it goes back down to its resting place in the nerve fibers where it resides until the next flare. Risk factors for outbreaks include emotional stress, excessive sun exposure, skin injury, or a weakened immune system.

Why do you get cold sores?

Viral infection is usually acquired during early childhood, through skin to skin contact, from kissing a child, sharing utensils, drinking cups, toys and other personal objects and belongings. Since infected individuals shed the virus even without having active sores, it is easily transmitted from any close contact. It is very prevalent, and approximately 80% of American population is infected. Once infected, the individual will continue to have the virus within their nerves, which is responsible for future outbreaks. Infected individuals shed the virus even when not experiencing an active flare, and virus may spread to other parts of the body, making transmission possible to uninfected individual.There is no cure, but treatment is sought to help suppress the virus and shorten the duration, severity and frequency of outbreaks. 

What is the treatment for cold sores?

There is no permanent cure for HSV1 or HSV2.. Mild cases of herpes are usually self-limited, resolving in days to weeks. Prescription antiviral medications are used to treat severe or recurrent flares to help reduce the frequency, severity, duration of outbreaks. Patients experiencing active flares should avoid close contact and avoid sharing utensils and drinking cups others to prevent transmission to others. Use of sunscreen can help reduce frequency of cold sores. Ibuprofen or Tylenol can be taken to help reduce pain or fever. Topical lidocaine or benzocaine can be used to help with painful sores. 

Talk to your dermatologist about your signs, and frequency and severity of your symptoms so the most appropriate treatment plan can be prescribed for you.