Help curb the spread of cold sores
By Dr. Peter Hong
Cold sores — a common and widespread problem, both unsightly and uncomfortable — have ruined many a big date, first kiss and job interview. Let’s have a look at the causes and some tips for prevention.
Causes
Herpes is the name of the virus that causes cold sores. The virus spreads easily, exposing or infecting some 50-60% of adults.
The course of the infection can be broken into two categories:
• Primary infection — The initial infection most commonly affects children under the age of 10, although increasingly adults who have never encountered the virus are developing primary infections. The infected individual will complain of fever, malaise and irritability. Gums become inflamed and clusters of blisters called vesicles rapidly form throughout the mouth. The vesicles burst and form large wet yellowish ulcers which eventually crust over.
• Recurrent Herpes Simplex — After the primary infection, the virus lives in the infected individual in a latent and undetectable manner. Recurrent infections are often triggered by sunlight, heat, stress, trauma, immunosuppression, fatigue, menstruation or upper respiratory tract infections. This latter accounts for its common name “cold sores”. Vesicles are generally seen on the lips. They burst and merge to form yellow-brown ulcers. Most people complain of pain but some experience little discomfort. Unlike primary infections, recurrent herpes is generally not associated with systemic symptoms.
Most individuals experience prodromal symptoms such as tingling, throbbing and burning in the affected area for about 24 hours prior to the eruption of vesicles.
How to prevent its spread
Infected individuals are contagious when lesions are present. Therefore, it is advisable not to kiss, share utensils, cups or food during an outbreak. Toothbrushes should be stored apart so that contamination of clean ones does not occur.
There is some controversy about whether mouth lesions can be spread to other parts of the body, like the eyes. Clearly, it is advisable to maintain good hygienic practices such as washing hands after touching a lesion and refraining from licking the area.
The use of sunscreen on the lips is recommended since it may prevent recurrent cold sores.
Treatment
Lesions run a course of seven to 14 days and heal with no scarring. Acyclovir, a topical antiviral medication, may be beneficial if administered before vesicles rupture.
In very severe cases, oral Acyclovir may be administered. There are also products, such as Lipactin and Zilactin, that will help treat symptoms.
Armed with a basic working knowledge of cold sores you can do your part to prevent their spread. Unlike a smile, this is definitely something you do not want to pass on to family or friends.
Dr. Peter Hong, on staff in the Dept. of Dentistry, Sunnybrook Health Science Centre, is an instructor at the University of Toronto Faculty of Dentistry and maintains a practice in Toronto.
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