Painful and ugly…

…are the best words to describe cold sores.

They typically show up on the lips, too, which makes them so difficult to hide.

Cold sores are caused by a virus, the herpes simplex 1 virus or HSV-1. (Herpes simplex 2 or HSV-2 is what’s known as genital herpes.)

If you’ve ever had a herpes cold sore, don’t feel embarrassed. HSV-1 is extremely common; more than 70% of Americans have been infected!

Of those, however, only an unlucky few have the genetic predisposition to develop cold sores. Yep, blame it on your genes.

Cold sores are also known as fever blisters because they often occur during fevers. Other triggers are stress, sun, cold and hormonal fluctuations (like puberty, pregnancy or menstruation).

They start out as small fluid-filled blisters. After the blister breaks, the sores become crusty and oozy. They take up to 2 weeks to heal.

Oozy cold sores are especially contagious, so be careful not to kiss anyone or share cups, eating utensils, towels, etc. And wash your hands frequently.

Home remedies for cold sores

• Stay hydrated, especially if you have a fever. Aim for 6-8 glasses of liquid every day.
• Suck on a Popsicle. The cold can be soothing, and Popsicles also count as fluids!
• Use a cold compress. Wet a washcloth and put it in the freezer. After it’s cold, us it as a cold compress.
• Use a warm compress. If Popsicles or cold compresses don’t help the discomfort, try a warm, moist washcloth instead. Very gently wipe away any oozing or crust. Make sure others don’t use the same washcloth, and wash it in hot water.
• Take an over-the-counter pain and fever reducer. See my previous post on OTC pain relievers for more information.

Other over-the-counter products

• Abreva (docosonal) is an OTC cream that is FDA-approved to treat cold sores. It costs about $15 for a small tube. It needs to be applied 5 times a day. Does it work? Yes and no. In a small randomized, double-blind, placebo-controlled study (the best kind), patients using docosonal had their cold sores heal about 18 hours sooner than those using the placebo. It’s not a miracle, but perhaps it’s better than nothing.
• Benzocaine is a common topical anesthetic found in products like Orajel and Orabase. It provides temporary relief from the pain, and may speed the healing process a little.

Prescription medications

Anyone suffering frequent cold sore outbreaks should talk to their doctors about a prescription antiviral cream or ointment.

There are two things to know about these prescription products.

One, they’re most effective when used within the first 24-48 hours of symptoms. Cold sores usually start with a tingly sensation before the blister appears.

Two, these antiviral products are expensive. Especially the cream form, because it doesn’t come generic. Brand-name acyclovir cream (Zovirax) can cost over $700 for a small tube! The generic ointment is much cheaper, although still costly (over $100) if you don’t have health insurance.

Canker sores

Some people confuse cold sores with canker sores.

Canker sores are small ulcers that develop inside the mouth. They are not caused by a virus, but rather as the result of an injury, such as biting your tongue. People with braces are often plagued with canker sores (I was). Stress or certain foods can also cause canker sores.

Because they aren’t caused by a virus, an antiviral medication won’t help.

Otherwise, home treatment is pretty much similar.

• Use an OTC pain reliever.
• Use a topical benzocaine ointment, such as Orajel.
• Suck on a Popsicle and drink cold liquids (cold feels better than heat on canker sores).
• Rinse your mouth with a salt water solution (1 teaspoon of salt to 1 cup water) a few times a day.
• Dab some Milk of Magnesia onto the canker sore several times a day.

Canker sores take one to two weeks to heal.

Sláinte,

Frugal Nurse

For more about home remedies, here are my favorite books:

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