Symptoms

Cold sores or fever blisters are the common names for herpes simplex. Cold sores are viral infection of the skin. The virus gets into the skin cells and lives there.

The cold sore begins as a group of small red bumps that blister, usually around the lips and mouth. Sometimes this is preceded by itching and burning of the area. The blisters begin to dry up after a few days and form a yellow crust. The crust then falls off and the redness slowly goes away. The whole process takes about 10-14 days. Scars rarely form. Some people experience just some itching or burning in the area while most people have no symptoms at all.

Causes

There are two kinds of herpes virus, type 1 and type 2. Type 1 virus causes 60% of the cold sores common on the lips and face. The other 40% of cases are caused by type 2. On the genitalia these percentages are reversed, that is 40% of genital herpes cases are caused by type 1 and 60% of cases are caused by type 2.

Once you have herpes simplex type 1, you cannot be reinfected with the type 1 virus. You can however be infected with the type 2 virus.

Fever, sun exposure and menstruation can act as trigger factors, which cause the virus to travel down the nerves to the skin and cause the outbreak known as herpes or cold sores.

Treatment

There are creams containing Aciclovir that have some effect on cold sores.

Aciclovir can also be given in tablet form. It is very expensive, over ?100 for one weeks course, so is not used routinely for cold sores. In patients with severe cold sores, and in patients who are taking drugs that reduce their immunity, Aciclovir could be given by mouth.

Aciclovir cream, which can be bought over the counter without the need for a prescription, shortens an outbreak from 14 days to 12-13 days and it is expensive.

Aciclovir only shortens the outbreaks - it does not prevent new outbreaks from occurring unless taken continuously. The area should be washed twice a day with a mild soap, such as Dove.

Prevention

Currently, there is no treatment to cure herpes; however, there is no cure for any virus at this point.

Seek medical advice

Seek advice from your healthcare professional if...

• You have a weak immune system and you develop cold sores

Recommended web sites

Some helpful information about cold sores from Best Treatments

A link to some information about cold sores from the BBC

An excellent article from Patient UK about cold sores