April 21, 2006

The Best Wealth is Your Health

Cold Sores can be an embarrassing matter

By Dr. Douglas W. Vierra, D.D.S.
Special to the Times

Each year, 150 million people in the United States (one-third of the population) suffer from the pain and embarrassment of cold sores. 

The average cold sore sufferer has two to six outbreaks per year averaging seven to ten days each. Though you cannot cure or completely prevent cold sores, you can take steps to limit their frequency and the duration of an occurrence.

Cold sores – also called fever blisters – are quite different from canker sores, a condition people sometimes associate them with. Cold sores are caused by the herpes simplex virus, and they’re contagious.

Canker sores, which aren’t contagious, are ulcers which occur in the soft tissues inside your mouth, places where cold sores don’t occur.
 
Cold sores usually occur on the lips. Onset is typically distinguished by a burning, tingling, or itching sensation approximately two days before the sore appears. Small, painful, fluid-filled blisters appear and last seven to ten days.

Cold sore infections are typically transmitted by an infected person to an uninfected person during two distinct periods of life – ages 3 to 7 (childhood) and ages 12-21 (adolescence). The herpes virus that causes these cold sores is so common that most Americans get infected by it, although many never have any symptoms. Those that show symptoms often get recurrence of the sores. That’s because even after the sores dry up and go away, the virus stays in the body, waiting for the stimulus that causes it to break out in a new sore.
 
A variety of stimuli have been shown to trigger cold sore recurrences including changes in the immune status, physical trauma, emotional stress, concurrent illnesses, and exposure to UV-B radiation from the sun.
 
Preventing the outbreak of cold sores requires simple common sense and healthy living. Getting sick can cause outbreaks, so eating well and getting appropriate rest is helpful. Learn how to properly deal with stress. Apply lip balm and sunscreen and wear a hat before going out into the sun or wind. Avoiding these triggers will minimize outbreaks.
 
While there is no cure for cold sores, there are medications and remedies that can be helpful in their treatment and management.
 
Most over the counter medications only relieve the symptoms of pain, itching or burning. Numbing medication with ingredients benzocaine, lidocaine, camphor, and phenol can help alleviate pain and burning from sores. Over the counter cream products containing the ingredient doconasol have shown very limited effects, decreasing duration of sores by only one day in clinical trials. Lip balms, herbal remedies, and nutritional supplements have inconclusive effects on the virus that causes the cold sores.
 
Several prescription medications have proven to be effective in decreasing the duration and severity of cold sores.

A critical factor in the effectiveness of these medications appears to be the timing of medicinal application. Ideally, the medicine must be taken at the prodromal stage, when the tingling sensation that precedes the break out of the sore first occurs. This early treatment results in significantly decreased duration and severity of the sores.
 
Several antiviral medications have proven effectiveness and FDA approval. These include Denavir, Acyclovir, Famciclovir, and Valacyclovir. They may come in the form of tablets to be taken orally, or cream to be applied topically.
 
If you are a frequent sufferer of these painful and unsightly cold sores, speak to your dentist or physician about ways you might limit the frequency and duration of outbreaks.

Douglas W. Vierra, D.D.S., is the owner of Plaza Dental Group, 1654 E. Capitol Expressway, San Jose, California, 95121. Call (408) 270-4333 with questions or to schedule an appointment.