COLD SORES (HERPES SIMPLEX 1)
This image shows a cold sore covering a larger area of the upper lip. If you have cold sores, it is wise to discard your toothbrush and replace with a new one. Repeat the process halfway through the cycle and again when the herpes cold sore has healed completely so that you do not re-introduce the infection. It takes just one kiss to pass on the virus so, if you have an active cold, refrain from kissing and cuddling a baby or young child. Unfortunately, most people contract the herpes cold sore virus when they are young as it is spread in saliva or mucus that comes from the nose and mouth.
Cold sores (Herpex Simplex 1), commonly known as fever blisters, are small lesions filled with fluid that occur around and/or on the lips. Often these blisters are clumped or grouped together and appear in a patch-like form. Cold sores will generally break open and leak out a clear fluid like substance that can spread the disease.
CAUSES OF COLD SORES
Cold sores are caused by the herpes simplex virus, also known as HSV. Although there are two different types of the herpes simplex virus (HSV-1 and HSV-2) both can cause the sores that are around one’s mouth (herpes labialis). The herpes simplex virus most commonly enters through a cut or split in the skin that is in or around the mouth. It can be spread when one touches a cold sore (or the fluid); this is most commonly done by sharing or using someone’s eating utensils, touching an infected person’s saliva, sharing other personal items, and kissing an infected person. Cold sores can spread to other areas of the body and can even be spread to children from an infected parent.
Generally cold sores do heal on their own, but if the pain associated with an outbreak or the discomfort of the appearance is becoming an inconvenience there are several different remedies and treatments that can alleviate symptoms and speed up the healing process. There are over the counter drugs as well as natural products to alleviate the condition. You can also get a prescription for an antiviral cream that can be put on the beginning stages of a cold sore so that the size and length of the sore is minimized. There are also oral medications that are available, however I generally do not recommend this treatment unless the condition is severe in frequency and size.
Once a person has the virus in their system the cold sore outbreaks are generally a result of a psychological or physical stress.
- Common triggers include:
- Low immune system
- Cold or flu
- Cold weather
- Exposure to sun
STAGES OF A COLD SORE
Cold Sore Stage 1 — LATENT:
Here the cold sore herpes simplex virus is hiding in the nerve ganglia near the back of the jaw on the same side as your cold sore usually appears. The cold sore virus may “sleep” for weeks or years without incident. Your body’s defense “soldiers” keep them in check. When there is stress in another part of your body, your defenses may drop at this location. Then the cold sore virus can escape and travel to the surface to reproduce, thus beginning the active cold sore stages.
Cold Sore Stage 2 — PRODROME:
The cold sore virus reproductive cycle begins here. The cold sore virus travels down your nerve fibers to the surface. This movement causes your cold sore target area to itch or tingle. You may notice a burning or dryness sensation. This stage could last a few hours to a few days before entering the more intense cold sore stages.
Cold Sore Stage 3 — INFLAMMATION:
Your cold sore virus has now arrived at the surface and begins it’s reproductive cycle by entering the cells at the end of the nerve. This causes a lot of swelling and redness at the cold sore site as your cells react to being invaded by the herpes cold sore virus.
Cold Sore Stage 4 — PRE-SORE:
Cold sores at this stage are defined by the appearance of cold sore vesicles. A full blown cold sore is not one big blister but a grouping of small blisters called vesicles. You will notice these vesicles as tiny, hard pimples or red bumps that are painfully sensitive to the touch.
Cold Sore Stage 5 — OPEN SORE:
Your most painful and contagious of the cold sore stages. All the vesicles break open and merge to create one big open, weeping sore. Depending on the severity, you may develop a fever and swollen lymph glands under the jaw. The weeping fluid is teaming with newly born cold sore viruses. Touching this fluid, you could easily spread the cold sore virus to another part of your own body or to someone else – either by direct touch or sharing objects such as hand towels, telephones, and faucets.
Cold Sore Stage 6 — CRUSTING:
A cold sore will develop a yellowish crust or scab as it begins to finally start the healing process. Your cold sore is still painful at this stage. More painful, however, is the constant cracking and bleeding of your cold sore scab when you move or stretch your lips, as when smiling.
Cold Sore Stage 7 — HEALING:
Cold sores, once scabbed over, begin healing from the inside out. As new skin forms under the crust, you will experience continued itching, irritation and some pain. Your cold sore virus is now retreating back to the nerve ganglia area where it will sleep until the next opportunity.
Cold Sore Stage 8 — POST SCAB:
Cold sores at this stage no longer have a visible cold sore scab and your skin has totally healed. Under your new skin, healing is still taking place as the destroyed cells are regenerated. This produces a red spot that may linger for another 2 to 14 days – depending on your personal healing speed. You are still contagious until this red spot disappears. This waiting is the most frustrating of the cold sore stages.
Please note: Cold sore stages #2 thru #8 are active stages and are very contagious. Usually 3 to 4 weeks is the average life-span of a cold sore; from first to last sore appearance. Much depends on your health and choice of treatments for each of your cold sore stages.
Many people are surprised to learn that their cold sores can cause genital herpes infections. That is, in part, because the innocuous name makes it easy to forget that cold sores are caused by a herpes virus. Some people don’t know that cold sores, or fever blisters, are infectious. Others assume that they’re a side effect of having a cold. However, cold sores are just another type of herpes. As such, maybe it’s time to stop calling oral herpes “cold sores” and start referring to it as oral herpes.
Many people don’t even realize that cold sores are something they even need to discuss when they’re having conversations about testing and safe sex. That means that they don’t practice safe sex at times where it might be a good idea. For example, they don’t use barriers for oral sex — even during an outbreak.
HSV-1 usually causes cold sores/oral herpes and HSV-2 usually causes genital herpes, but either virus can infect either site. This means that oral sex puts people at risk of transmitting herpes from the mouth to the genitals and vice versa.
In fact, some researchers estimate that more than half of all genital herpes cases are caused by HSV-1. At one time, genital HSV-1 infections were thought to be rare. That is no longer the case. A lot of that change is thought to be due to higher numbers of people having oral sex.
As with other highly stigmatized topics, there is a fine line to walk between accuracy and clear communication.
Still, it’s my opinion that, in many ways, calling oral herpes lesions “cold sores” does people a great disservice. When people are ignorant of their oral herpes infections, they also don’t realize that these infections can be transmitted sexually as well as casually. The term “cold sore” may reduce stigma. However, it also reduces comprehension.
It particularly bothers me that calling oral herpes lesions cold sores makes them seem so different from genital lesions. In many social groups, genital herpes is highly stigmatized in a way that oral herpes is not. That problem reflects, in part, a lack of understanding about how similar the two infections are. Calling oral herpes “cold sores,” while genital herpes has no similarly camouflaged name, encourages the perception that the conditions should be thought of differently. However, the main difference is just that one infection is usually sexually transmitted when the other is predominantly spread through more casual contact.