Colds and flu are an unfortunate part of this otherwise festive season.  Frequently, with colds and flu come “cold sores”, so named because they often accompany a cold or flu.   Since it is the time of year when cold sores are most common, I want to share some facts about cold sores so you know how best to deal with them and maybe even avoid getting them.

What is a cold sore?

A cold sore is a blister that usually forms on or around the lips.  The blister typically lasts 7 to 14 days; it may be a singular blister or a cluster of blisters.  The blister is actually an infection caused by the herpes simplex virus, HSV-1.  Most of us were initially exposed to the virus as children.  The initial exposure to the virus will go dormant (asleep) until it is triggered to reappear.  There is no cure for the virus but there are things you can do to shorten the severity and duration and in some cases, avoid the outbreak.

Who gets cold sores?

Most everyone experiences a cold sore from time to time.  Some people react severely and get more involved outbreaks while others get a single blister.

What triggers a cold sore outbreak?

Fatigue, stress, anxiety, cold weather, excessive sunlight, hormonal changes, certain foods, lip and mouth injuries and a weakened immune system are the most common triggers.  Fatigue and stress can deplete your immune system. Cold weather and excessive sunlight will dry out and damage the lips causing cracking and possibly blistering.  Hormonal changes during menstrual cycle and pregnancy may cause outbreaks.  Certain foods (e.g. acidic foods and nuts) can cause outbreaks in some people.  Lip and mouth injuries, even something as simple as bumping your lip with a toothbrush or a routine dental visit or orthodontic braces may stimulate an outbreak.

How can I shorten the duration or prevent outbreaks?

To help strengthen your immune system eat a well-balanced diet, exercise, get a good night’s sleep and identify your stress and anxiety and work to minimize them (e.g., through exercise, prayer, healthy distraction, counseling).  Regular use of a lip protectant balm or lipstick is important.  Use a high quality lip balm with good moistures and UV protection (SPF) or high quality lipstick with good moistures and SPF to protect your lips.  If you are sensitive to some foods, avoid those foods that cause outbreaks. The cold sore virus is contagious so don’t:  touch the blisters, share eating utensils, share drinking glasses or kiss during or immediately after an outbreak.  Clean your hands regularly with soap and water or 70% isopropyl alcohol hand sanitizers.  Often, people who get cold sores on a regular basis know when it is going to appear due to a tingling feeling.  If you occasionally get a limited outbreak, an over the counter cream, Abreva, found in the drug store can be effective when applied from the first tingle and following the directions on the box.  If you experience more frequent and/or severe outbreaks a prescription cream or pill may be a better choice.  Ask your dentist or physician about the use of these prescription medicines.  These simple precautions and treatments can make the season more joyful.

Dr. Robert A. Gallegos is a Fellow in the Academy of General Dentistry, he is on the faculty of Spear Education, a member the American Academy of Cosmetic Dentistry, the American Academy of Dental Sleep Medicine and the American Dental Association.  Dr. Gallegos practices dentistry in Middleburg, VA.

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