Cold sores: symptoms and treatment

Cold sores are also called, in some countries, 'febrile herpes', or simply 'fever'. Its condition has a high aesthetic component, since, in its period of greatest clinical manifestation, it produces blisters in the external buccal region.

The disease is caused by a virus and the contagion is simpler than what happens with other pathologies.

According to the World Health Organization, about 67% of the world's adult population would get a positive result if they were tested for the cold sore virus in their blood. This can happen even if the person has never had symptoms.

How cold sores are spread

The virus that causes the disease is the Herpes Simplex Virus -VHS1. This pathogen belongs to the family of viruses known as Herpesviridae. The Genital Herpes Virus-VHS2 also belongs to the family.

In general, each of these viruses affects different parts of the body:

The contagion of both viruses is by contact, even when there are no active and visible lesions. That is, one person can infect another without having blisters at the time of doing so.

Of course, contagion is much more possible when the blisters are visible and, above all, when they break and let out the liquid they contain. The fluid in the blisters is a great transport route for the virus.

The degree of infection is high. One person can transmit the VHS1 virus to another with a kiss, but also sharing cooking utensils. In the case of HSV2, the main route of transmission is sexual intercourse.

But nevertheless, This separation between VHS1 and VHS2 is not strict. A person can be infected with the genital herpes virus and manifest symptoms in the mouth, as if it were cold sores, after being infected by oral sex.

Discover more: What to do in case of Genital Herpes

What are the symptoms of cold sores?

The different stages with which the disease manifests in the oral region are those that determine the symptoms. Every moment of evolution is present with different visible signs.

Here we describe the natural evolution in most cases:

• Periodic burning: until one day before the appearance of the blisters, the person may feel burning, burning or tingling around the lips.
• Visible blisters: The second phase is the appearance of the blisters themselves. Cold sore blisters have clear fluid inside and they are located on the lip or around. They may be accompanied by a slight fever.
• Blister rupture: After about 4-7 days of presence of the blisters, breakage occurs. The blisters open and let out the fluid. In the place where the blister was, an ulcer forms and gradually becomes covered with a scab.
• Cicatrization: between fifteen days and a month after the appearance of the first symptoms, the scabs will disappear without leaving any scar. The time varies depending on whether it is the first time or a reappearance, since the reappearances usually last less.

To continue reading: Canker sores

Treatment options

If the cold sore does not receive any medication treatment, it will carry out its natural evolutionary cycle. After a few days, which can go from a week to a month, it will be resolved without leaving a scar.

The virus will be lodged in the peripheral nervous system of the person and, in the future, may or may not reappear with similar symptoms of shorter duration.

The medications that have been shown to help are antivirals, such as Aciclovir or Valaciclovir. Its only benefit is to reduce the days of duration of the disease, but they are not curative.

Despite antiviral drugs, HSV1 will remain present and nested in the peripheral nervous system and, therefore, may be reactivated in the future.

Antivirals are presented as tablets to be taken orally or as creams for local application. The oral route is more effective than the local one. The effectiveness depends on the early start of the treatment.

Ideally, start with an antiviral drug on tingling day or burning or, at the latest, the first day of appearance of the blisters.

When the clinical picture is very painful, you can accompany the treatment with some analgesic. Both Ibuprofen and Paracetamol are valid options.