Cold Hard Truth: The Cold Sore

Sara Wilchowski, MS, PA-C

Cold sores, otherwise known as orolabial herpes or herpes labialis, is caused by the herpes simplex virus type 1 (HSV). This virus primarily affects epithelial cells within and around the mouth with the development of the classic cold sore. HSV 1 is primarily spread through direct contact with infected tissue or secretions. This virus implants its genetic material into human epithelial cells (skin cells), sometimes lying dormant for months to years without reactivation. During times of increased stress, ultraviolet light, fever, local tissue damage, and immunosuppression, the virus can be reactivated, causing symptoms of localized pain, burning, tenderness, and tingling. Prior to the onset of these lesions, symptoms of fatigue, loss of appetite, fever, and painful lymph nodes may be experienced. HSV is extremely common in the United States. In person’s aged 14-49, the prevalence of HSV 1 is 54%.

It is very important to keep in mind that another version of this virus, HHV-2, is primarily responsible for the development of genital lesions and is often sexually transmitted. HHV-1 primarily affects the mouth, while HHV-2 primarily affects the genital region; however, these viruses have the ability to affect both oral and genital locations. If you suspect that you may have acquired a sexually transmitted disease, schedule an appointment with you doctors promptly.

Once HSV is contracted, the virus is maintained within nerves permanently, exhibiting periods of relapse and remission over the course of the infection. Below are some helpful tips to help prevent reactivation of the virus.

  • stressStress:
    • Attempt to take steps to minimize the amount of stress in your life. This can be a huge challenge, however there are a number of ways that can help to decrease stress. Exercise, knitting, reading, meditation, yoga, deep breathing, soft music, walking, praying, and even laughter are just a few ways to help with stress reduction. Next time life is getting you down, try a few of these activities to help prevent viral relapse.
  • sunUltraviolet Radiation:
    • The sun’s UV rays can act as a strong trigger for reactivation of the virus. It is extremely important to practice good sun protection with a quality sunscreen with an SPF of 30 or greater. Application of a lip balm containing at least SPF 15 protection is essential to preventing future breakouts caused by UV radiation exposure.
  • Illness+&+DiseaseTimes of illness:
    • This technically is another form of intrinsic stress on the body, thus lowering the ability to prevent viral reactivation. Take steps to limit contact with individuals who may be ill. If you do become ill, you are at increased risk for reactivation of the virus and may need antiviral medication.
  • lysineL-Lysine
    • This is an over-the-counter (OTC) essential amino acid. Taking 500-1000 mg of L-Lysine daily on an empty stomach may decrease the frequency of HSV outbreaks. This supplement has the potential to shorten the duration of an outbreak when taken regularly.
  • medication-valtrexAntiviral Medication
    • Both prescription and over-the-counter medication can be used to help reduce the severity and duration of an outbreak. If antiviral medications, both topical and oral, are started prior to exposure to the triggering factor or shortly thereafter, some protection results. Chronic suppressive therapy with oral antiviral medication is often reserved in those individuals that have more than 6 outbreaks per year.

Photo Credit: Healthline

Please note, our medical disclaimer applies to all information, images, recommendations, and comments published on this page.

Published by Dr. Paul M. Graham

Paul M. Graham, D.O. (Founder/Editor-in-chief) founded Dimensional Dermatology in May 2016 with the vision to provide concise, easy to read, up-to-date dermatology and aesthetic medicine information to patients, medical staff, providers, and the general public. Dr. Graham is currently completing his training as a cosmetic dermatologic surgery fellow in Virginia Beach, Virginia at the McDaniel Laser and Cosmetic Center. He completed his dermatology training at St. Joseph Mercy Hospital and was a clinical instructor at Michigan State University. He received his B.S. degree as Summa Cum Laude at Old Dominion University, his D.O. degree as Cum Laude at Edward Via College of Osteopathic Medicine, completed his internship at Largo Medical Center in Largo, Florida as chief intern, and completed his dermatology residency training at St. Joseph Mercy Hospital Ann Arbor, Michigan.

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