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Cold sores – fever blisters or herpes simplex or oral-facial herpes or recurrent herpes labialis – are the result of a virus that usually lies low in the nerve cells and then emerges to attack when the conditions are favorable, i.e. when your body’s immunity level is low. Thousands of people suffer from this condition which is caused by a strain of the herpes simplex virus type 1 (HSV-1), which in turn, is different from herpes simplex 2 virus (HSV-2) responsible for genital herpes infection. Although, HSV-1 is predominantly responsible for cold sores and HSV-2 for genital herpes, both can actually cause infection in any part of the body. Another virus of the herpes family is varicella zoster virus (VZV), or herpes zoster, and it is responsible for chickenpox and shingles. These three common forms of herpes, all have the ability to ‘lie low’ in the body after the initial infection until they are reactivated. That is why, the sufferers often get recurrent attacks. All these forms of herpes are highly infectious during attacks, but one type cannot usually cause another. |
Cold sores are spread by direct contact with skin affected by the virus. The liquid in cold sore blisters is highly infectious. The usual way of transmission is through kissing or sharing utensils, towels, pillowcases etc. The virus may enter right into your mouth and seek shelter in a host cell, probably a nerve cell that would let the virus move right in. The virus then makes the host cell to order its DNA to make many more exact clones of it (the virus). Now, these viruses may, and usually do, remain dormant for years before they decide to take a stroll down the nerve highways until they reach the skin surface. Then the tingling sensation sets in and sores appear.
The triggering factors are predominantly compromised immune system due to stress, fever, some infection, overexposure to the sun etc. Once these viruses make their presence felt in the form of sores, the attacks usually become more regular (at least once a year). Although, generally the virus affects the mucus membranes in an around your lips, it may also affect those of the eye. Then it becomes potentially life threatening as there may be a development of herpetic ulcers, acute recurring inflammation and even blindness. The seriousness of the disease is also replicated in infants where complications may arise. People with overtly weak immune system like those having cancer, AIDS or undergoing chemotherapy may also develop complications.
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Appearance of tiny white blisters, alone or in groups, around the corners of the lips or inside the lower lip. They may, and most often do, spread to the cheek or the tongue |
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Blisters are filled with yellowish liquid outlined in red |
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A tingling, prickling and burning sensation precedes the appearance of blisters (called prodrome) |
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Blisters often weep a clear fluid and finally, a yellowish scab forms that falls off on its own in a few days |
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Itching and burning sensation persists for usually the entire period |
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Blisters may also get accompanied by fever, headache, muscle aches and malaise (generally feeling bad) |
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Difficulty in swallowing any food stuff or liquid |
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Lymph nodes on the neck may swell |
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In children, small ulcerations appear on the lips, palate, inside the cheeks, accompanied by painful under-arm swelling. Drooling may also be seen among small children |
Symptoms generally last for seven to ten days. Usually diagnosis of herpes is easy from physical appearance of the lesions and therefore, no tests are required. Still, if your doctor is not quite certain, fluid from the blisters can be taken as sample and tested for the virus. This is done through viral cultures and takes 2 to 3 days to give the results.
Another fast, but less accurate, approach is to do a Tzanck test of the skin lesions. This involves taking a sample of fluid from the blisters and staining it with a dye. Then the stained fluid is examined under the microscope and the characteristic appearance of the virus is searched for. Finally, there is a blood test that may be helpful for making a diagnosis, especially if herpes simplex is suspected but no symptoms are present. It is also carried out if a distinction between HSV-1 and HSV-2 is needed.
As the viruses responsible for cold sores are highly contagious in nature, there are many ways you can contract them from someone else or some place. The usual suspects are:
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Cold sores are spread by direct contact with skin affected by the virus. |
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Similarly, sharing the same drinking utensils, other crockery and cutlery becomes a potential source of transmission |
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Sharing pillowcases, facecloths and towels |
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| · | Sharing toiletries like razor blades and toothbrush. In effect, even exposure of your moist toothbrush to herpes virus is enough for it to become a host | |
| · | Oral-genital sex | |
| · | Damp areas and public places like swimming pools, gardens, playing fields are active sources of these viruses | |
| · | Children usually transmit the virus to others while playing |
Once this virus enters your body, it may choose to remain dormant or become active based on your physical condition. As discussed earlier, weak immunity level is the prime triggering point for these viruses to become active. The usual reasons for your compromised immunity are:
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Excessive stress (remember, emotional stress is also included) |
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Fever |
| · | Mild infection |
| · | Increased exposure to ultraviolet radiation, particularly during beach or mountain holidays |
| · | Women often suffer just before the start of their periods |
| · | Exposure to extreme cold |
| · | People on immunosuppressant drugs, like after a transplant or during chemotherapy |
Some other known reasons are
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Pregnancy |
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Exposure to wind |
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Lip or gum injuries |
| · | Dental infections |
| · | Hormonal changes |
| · | Cosmetic surgery |
Cold sores treatment should begin as soon as the symptoms first appear. There are a variety of topical creams such as skin protectants and oral analgesics that are available over-the-counter that can provide temporary relief. There are also prescription medications available; but as with other drug treatment, they carry the risk of side effects. Most cold sores usually clear within 7-10 days.
A natural alternative to conventional medications in treating cold sores is the use of herbal and homeopathic remedies. These remedies are gentle to use, and also address your overall health and well-being without harsh side effects. Herbs such as Echinacea and Viscum album can provide a natural immune system boost. Astralagus membranaceus is a potent Chinese remedy with a variety of benefits as a convalescent and rejuvenating tonic. Olea europea (extract of olive leaf) contains a compound called oleuropein acid, which is effective against numerous viruses, bacteria, and fungi.
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Hypoxis Rooperi (extract of African Potato) – Hypoxis contains phytosterols and sterolins, which help to modulate the effect of the immune system. Research has shown the beneficial effect of plant sterols and sterolins on the immune system. Research done on a group of volunteers demonstrated a significant increase in the number of T-cells, which are involved in enhancing immunity. |
| · | Agothosma betulina (Buchu) – This is a urinary antiseptic and possesses diuretic properties. Buchu has been used by the natives of the Western Cape of South Africa for many centuries and assists the body to rid itself of toxins by stimulating the secretion of retained water. |
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Solidago virgaurea – This herb helps the body in its ability to routinely regulate mucus and has been used traditionally by herbalists for centuries as a tonic remedy to strengthen the natural protective ability of the body to fight infection. |
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Viscum album – This herb acts as a natural diuretic, and vasodilator, supporting the natural strength of capillary walls and the body’s natural ability to encourage repair of damaged cells. |
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Crataegus oxycanthoides – This herb is highly respected as a tonic to support healthy circulation. Studies have demonstrated the ability of Crataegus to positively assist with cardiological indications utilizing active flavonoids in the herb producing simultaneous cardiotropic and vasodilatory action, thus dilating blood vessels for improved circulation. |
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Schizandra sinesis – This herb is a powerful native ingredient from China. Schizandra is also used to assist the body in its capacity to regulate and maintain healthy energy levels and to routinely protect against toxins and cell damage. It is effective in helping the body to perform its natural function of regeneration of damaged liver tissue, while promoting improved overall regulation of physiological processes. |
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Astralagus membranaceus – This is another potent Chinese remedy, also called ‘huang qi‘, and has a variety of benefits as a convalescent and rejuvenating tonic. |
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Olea europea (extract of olive leaf) – This herb contains a compound called oleuropein acid that is effective in helping the body to routinely combat numerous pathogens (germs). The positive effects of Olive leaf have recently been demonstrated in a variety of clinical studies. |
A well-balanced, nutritious diet is essential for maintaining general good health and resisting diseases. It obviously helps in avoiding flare-ups of dormant viruses, like those of the herpes family. As there is no cure for herpes, in this case cold sores due to herpes simplex virus type 1, boosting your immunity is the only way you can control the recurrence and alleviate the symptoms. Also, to give your immune system a good chance to fight off an attack of any herpes virus, you should either avoid or reduce the intake of certain foods and drinks as discussed below.
Some of the most important nutrients required by your body to inhibit the growth of HSV-1 and give a general fillip to the immune system are
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Zinc – Zinc is found to inhibit the growth of HSV-1 by inhibiting the replication of the virus. It is also a great immune booster, being a very good antioxidant. Zinc supplements may be advised in case of severe recurrence issues, but as always, take supplements only on the insistence of your doctor. |
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Vitamin C – It is one more extremely important immune booster and is supposed to inactivate HSV-1. A combination of vitamin C and bioflavonoids (antioxidants that help fight infection and boost immune function) given at the first sign of flare-up prevents the development of blisters in majority of the cases. |
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Lysine – The amino acid arginine is required by the herpes virus for growth while the amino acid lysine inhibits this growth. It is believed that recurrent bouts of cold sores are brought up by the lowering of the vitality. This imbalance can be corrected by taking more lysine containing foods and avoiding arginine containing foods. |
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Iron – Some people with low iron levels have to be found with more prone to recurrent bouts of cold sores. Remember! don’t generally consume more iron rich food unless you have a deficiency of this mineral. Supplements are even more dangerous if taken without a doctor’s approval. |
Good dietary sources for the above nutrients include
– Zinc: Shellfish (especially oysters) and nuts are rich sources of zinc. Other sources include red meats, poultry, cheese (ricotta, Swiss, gouda), shrimp, crab, legumes (especially lima beans, black-eyed peas, soybeans), whole grains, tofu, brewer’s yeast, cooked greens, mushrooms, green beans, tahini, and pumpkin and sunflower seeds.
– Vitamin C: Diet containing fresh fruits and vegetables should provide you with enough vitamin C in a day although emphasis must be given on citrus fruits (fresh fruits in totality and not their juice only) like grapes and blackberries, as they also contain bioflavonoids. Some important fruits and vegetables are blackcurrant, vegetables (broccoli, potatoes)red capsicums and chillies, strawberry, kiwifruit and rockmelon.
– Lysine: Lamb, brewer’s yeast, chicken, fish, non-fat yoghurt, non-fat milk, beans, vegetables (particularly potatoes) and fruits. High intake of lysine containing foods or supplements is not recommended if you have high cholesterol, heart disease, or high triglycerides as they may raise cholesterol and triglyceride levels.
– Dietary iron: It is also very essential for the formation of antibodies. Rich sources include green leafy vegetables, oily fish, offal (heart, liver), red meat, eggs.
Foods to avoid are:
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Arginine containing foods such as chocolate, nuts, peanuts, cola, peas, grain cereals, cashews, beer and gelatin. |
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Reduce your intake of alcohol and caffeine, which is found in coffee, tea and colas. This will help maintain a healthy immune system. |
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Acidic, salty and processed foods. |
Don’t Spread the Infection | |
Pay Close Attention To Hygiene |
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When you experience an outbreak, you must take care not to spread the infection. Don’t share the same drinking utensils, other crockery, cutlery, pillowcases, facecloths, towels, razor blades and toothbrush. |
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Always wash your hands after touching a lesion. |
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Cut down on smoking or give up altogether. |
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| · | During the attack, try to make sure that you take plenty of rest and avoid stress. | |
| · | Avoid having physical contact, both kissing and sexual intercourse, with your partner whilst having a cold sore attack. This will save your partner from acquiring the virus. | |
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If the infection reaches the eyes, contact an ophthalmologist immediately as this could lead to blindness. |
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Propolis and vitamin E – Propolis, a resin from tree bark and leaves, is loaded with flavonoids. Ointments based on propolis or vitamin E oil, when used topically, are found to be much more effective than the conventional medications, like acyclovir ointment. |
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Cayenne Pepper (capsicum) – When you feel the first tingle of a sore, make a paste out of cayenne and apply it to the afflicted spot. It surely tingles but is supposed to be a very effective remedy. You may repeat it a few more times every day. |
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If there is herpes virus present in your family, never buy large tubes of toothpastes. As the contact of toothbrushes with toothpaste tubes is inevitable, buy smaller tubes that can be replaced early. |
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De-stress – Making yourself stress free is not one of the easiest things in life. There are certain parameters and constraints that are simply out of your control. Still, as stress contributes to almost all the diseases in one way or the other, including cold sores, you have no option but to take a positive attitude towards yourself in general, and your health in particular. There are several techniques available: biofeedback, meditation, deep muscle relaxation etc., but yoga is the most recommended one as it takes care of your mental agitation along with improving your general well being and strengthening your immune system. |
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