Cold Sores

Cold sores are very commonly experienced, and though a nuisance, they are not serious or harmful. Dr Joe Kosterich talks about cold sores, including causes, appearance, duration, frequency and what to do about them.

Cold sores are a very, very common thing for people to experience and it is quite a harmless thing. It is a nuisance, and I don’t think anyone likes having cold sores but they’re not harmful. You hear all these horror stories but really, I’m yet to see anybody who died of a cold sore. It’s a bit of a nuisance but it’s not going to be serious.

What are cold sores? Cold sores are blisters that typically form on the lips or on the nose. They can be elsewhere on the body, but those are the most common places. They are caused by the herpes virus and there are two of those, herpes 1 and herpes 2. A lot of you are immediately thinking that herpes can affect a different part of the body. Yes it can be there too, and essentially that is just cold sores on another part of the body. It used to be thought that herpes 1 affected the mouth and the facial area and herpes 2 affected the genitals, but now we’ve found out that really they’re two different viruses and they can land anywhere on the body.

How do you get cold sores? Essentially is does come from contracting the virus and that’s going to mean you’ve picked it up from someone. Because it is so common, it’s not that difficult to get. Perhaps grandma had a cold sore and gave you a kiss when you were six months old, and you may have picked up the virus at that stage. It is very, very common.

Initially what people will get are blisters or sores typically on the mouth and they typically come out with a cold, hence the name. They’ll last usually about three and ten days and then they’ll go; nobody has cold sores 365 days a year so it will go by itself. However, the virus does sit quietly in the system and it is thought to sit along the nerves. At some point, it might reactivate and if it does reactivate, that’s when you, again, get cold sores. Some people get them frequently, some people will get them very infrequently, some people will get them once in their life and never again; others will get them once every so many years or multiple times per year.

There are certain things that are thought to bring out cold sores and colds and viruses are number one. Essentially, if you have a cold or virus, you might be a little bit run down and your immune system is working harder, that’s the time the virus slips out from under the net and reactivates. Times of stress are often when people may get cold sores; sunburn is another time and women sometimes notice they can get cold sores towards the time when their periods are coming up. So again, all of these things are at a time when perhaps the body is under some load for some other reason, and that’s when the cold sores emerge.

It can be a little bit sore, literally, hence the name. Sometimes they feel a little bit itchy; some people can get a burning sensation and sometimes you can just see them and there’s not much else. Some people get one or two and some people can get a whole cluster.

What can we actually do about cold sores? As I said, if you leave them alone and do nothing, they will go away – that’s a given. There are some things that you can do to speed the process up and there are some ointments, most of these are over the counter that you can use, but none of these are a cure. Prevention where possible and being practical is the key; it’s not an absolute, but simple things are important to try and stimulate and help your immune system. It’s all the basic stuff like eating more fruits and vegetables and less packaged foods, keeping yourself hydrated, managing your stress – which is probably a big one with cold sores so getting enough sleep – mindfulness, perhaps some slow deep breathing or mediation. These things don’t guarantee that you will never get a cold sore, but they’re going to help reduce the likelihood.

A lot of people have their personal favourites, and over the years, I’ve heard from a lot of patients who have different things that they take. Antioxidants, multivitamins, B group vitamins, L-lysine; none of these are proven to make a difference, but different people swear by them and find that it helps them. In most instances, it’s not going to do you any harm if you want to try different things. If it helps you, then that’s great; if it doesn’t, then there’s not going to be any harm done. A lot of people argue that it’s a bit of mind-over-matter, but for those people who think it’s beneficial, you can’t argue with that.

So to sum up, cold sores are very common, not harmful, but definitely a nuisance. Prevention where possible or being practical is the key. Again, it is not an absolute, but if you are doing things like managing your stress, protecting you immune system, drinking enough water, getting enough sleep, it’s going to reduce the likelihood of getting recurrent cold sores. You may still get them from time to time but hopefully less.

If you do get them you can manage them very, very much on their merit, and as we mentioned, there are some over the counter preparations that you can use that can speed the process up a little bit.

Like with all things in medicine, if you are concerned then see your doctor but I think it is worth saying that it’s not an instance where your doctor will be able to pull something out of a hat and give you a miracle cure, because there isn’t one.