Dr. Urban on Today’s Dentistry/Oh No! Not another cold sore!

Cold sores are common lesions that typically occur outside of the mouth. The lips, chin, face, and nasal areas are most affected. They are caused by the herpes virus (a little different strain from genital herpes) and are very contagious. Once you get infected you have it forever. So now that you have it what do you do with it?
Let’s first discuss the infection process. Someone in your past inoculated you with the active herpes virus. I am sure it was unknowing and innocent. During this primary stage the virus could infect inside or outside the mouth and produce very painful blisters. The blisters will last from 3-21 days and then disappear. The virus will then enter a latent period where it calmly resides in the nerves only to be reactivated in the future and start the process all over.
It is very important not to pop and drain the blisters because they contain the virus. Even when the blisters are crusted over they will have the live virus. Keep your hands washed and do not share lip balms and towels and eating utensils. You can spread the herpetic sores to other parts of your body-so no scratching. Did I mention no kissing? Use the same common sense you would use during a flu epidemic.
We really have no real answer to what triggers an outbreak. It seems that sun exposure, stress, sickness, compromised immune systems, and lack of sleep may initiate an outbreak. Other times it seems the outbreaks just occur to mess with you-like before a vacation, senior prom, graduation or wedding.
The first sign of an outbreak is the tingling and itchiness. At this time it is advised to “freeze” the lesion with ice or overwhelm it with an antiviral drug like Famvir. Using a mega dose within the first hour of the outbreak will eliminate or reduce the severity and duration. We can’t all walk around with Famvir in our pockets so this chance of stopping it in the first hour is small.
The second stage is puffiness and blistering. Topical applications of antiviral creams may reduce the severity and possibly the duration. Other medications like Abreva , Blistex, and Zilactin allow you to tolerate the blister and keep it moist so it will be less likely to crack. Health food stores sell lysine lip ointments and drops and red algae capsules. I have personally used all of these methods with varying degrees of success. I am very impressed with the lysine and red algae supplements since they helped the most to shorten the duration. You have to evaluate your own outbreak to determine if the treatment would be of any value. In other words, sometimes we just have to deal with it and not spread it around to the nose or eyes.
Medical advice should be sought if the lesions do not go away in a couple of weeks or quickly return. Herpes infections can cause complications with eczema, compromised immune systems, organ transplants and deliveries of newborns.
For answers to your dental questions, contact
Douglas Urban, D.D.S.
Cerritos, CA 90703
562 924-1523
DrDouglasUrban.com