Cold Sores
How do I know I have a cold sore?
Cold sores are most frequently located on the lips at the place where the lips meet the skin and the mucosa. This is
known as the vermillion border. These herpes outbreaks can also be found occasionally on the cheek, chin and nose. In
individuals who have their immune system suppressed by medications or infections, the herpes outbreaks can also
appear in the mouth and can sometimes be seen as chronic superficial ulcers. They can pass from person to person.
There are symptoms that some people can recognize that indicates that a cold sore is on its way. These are called
prodrome or prodromal symptoms. Some people will experience a sense of tiredness the day before the recurrence of
the cold sore. Others feel a tingling, or numbness, or just a feeling of discomfort at the site of the future outbreak.
Some will feel subtle tenderness or a sense of localized fullness or swelling in the skin. It is important to cold sore
sufferers to be aware of these symptoms as they allow early intervention or treatment that could abort or shorten the
duration of the outbreak. There is usually a specific cycle of events in the life cycle of a cold sore. This will usually last
10-14 days.
What triggers cold sores?
1. Emotional and physical stress may alter or lower the immune system allowing the virus to awaken or reactivate.
2. Cold or other upper respiratory tract infection may also reactivate the virus. These cold sores are often called
fever blisters.
3. Sun (including tanning beds) or wind exposure without protection, especially on the lips, may reduce the
immune activity in the skin leading to a recurrence of cold sores.
4. Local trauma or injury to the skin around the lips including dry cracked lips and injury to the skin following
cosmetic surgery, chemical peels or laser therapy.
Tips to prevent cold sores
 Use skin protectants, with sun protection factor, frequently on lips and surrounding skin especially before sun or
wind exposure.
 Avoid triggers that can reactivate the virus such as windburn, UV light (sun and tanning booths), dry lips,
emotional stress, fatigue, food allergies.
 Be aware of unpreventable triggers such as menstruation, fever, illness, allergic reactions, physical injury, dental
injury, facial trauma (including facial surgery, laser therapy , chemical peels)
 Get plenty of rest.
 Learn techniques to deal with stress.
 Do not share cutlery, cups, glasses, water bottles, towels, razors.
 Use proper hygiene, wash hands carefully and frequently.
Tips when you have a cold sore
 Do not squeeze, pinch, bite or pick at blisters.
 Avoiding eating acidic foods such as citrus fruits, tomatoes, pickles, or other foods such as salty snacks as they
may sting and irritate the cold sore.
 Rinse your mouth as often as necessary with a mouthwash product or a solution made by mixing 1 tsp of salt in
500ml of water. These remedies will help soothe cold sores and reduce irritation.
 Analgesics such as ASA, acetaminophen, or ibuprofen may help relieve the severe pain of cold sores. Be sure to
follow the directions for use. Children should not take ASA.
 Use a skin protectant or lip moisturiser to keep cold sore lesions moist and to prevent drying or cracking.
 Cold sores are contagious. Avoid direct contact with other persons during the period when the blisters are
developing. Try not to touch your eyes or genital area unless you have first washed your hands thoroughly.
Avoid oral sex during an episode as this can transmit the infection to the genitals.