Cold Sores; Symptoms, Causes, Treatment & Prevention

Overview

What is a cold sore?

A cold sore is a fluid-filled blister (or a cluster of blisters) that appears on the lips and around the mouth. Cold sores are also called fever blisters, oral herpes or herpes labialis.

Are cold sores contagious?

While cold sores are highly contagious, they usually aren’t serious. In healthy people, cold sores generally clear up on their own in one to two weeks.

How common are cold sores?

Cold sores are widespread. More than half of the people in the United States have been infected with the virus that causes cold sores, though many people never develop cold sores or have any symptoms. About 20 to 40 percent of people who have the virus develop cold sores.

How often do people get cold sores?

A cold sore can develop multiple times a year or only once or twice in your lifetime. The frequency of a cold sore outbreak varies from person to person.

Who is affected by cold sores?

People of all ages can become infected with the virus that causes cold sores. Many people are exposed to the virus during childhood.

It is possible to develop a cold sore at any age, though the chance of having a cold sore outbreak decreases after the age of 35.

Symptoms and Causes

What are the symptoms of cold sores?

For many people, symptoms are more severe the first time they develop a cold sore. When you have a cold sore outbreak:

• The first sign of a cold sore is usually a tingling, burning, or itching sensation on or around the lips, beginning about 12-24 hours before the cold sore develops.
• The area becomes red, swollen and painful as the blisters form.
• Over 2-3 days, the blisters rupture and ooze fluid that is clear or slightly yellow. This is sometimes called the “weeping phase.”
• About 4-5 days after the cold sore appears, it crusts and scabs over. It might crack or bleed as it heals.
• The scab then falls off, revealing skin that may be a little more pink or reddish than usual for a few days. It usually takes 1-2 weeks for the cold sore to heal completely.

What causes cold sores?

Cold sores are sometimes called oral herpes because they are caused by the herpes simplex virus type 1 (HSV-1). This virus is very common and highly contagious. It spreads through saliva or close contact — often through kissing or by sharing utensils, straws, towels or lip balm with someone who has a cold sore.

You may not know if you have been infected with HSV-1 because symptoms of exposure to HSV-1 are generally mild. Children sometimes develop a fever and small blisters inside and around their mouths when they are first exposed to HSV-1.

What triggers a cold sore?

After you have been infected with HSV-1, the virus never goes away. It remains dormant (inactive) in a group of nerve cells in your face called the trigeminal ganglion.

When the virus is triggered, or activated, it “wakes up” and travels through your nerves to your lips, where a cold sore develops. After an outbreak, the virus goes back to sleep in your body.

What triggers a cold sore in one person might not cause an outbreak in another person. Some people with HSV-1 never develop a cold sore.

A cold sore can be activated by a variety of factors, including:

• Hormonal changes during menstruation or pregnancy
• Sunburn
• Extreme temperatures (hot or cold)
• Stress (physical or emotional)
• Fatigue
• Fever and illness, such as cold or flu
• Damaged, dry or cracked lips

Diagnosis and Tests

How is a cold sore diagnosed?

Your doctor will probably be able to tell if you have a cold sore by looking at the affected area. He or she may also swab the cold sore to test the fluid for the herpes simplex virus.

How do I know if I have a cold sore?

If you’ve had one before, you’ll likely recognize the symptoms: a tingling sensation followed by redness, swelling and blisters on or around your lips. You can visit your doctor for a diagnosis, although it is not always necessary to go to the doctor if you have a cold sore.

Management and Treatment

How do you get rid of a cold sore?

Although it may take a while to get rid of a cold sore, some medicines can shorten the healing time and make the symptoms less painful. Cold sore treatments include:

• Over-the-counter medications: You can buy without a prescription creams or ointments that you apply directly to the cold sore. If you start using these creams when you first notice tingling or itching — before the cold sore forms — you may be able to prevent the cold sore from appearing.
• Oral antiviral medicine: Your doctor may prescribe an antiviral medication that you take orally (by mouth).
• Intravenous (IV) antiviral medicine: If other medications aren’t working, your doctor may need to prescribe an antiviral medication that will be administered through an IV. In this case, your doctor will monitor you closely throughout treatment.

What are the complications associated with cold sores?

Although complications from cold sores are rare, they can include:

• Eye infections: The herpes simplex virus (HSV-1) can spread to the eye when someone touches a cold sore and then touches their eye. If HSV-1 spreads to the eye, it can cause HSV keratitis — a potentially serious infection of the cornea. Severe HSV keratitis infections can lead to blindness.
• Genital sores: HSV-1 can spread to the genitals through oral sex, producing warts or ulcers on the genitals or anus. But even though people sometimes call it oral herpes, HSV-1 is not the same as HSV-2, the sexually transmitted virus that causes most cases of genital herpes.

For certain groups of people, cold sores can lead to serious complications. The following groups of people should receive medical treatment immediately if they have a cold sore:

• Newborns: Babies under 6 months old may develop complications such as high fever and seizures because their immune systems aren’t fully developed.
• Immunocompromised people: For people with weakened immune systems, the herpes simplex virus can lead to encephalitis (swelling of the brain). If you have HIV or are undergoing chemotherapy, cold sores could be more severe and could take longer to go away.
• People who have eczema: The herpes simplex virus can cause a life-threatening infection called eczema herpeticum in adults and children with eczema. It is important to see your doctor right away if you have eczema and you develop a cold sore.

What can I do to help relieve symptoms of cold sores?

While cold sores are uncomfortable, you can find relief at home. Suggestions to help manage cold sores:

• Use over-the-counter creams and ointments: These remedies can help shorten the healing time and ease your symptoms. They are most effective when you use them as soon as you feel a cold sore coming on.
• Take pain relievers: If you are in a lot of pain, your doctor may recommend an over-the-counter topical pain reliever such as lidocaine that you can apply directly to the cold sore. You can also take acetaminophen or ibuprofen by mouth to ease your discomfort.
• Wear sunscreen and SPF lip balm: It is important to make sure a cold sore doesn’t get sunburned while it is healing. Also, wearing a lip balm with SPF 30 every day could prevent future cold sores.
• Avoid acidic foods: Orange juice, tomatoes and other acidic foods can aggravate a cold sore.
• Apply a cool compress: You can use a cool, damp washcloth to soothe a cold sore. Apply it for a few minutes off and on throughout the day. Be sure to wash the towel after you’ve used it to avoid spreading the cold sore to others.

Prevention

How can you prevent cold sores?

To avoid being infected with HSV-1, you should take the following precautions around people who have cold sores:

• Avoid kissing, intimate contact and oral sex with someone who has a cold sore.
• Don’t share towels, razors, dishes, cutlery, straws, lip balm or lipstick.
• Wash your hands before touching your lips, eyes or genitals.

If you’ve already come into contact with HSV-1, do these to reduce risk of a cold sore outbreak:

• Try to stay healthy: A fever can trigger a cold sore, which is why people sometimes call them fever blisters.
• Get enough rest: Fatigue weakens your immune system and makes you more likely to get sick.

• Wear lip balm with SPF: Protecting your lips from sunburn can help you avoid an outbreak.

  If you have a cold sore, be careful around babies. Always wash your hands, and do not kiss a baby until the cold sore has healed completely.

Outlook / Prognosis

What is the outlook for patients who have cold sores?

The majority of people who develop cold sores learn to live with and manage their outbreaks. In healthy people, cold sores usually clear up in one to two weeks and have no lasting effects. However, in young babies, immunocompromised people and those with eczema, cold sores can cause life-threatening infections.

Living With

When should I call my doctor about my cold sores?

You should seek treatment for a cold sore if you have:

• Eczema (also known as atopic dermatitis)
• Numerous, frequent or extremely painful cold sores
• An outbreak that doesn’t clear up on its own in about 2 weeks
• Sores on your eyes, hands, genitals, or another part of your body
• HIV or cancer
• A compromised immune system, or if you are undergoing chemotherapy or taking medication that weakens your immune system

Cold sore symptoms & treatments – Illnesses & conditions

Cold sores usually clear up without treatment within 7 to 10 days. Antiviral tablets or cream can be used to ease your symptoms and speed up the healing time.

If you develop a cold sore, some general advice to follow includes:

• drink plenty of fluids to avoid dehydration
• avoid acidic or salty foods and eat cool, soft foods
• if brushing your teeth is painful, use an antiseptic mouthwash
• dab creams on to sores rather than rubbing them in
• wash your hands using soap and water before and after applying cold sore creams
• avoid touching your cold sores, other than to apply cream, and don’t share your cold sore cream with others

Antiviral creams and tablets

Antiviral creams such as aciclovir or penciclovir (also known as Fenistil^®) may speed up the healing time of a recurrent cold sore infection if used correctly.

Cold sore creams are widely available over the counter from pharmacies without a prescription.

They’re only effective if you apply them as soon as the first signs of a cold sore appear, when the herpes simplex virus is spreading and replicating. Using an antiviral cream after this initial period is unlikely to have much effect.

If you have frequently recurring bouts of cold sores, use antiviral medication as soon as you feel the tingling sensation that indicates a cold sore is about to develop. You’ll need to apply the cream up to five times a day for four to five days.

Antiviral creams can only help to heal a current outbreak of cold sores. They don’t get rid of the herpes simplex virus or prevent future outbreaks of cold sores occurring.

Antiviral tablets are generally more effective than creams at treating cold sores, but are usually only prescribed for more severe cases.

Cold sore patches

Cold sore patches that contain a special gel called hydrocolloid are also available. They’re an effective treatment for skin wounds and are placed over the cold sore to hide the sore area while it heals.

Non-antiviral treatments

Several non-antiviral creams are also available over the counter from pharmacies without the need for a prescription.

These creams aren’t specifically designed to treat cold sores and won’t help them heal faster, but they may help ease any pain or irritation. Ask your pharmacist to recommend a suitable treatment for you.

Pain can also be treated with painkillers such as ibuprofen or paracetamol – both are available in liquid form for young children.

However, don’t take ibuprofen if you have asthma or stomach ulcers, or you’ve had them in the past.

Children under the age of 16 shouldn’t be given aspirin.

Speak to your pharmacist if you have cold sores and you’re pregnant.

Treating complications

If your cold sores are particularly severe or your immune system is damaged – for example, if you have HIV or you’re having chemotherapy treatment – you may be at risk of developing serious complications.

For example, your risk of developing encephalitis or the infection spreading to other parts of your body, such as your eyes, is increased.

Speak to your GP if you’re at risk. They may prescribe antiviral tablets and refer you for specialist treatment.

The type of treatment recommended will depend on the severity of your cold sore symptoms and the complication that’s causing problems.

For example, if you develop herpetic keratoconjunctivitis – a secondary eye infection – you may need to see an ophthalmologist, a specialist eye doctor.

Gingivostomatitis

Visit your pharmacist if you or your child develops swollen, painful gums (gingivostomatitis) as a result of the primary herpes simplex infection. They’ll be able to suggest treatments to help ease your symptoms.

If the infection is painful, your pharmacist may suggest using a preparation that contains benzydamine, which is available as an oral rinse or oral spray, to help relieve any pain in your mouth or throat.

Brushing your teeth may also be painful because of the swelling of your gums. Your pharmacist may suggest using an antiseptic mouthwash. This helps prevent secondary infections and will also control a build-up of plaque if you can’t brush your teeth effectively.

As with the treatment of cold sores, any pain or fever can be treated using ibuprofen or paracetamol.

In rare cases of gingivostomatitis, it’s possible for your lips to become stuck together in places. Using a lip barrier cream available from your local pharmacist will help prevent this.

Dehydration

If you or your child has gingivostomatitis, it’s important to drink plenty of fluids to avoid becoming dehydrated. Young children are particularly at risk as they may refuse to eat or drink because of the pain in their mouth.

It’s important to watch out for signs of dehydration, such as:

• headaches
• tiredness
• irritability
• lightheadedness
• low urine output

Most cases of gingivostomatitis get better in 7 to 14 days, although it may take up to three weeks for the sores to heal completely.

Specialist treatment

If you or your child still has symptoms of gingivostomatitis after two weeks or the infection is severe your pharmacist may advise you to contact your GP, who may refer you for specialist treatment.

Specialist referral may also be needed for gingivostomatitis if you’re pregnant or have a weakened immune system.

Visit your GP if you have a newborn baby who develops gingivostomatitis, as they may also need to be referred for specialist treatment.

Cold Sores | Cedars-Sinai

Not what you’re looking for?

What are cold sores?

Cold sores are small blisters
around the mouth. They are also called fever blisters. They are caused by the herpes
simplex virus. The most common strain of the virus causing cold sores is herpes simplex
virus 1. It can be spread by kissing or sharing eating utensils or even sharing
towels.

Herpes simplex is not curable. But
may stay inactive for a long time.

What causes cold sores?

Cold sores are caused by the herpes simplex virus. Once this virus is
in you, it can cause outbreaks of cold sores. Cold sore outbreaks are often triggered
by
exposure to hot sun, cold wind, a cold or other illness, a weak immune system, changing
hormone levels, or even stress.

What are the symptoms of cold sores?

Some people don’t have any symptoms
with the first attack. Others have flu-like symptoms and sores (ulcers) in and around
the mouth. Symptoms may occur a bit differently in each person. These are the most
common symptoms:

• Tingling of the lips, commonly felt before cold sores appear 
• Small blisters on the lips and mouth that enlarge, burst, then crust over
• Itching, dryness, and irritation of the lips and mouth
• Soreness of the lips and mouth

How are cold sores diagnosed?

Your healthcare provider can often diagnose cold sores by looking at
the sores. If the diagnosis is unclear, your provider may swab the sore and send
it to
the lab for examination.

How are cold sores treated?

Cold sores can’t be cured. But if
symptoms are severe, treatment may help ease some symptoms. Treatment may include:

• Antiviral ointments such as acyclovir
  and penciclovir to put on the sores. These work for some people but are often not
  very helpful.
• Antiviral oral medicines such as
  acyclovir, famciclovir, and valacyclovir may decrease the time the sores are present
  or their severity.
• Over-the-counter pain relief medicines
  to put on the sores (topical) may help with symptoms. Anti-inflammatory medicines
  may
  also help.

Cold sores take about 1 to 3 weeks
to heal. The first time they appear, they can take up to 3 weeks to heal. But when cold
sores return, they usually are less severe and take a week to heal if no medicines
are
used. Antiviral medicines may help, but they work best if started with early symptoms
before a blister appears. Antivirals are usually not advised for otherwise healthy
people. Always talk your healthcare provider or dentist if the sore doesn’t heal or
becomes worse as time passes.

Can cold sores be prevented?

If you have never had a cold sore, don’t have skin-to-skin contact
with someone who has an active cold sore. If you have had a cold sore, you may prevent
or reduce the number of times they come back by finding out what triggers your
outbreaks. Then stay away from that trigger. For instance, if sun exposure is a trigger,
use sunscreen when in the sun. If you have outbreaks often, talk with your healthcare
provider. Starting treatment as soon as you know you are getting a cold sore can help
it
heal faster.

The long-term use of oral antiviral medicines may prevent cold sores,
but the benefit is very small. This approach is usually used only for people who get
frequent and painful cold sores. Antiviral medicines put on the sores don’t help
prevent them.

Key points about cold sores

• Cold sores are small blisters around
  the mouth caused by the herpes simplex virus.
• Cold sores can be spread by kissing or
  sharing eating utensils or even sharing towels.
• Tingling often happens before the
  blisters appear.
• Cold sores cause small blisters on the
  lips and mouth that enlarge, burst, then crust over.
• Early treatment can promote healing
  and reduce the time it takes a cold sore to heal.
• Using antiviral medicine on the sores does not prevent them or
  help them heal faster.

Next steps

Tips to help you get the most from a visit to your healthcare provider: 

• Know the reason for your visit and what you want to happen.
• Before your visit, write down questions you want answered.
• Bring someone with you to help you ask questions and remember what your provider tells
  you.
• At the visit, write down the name of a
  new diagnosis and any new medicines, treatments, or tests. Also write down any new
  instructions your provider gives you.
• Know why a new medicine or treatment
  is prescribed and how it will help you. Also know what the side effects are.
• Ask if your condition can be treated in other ways.
• Know why a test or procedure is recommended and what the results could mean.
• Know what to expect if you do not take the medicine or have the test or procedure.
• If you have a follow-up appointment, write down the date, time, and purpose for that
  visit.
• Know how you can contact your provider if you have questions.

Medical Reviewer: Michael Lehrer MD

Medical Reviewer: Marianne Fraser MSN RN

Medical Reviewer: Raymond Kent Turley BSN MSN RN

© 2000-2021 The StayWell Company, LLC. All rights reserved. This information is not intended as a substitute for professional medical care. Always follow your healthcare professional’s instructions.

Not what you’re looking for?

How to Stop a Cold Sore in the Early Stages

Medically reviewed by Michele Emery, DNP Written by Our Editorial Team Last updated 5/27/2021

Worried you might be developing a cold sore? Cold sores, fluid-filled blisters that develop as a result of the HSV-1 or HSV-2 virus, are extremely common, affecting well over half the world’s population.

For most people, when herpes outbreaks occur, they’re a major annoyance, causing everything from discomfort and itching to awkward romantic and social situations. Luckily, for the most part, cold sores heal themselves over the course of a few weeks. 

However, a proactive approach to treating a cold sore can speed up the healing process, resulting in a clear, cold sore-free face without the usual time spent dealing with discomfort and embarrassment.

Below, we’ve covered the best ways to attack cold sores when and as they form, as well as the medications that are most effective for helping you treat, heal and remove cold sores as quickly as possible once they start to develop.

Early Warning Signs a Cold Sore is Forming

The key to stopping a cold sore quickly is to treat it the moment you notice symptoms. While it’s rarely possible to completely avoid a cold sore, treating it before it develops into a larger sore is a good way to limit its development and deal with a smaller, less obvious sore.

In a best-case scenario, treating a cold sore early prevents it from developing into a full-on sore.

In a worst-case scenario, even if you act a little too late in treating the cold sore, you’ll still speed up the healing process.

Because of this, it’s important to be aware of the initial warning signs of a cold sore. The faster you can act once you notice these symptoms, the less time the cold sore will have to break out and affect your lips, gums and mouth.

Itching or tingling around the lips. Normally, you’ll start to notice your lips itching or tingling for a day or two before the cold sore starts to form — a phase known as a “prodrome.” If you’ve had cold sore outbreaks before, you might find it easier to recognize this feeling than someone who has never been affected.

While not a specific warning sign, cold sores tend to be triggered by things like stress, illness, sun exposure, hormone fluctuations or fatigue. It’s best to be extra attentive to the potential warning signs of a cold sore if any of these issues affect you.

get rid of cold sores fast

Use the 24 hr cold sore treatment that works.

How to Treat a Cold Sore Before it Develops

If you’ve noticed the warning signs above and think a cold sore is developing on or around your lips, it’s important to take action as promptly as possible. The faster you treat the cold sore, the shorter it will usually stick around once (or if) it pops up.

Topical Treatments for Early Cold Sores

There are several ways to treat cold sores while they’re still in the itching/tingling stage. If you rarely get cold sores, over-the-counter topical treatments like docosanol can provide a modest amount of relief and potentially shorten the amount of time needed for the cold sore to heal.

Topical medications are only effective on the area to which they’re applied, meaning you’ll need to use the medication over the area surrounding the cold sore as it begins to form.

Most topical medications will speed up the healing process, but they’re rarely the best option for preventing cold sores. If you get frequent outbreaks, the best option is usually to treat your cold sores using oral antiviral medication

Oral Antiviral Medication for Early Cold Sores

Antiviral medication is designed to prevent the spread of the virus by stopping it from replicating within your body. This means a cold sore doesn’t have the same environment in which to grow as it normally would, shortening its lifespan and making it smaller and less obvious.

Used early, antiviral medications like valacyclovir (Valtrex®) are scientifically proven to reduce the amount of time required for cold sores to heal. This means you can effectively “zap” a cold sore in its early stages and cut down the total amount of time required to heal.

Other oral antiviral medications used to treat cold sores include acyclovir and famciclovir, both of which have a similar mechanism of action to valacyclovir. All of these medications are available on prescription, meaning you’ll need to see your doctor before taking them.

Our guide to valacyclovir goes into more detail about how antiviral medications work to stop cold sores from developing and speed up the healing process, as well as things like common dosage instructions, potential side effects and the amount of time required for valacyclovir to work.

How to Treat a Cold Sore After it Develops

While it’s best to treat a cold sore during the itching/tingling stage before it can develop, doing so isn’t always possible.

Once a cold sore develops into an open sore, the treatment options are the same as before — topical medications such as docosanol and oral antiviral medications such as valacyclovir.

Cold sores can be quite painful after they develop, meaning you might also want to use an over the counter pain medication if your sores start to bother you. It’s best to avoid eating spicy foods or hot liquids (such as hot tea or coffee), as these can sting if they touch an open cold sore. It’s also suggested to avoid salty foods and citrus.

While healing a cold sore after it develops can be a slower process than treating it in the earlier stages, it can and will happen. Follow the instructions of your doctor and use medications such as valacyclovir as recommended, and within a few days, the sores will begin to heal.

Tips and Tactics for Speeding Up Cold Sore Healing

Beyond medication, there are also several tips and techniques you can use to speed up the cold sore healing process — and, just as importantly, to avoid accidentally making the outbreak worse.

First, avoid touching the cold sore. Cold sores contain infectious fluid that can affect other parts of your body. Touching an open cold sore is an easy way to transfer this fluid to your fingers and increase your risk of spreading it to your eyes, genitals or other parts of your body.

Touching a cold sore also increases your risk of spreading the virus to other people. It can also irritate the sore, worsening the appearance of the cold sore and increasing the amount of time required for it to heal.

If you accidentally touch a cold sore, even when it’s in the early stages of developing, wash your hands thoroughly as soon as possible.

Second, avoid using any non-pharmaceutical products to “treat” the cold sore. Things like facial moisturizers, lip balms and other products don’t speed up cold sore healing and are more likely to slow down the healing process than provide any improvement.

Instead, stick to proven treatments like topical cold sore ointments and oral antiviral medications.

Third, focus on a healthy lifestyle. Lack of sleep, excessive amounts of stress and a poor diet can all weaken your general health and slow down the healing process for a cold sore. Focus on sleeping well, eating well and avoiding too much strenuous activity until the sore heals.

Finally, make sure you avoid any activity that could spread the cold sore to other people. Skin contact like kissing is best avoided until the sore is completely healed. It’s also best to avoid sharing things like dining utensils and facial towels when you have a visible cold sore.

Most of the time, treating a cold sore early will reduce the size to which it develops and shorten the healing process.

From itching and tingling, to a burning sensation around your lips, pay attention to the warning signs of an impending cold sore and you’ll be better prepared to act quickly using medications like valacyclovir for a shorter, easier and less stressful outbreak.

This article is for informational purposes only and does not constitute medical advice. The information contained herein is not a substitute for and should never be relied upon for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment.

Cold Sores | Johns Hopkins Medicine

What are cold sores?

Cold sores are small blisters around the mouth, caused by the herpes simplex virus. They are sometimes called  fever blisters. The most common strain of the virus causing cold sores is herpes simplex virus 1. It can be spread by kissing or sharing eating utensils or even sharing towels. 

Herpes simplex is not curable, but may lie dormant for a long time. Episodes of the cold sores last no longer than 2 weeks. Hot sun, cold wind, a cold or other illness, or a weak immune system can cause an outbreak of herpes simplex virus.

What causes cold sores?

Cold sores are caused by the herpes simplex virus. Once the herpes simplex virus is in you, it can cause outbreaks of cold sores. Cold sore outbreaks are often triggered by exposure to hot sun, cold wind, a cold or other illness, a weak immune system, or even stress.

What are the symptoms of cold sores?

Some people don’t have any symptoms with the first attack; others have flu-like symptoms and ulcers in and around the mouth. While each person may experience symptoms differently, these are the most common:

• Tingling of the lips, commonly felt before cold sores appear 

• Small blisters on the lips and mouth that enlarge, burst, then crust over

• Itching, dryness, and irritation of the lips and mouth

• Soreness of the lips and mouth

How are cold sores diagnosed?

Your doctor can often diagnose cold sores by examining the sores. If the diagnosis is unclear, he or she may culture the sore by taking a sample of cells using a swab and examining it under a microscope.

How are cold sores treated?

Cold sores can’t be cured, but, if symptoms are severe, treatment may help relieve some symptoms. Treatment may include:

• Antiviral topical ointments (such as acyclovir and penciclovir)

• Antiviral oral medications (such as acyclovir, famciclovir, and valacyclovir)

• Over-the-counter topical anesthetics or anti-inflammatory agents may help with symptoms  

Cold sores take about 1 to 3 weeks to heal. The first time they appear, they can take up to 3 weeks to heal. But, when cold sores return, they usually take a week to heal if no medicines are used.  Antiviral medications may help, but they need to be started before day 3 or 4 of the blister formation. Antivirals are usually not recommended for otherwise healthy people. Always consult your health care provider or dentist if the sore does not heal or becomes worse as time passes. 

Can cold sores be prevented?

If you have never had a cold sore, avoid skin-to-skin contact with someone who has an active cold sore. If you have had a cold sore, you may prevent or reduce the number of recurrences by determining what triggers your outbreaks and avoiding the trigger. For instance, if sun exposure is a trigger, use sun screen when in the sun. If you have frequent outbreaks, consult with your health care provider. Starting treatment as soon as you know you are developing a cold sore can promote healing and reduce the time it takes a cold sore to heal.

Key points

• Cold sores are small blisters around the mouth, caused by the herpes simplex virus.

• Cold sores can be spread by kissing or sharing eating utensils or even sharing towels.

• Tingling often occurs prior to the appearance of blisters.

• Cold sores cause small blisters on the lips and mouth that enlarge, burst, then crust over.

• Early treatment can promote healing and reduce the time it takes a cold sore to heal.

Next steps

Tips to help you get the most from a visit to your health care provider:

• Before your visit, write down questions you want answered.

• Bring someone with you to help you ask questions and remember what your provider tells you.

• At the visit, write down the names of new medicines, treatments, or tests, and any new instructions your provider gives you.

• If you have a follow-up appointment, write down the date, time, and purpose for that visit.

• Know how you can contact your provider if you have questions.

Cold Sores | HealthLink BC

Topic Overview

What are cold sores?

Cold sores , sometimes called fever blisters, are groups of small blisters on the lip and around the mouth. Often the first sign of a cold sore is a spot that tingles, burns, itches, or causes discomfort. A blister usually forms within 6 to 48 hours. The skin around the blisters is often red, swollen, and sore. The blisters may break open, leak a clear fluid, and then scab over after a few days. They usually heal in several days to 2 weeks.

What causes cold sores?

Cold sores are caused by the herpes simplex virus (HSV). There are two types of herpes simplex virus: HSV-1 and HSV-2. Both virus types can cause sores around the mouth (herpes labialis) and on the genitals (genital herpes).

The herpes simplex virus usually enters the body through a break in the skin around or inside the mouth. It is usually spread when a person touches a cold sore or touches infected fluid—such as from sharing eating utensils or razors, kissing an infected person, or touching that person’s saliva. A parent who has a cold sore often spreads the infection to his or her child in this way. A person can spread the virus to someone else if they contact the affected area even when sores are not present. Cold sores can also be spread to other areas of the body.

What are the symptoms?

The first symptoms of cold sores may include a spot that tingles, burns, or itches around your mouth and on your lips. You may also have a fever, a sore throat, or swollen glands in your neck or other parts of the body. Small children sometimes drool before cold sores appear. After the blisters appear, the cold sores usually break open, leak a clear fluid, and then crust over and disappear after several days to 2 weeks. For some people, cold sores can be very painful.

Some people have the virus but don’t get cold sores. They have no symptoms.

How are cold sores diagnosed?

Your doctor can tell if you have cold sores by asking you questions to find out whether you have come into contact with the virus and by examining you. If an examination does not confirm cold sores, your doctor may take a sample of the fluid for testing.

How are cold sores treated?

Cold sores will usually start to heal on their own within a few days. But if they cause pain or make you feel embarrassed, they can be treated. Treatment may include skin creams, ointments, or sometimes pills. Starting treatment right away may get rid of the cold sores only 1 to 2 days faster, but it can also help ease painful blisters or other uncomfortable symptoms.

The herpes simplex virus that causes cold sores can’t be cured. After you get infected, the virus stays in your body for the rest of your life. If you get cold sores often, treatment can reduce the number of cold sores you get and how severe they are.

How can you prevent cold sores?

There are some things you can do to keep from getting the herpes simplex virus.

• Avoid coming into contact with infected body fluids, such as kissing an infected person.
• Avoid sharing eating utensils, drinking cups, or other items that a person with a cold sore may have used.

After you have been infected with the virus, there is no sure way to prevent more cold sores. But there are some things you can do to reduce your number of outbreaks and prevent spreading the virus.

• Avoid the things that trigger your cold sores, such as stress and colds or the flu.
• Always use lip balm and sunscreen on your face. Too much sunlight can cause cold sores to flare.
• Avoid sharing towels, razors, silverware, toothbrushes, or other objects that a person with a cold sore may have used.
• When you have a cold sore, make sure to wash your hands often, and try not to touch your sore. This can help keep you from spreading the virus to your eyes or genital area or to other people.
• Talk to your doctor if you get cold sores often. You may be able to take prescription pills to prevent cold sore outbreaks.

Symptoms

Cold sores are blisters on the lips and the edge of the mouth that are caused by an infection with the herpes simplex virus (HSV). Often the first sign of a cold sore is a spot that tingles, burns, or itches. A blister usually forms within 24 hours.

Cold sore blisters usually break open, weep clear fluid, and then crust over and disappear over a few days to 2 weeks.

Other symptoms may include:

• A sore mouth that makes eating, drinking, and sleeping uncomfortable. Cold sores can be painful.
• A fever.
• A sore throat.
• Swollen lymph nodes in the neck.
• Drooling, in small children.

You may not develop cold sores when you are first infected with HSV. If cold sores do develop when you are first infected, they may be more severe than in later outbreaks. During the first outbreak of cold sores, the blisters may spread to any part of the mouth.

After you become infected, HSV remains in your body and may cause cold sores to return throughout your lifetime (recurrent cold sores).

Recurrent cold sores usually develop where facial skin and the lip meet. About 6 to 48 hours before a cold sore is visible, you may feel tingling, burning, itching, numbness, tenderness, or pain in the affected area. This is called the prodromal stage.

Some common triggers that cause cold sores to return include:

People who have weakened immune systems are more likely than those with strong immune systems to have longer or more severe outbreaks of cold sores. HSV infection may be life-threatening in certain people who have weak immune systems.

Who is at greatest risk for developing cold sores?

Anyone who is exposed to the herpes simplex virus (HSV) is at risk for developing cold sores. But many people have the virus and may never develop cold sores.

People who have weakened immune systems are at an increased risk for having more severe and longer-lasting outbreaks of cold sores.

One form of HSV infection, called primary herpes stomatitis, is seen most often in children 1 to 3 years old. It can cause a high fever and blisters throughout the mouth, which can interfere with the ability to eat. It can be serious in children—they can get quite sick from this illness, although they usually recover without any long-term problems.

Examinations and Tests

Your doctor can diagnose cold sores by asking questions to find out whether you’ve been exposed to the herpes simplex virus (HSV) and by examining you. No further testing is usually needed.

There are two types of herpes simplex virus: HSV-1 and HSV-2. Both virus types can cause lip and mouth sores (herpes labialis) and genital herpes if your skin comes into contact with either type.

If it is not clear that you have cold sores, herpes tests may be done. The doctor takes a sample of fluid from a sore and has it tested. Having the sample taken is usually not uncomfortable even if the sore is tender or painful.

Treatment Overview

There is no cure for cold sores, nor is there a cure for the herpes simplex virus (HSV) that causes them. Most cold sores will go away on their own. But medicines may slightly reduce the duration of cold sores and sometimes prevent a future outbreak.

Treatment with medicines depends on whether you are having a first outbreak or a recurrent outbreak or are trying to prevent future outbreaks.

When treating a first outbreak of cold sores, oral antiviral medicines may reduce pain and slightly improve healing time.

For treatment of recurrent cold sores, the following medicines may reduce the severity and duration of the outbreak:^{footnote 1}

• Topical creams or ointments, which are available with or without a prescription, can reduce pain, itching, and healing time.
• Oral antiviral medicines, which are available by prescription only, may be used when the first symptoms (such as burning or itching) begin. Starting treatment right away may get rid of the cold sores only 1 to 2 days faster, but it can also help ease painful blisters or other uncomfortable symptoms.

Oral antivirals may also be taken daily to prevent recurring cold sores, especially in people who have frequent and painful outbreaks.

If you have a weakened immune system and develop cold sores, you may need medicines to control your symptoms or daily doses to prevent outbreaks.

Other treatments

The first episode of cold sores can be so painful that you may have trouble eating, drinking, and sleeping. A child who has a fever and many mouth sores may need to be encouraged to drink water and other fluids to prevent dehydration.

Adults and older children who have a painful first episode of cold sores may sometimes need a prescription-strength medicated mouth rinse to reduce pain.

Complementary medicine

Several complementary medicine treatments are available if you wish to try an alternative way to ease your symptoms. Although some people find relief from the symptoms by taking zinc or lysine there is little research to support this treatment.  Before you try a complementary treatment, talk to your doctor or pharmacist about the possible value and potential side effects. 

Home Treatment

Most cold sores heal on their own. But you can manage your symptoms at home by:

• Placing a cool, wet towel on the sores 3 times a day for 20 minutes each time to help reduce redness and swelling.
• Using a mouth rinse that has baking soda to soothe a sore mouth.
• Avoiding foods that contain acid (such as citrus fruits and tomatoes).
• Using non-prescription ointments that can relieve pain or help heal the cold sore.
  • Some products such as Abreva and Zilactin can speed the healing of cold sores or prevent them if applied early enough.
  • Other products such as Orajel and Anbesol can numb sore areas in the mouth or on the lips.
  • Children age 2 and older can be treated with Zilactin Baby, Orajel Baby, and Anbesol. Abreva is for people age 12 and older, so talk to your doctor before using it for a younger child. And if your child is younger than 2, talk to your doctor before using any of these medicines.

Ask your doctor if you can take ibuprofen (such as Advil or Motrin) or acetaminophen (such as Tylenol) to reduce pain. Do not give aspirin to anyone younger than 18 because of its link to Reye syndrome, a serious but rare problem. Be safe with medicines. Read and follow all instructions on the label.

You can reduce the frequency of cold sore outbreaks by taking the following steps:

• Avoid prolonged exposure of your lips to sunlight. Use sunscreen at all times on your lips (in a lip balm form) and protect your face from the sun. Using lip balm that contains sunscreen may help reduce outbreaks of cold sores.
• Avoid intimate contact (such as kissing) with people who have cold sores or genital herpes.
• Avoid sharing towels, razors, silverware, toothbrushes, or other objects that a person with a cold sore may have used.

These measures may help prevent the spread of cold sores in children:

• Encourage frequent handwashing.
• Do not let children share toys that other children put in their mouths.
• Clean toys occasionally with a disinfectant.
• Do not let children kiss each other while they have cold sores or uncontrollable drooling.
• Use disposable gloves or a cotton swab to apply medicated ointment to a child’s cold sores.

References

Citations

1. Worrall G (2009). Herpes labialis, search date February 2009. Online version of BMJ Clinical Evidence: http://www.clinicalevidence.com.

Other Works Consulted

• Habif TP, et al. (2011). Herpes simplex section of Viral infections. In Skin Disease: Diagnosis and Treatment, 3rd ed., pp. 224–229. Edinburgh: Saunders.
• Sterling JC (2010). Herpes labialis. In MG Lebwohl et al., eds., Treatment of Skin Disease: Comprehensive Therapeutic Strategies, pp. 303–305. Edinburgh: Saunders Elsevier
• Wolff K, et al. (2013). Herpes simplex virus disease. In Fitzpatrick’s Color Atlas and Synopsis of Clinical Dermatology, 7th ed., pp. 660–667. New York: McGraw-Hill.

Credits

Adaptation Date: 7/22/2020

Adapted By: HealthLink BC

Adaptation Reviewed By: HealthLink BC

Adaptation Date: 7/22/2020

Adapted By: HealthLink BC

Adaptation Reviewed By: HealthLink BC

Signs and Symptoms of Cold Sores

What are cold sores?

Cold sores, also known as herpes labialis, is a viral infection. In the majority of cases, it is caused by the so-called herpes simplex virus 1 (HSV-1) but also can be caused by the herpes simplex virus 2 (HSV-2). Patients with cold sores typically have one or more painful blisters on the lips area.

Most people get infected with the herpes simplex virus 1 in childhood. The virus is usually transmitted through saliva. In the majority of cases, no symptoms occur during this initial transmission. After infection, the virus remains in the nervous system. Stress and other triggers can lead to the virus reactivating, which then leads to an outbreak of the blisters. These outbreaks can recur over a lifetime. By the age of 40, more than 90 percent of all people are infected with the virus. However, many infected people never have an outbreak.,,

Although herpes on the lips is contagious and painful, it is usually a harmless infection. However, it can have serious health consequences if it affects newborns or people with impaired immune systems.,

If you think that you might have cold sores, you can try using Ada App to find out more about your symptoms.

What causes cold sores?

The viruses that cause cold sores are very contagious. The entry port is usually the mucous membrane of the mouth, but the virus can also enter the body through a small wound. Transmission can occur if you come into direct contact with a herpes blister or the saliva of someone who currently has a herpes blister. You can also get infected if you share dishes, cutlery, towels, cosmetic tissues, toothbrushes, toothbrush holder, or razors with someone who currently has cold sores.

The people most at risk are those who have a family member or intimate partner with a cold sore outbreak. Since both herpes simplex viruses 1 and 2 can cause both cold sores and genital herpes at different frequencies, it is also possible to become infected during oral sexual intercourse if there is mucous membrane contact with an affected person.,,,

After the virus has usually persisted for a while in the affected person’s nervous system without causing discomfort, certain factors can lead to reactivation and then to an outbreak. These factors include:,,,

• fever
• menstruation
• sunlight
• upper respiratory tract infections
• injuries
• emotional stress
• weakened immune system
• certain medications

What are the symptoms of cold sores?

The typical symptoms of cold sores are itching and tingling, followed by painful blisters on the mouth and lip area, from which encrusted wounds eventually develop. The symptoms can last up to two weeks. During the first episode of cold sores, the blisters can be very painful and can also be accompanied by fever, muscle pain, and swelling of the lymph nodes in the face and neck.,,,

An outbreak of cold sores typically occurs in several stages:,,

Prodromal stage

• This stage lasts about one to two days. The affected person initially only notices a tingling sensation and possible redness at the site where a blister will form. The blisters in cold sores can occur again and again in the same place. If treatment is already started at this stage, the entire duration of the outbreak can be shortened.

Blister stage

• This stage lasts about two to three days. One or more blisters appear on and around the lips or more rarely around the nostrils. The appearance of blisters is usually accompanied by slight pain, which can be intensified by speaking, laughing, or eating.

Weeping stage

• This is the most painful stage. It lasts about one to three days. The blisters rupture and a clear fluid emerges.

Crusting stage

• This stage is where the bubbles crust and form scabs on the surface. This often leads to itching, and as a result, this stage is often described by those affected as the most unpleasant stage.

Healing stage

• This stage is where the scab and crusted areas fall off. Small, temporary scars can develop until the skin has completely healed.

Good to know:

Cold sores are contagious during all of these stages. However, the greatest risk of infection is during the third stage. The outbreak of cold sores usually disappears by itself. The affected person is no longer contagious to others from the moment the skin on which the blister was located has completely healed again.

If you are not sure if this matches what you’ve been experiencing, check your symptoms with Ada.

How are cold sores diagnosed?

The diagnosis is based on the symptoms and appearance of the blisters. The examination of the fluid or a tissue sample from a blister can be used to confirm the diagnosis of the herpes virus. However, this is usually only the case if the diagnosis is unclear or if other causes are also likely. With people with a weakened immune system, the diagnostic measures may also need to be more extensive.,,

What is the treatment for cold sores?

Cold sores can usually be treated quite easily, especially if the treatment is started immediately after the first signs appear. There are several factors that determine the exact type of treatment, which are:

• Is it a pronounced initial infection or a usually milder reactivation?
• Does severe pain or fever occur?
• How regularly do the symptoms occur?
• Does the affected person have a general immunodeficiency?

The treatment differs depending on these considerations. If the symptoms are rare, fairly mild, and the current outbreak is already in one of the later stages (see above), treatment may not be necessary.
The available drugs counteract the spreading of the virus. For this reason, treatment with so-called antiviral medication is much more effective if it is started early, even before the virus has been able to multiply and before a blister has formed.

Medication for cold sores:

• If the affected person is alert and notices the onset of cold sores at an early stage (when it is only tingling), a prescription-free antiviral cream, such as acyclovir cream, can be applied. This often prevents the formation of blisters and shortens the outbreak of the virus considerably. Once a blister has formed, the application of creams is less effective.

• Alternatively, zinc-containing creams or slightly anesthetic creams can be applied. Although these creams can relieve pain, they are not as effective as antiviral creams.

• Oral antivirals (tablets) are sometimes prescribed by doctors. However, this is the exception and usually only necessary in very severe cases. Since it is the same group of active ingredients as in antiviral creams, antiviral tablets are also much more effective if treatment is started during the prodromal phase (see above). However, if a patient has already developed blisters, doctors may prescribe oral antivirals in certain cases so that the patient can take them to prevent future outbreaks.

There is some evidence that oral antivirals may be most effective when prescribed in cases where a patient’s cold sore has a known trigger, such as strong sunlight. In such cases, an antiviral tablet may be taken immediately after the person has been exposed to the trigger. This is another form of lip herpes prophylaxis and can prevent an outbreak.

There is no evidence that the combination of oral antivirals and antiviral creams reduces the duration of an outbreak more than the use of only one of the two preparations.,,,,

Can cold sores be prevented?

To reduce the risk of spreading herpes simplex viruses, which can cause cold sores and genital herpes, it is important to avoid sexual contact when lesions are present. Of course, outbreaks and lesions are not always noticed by those affected. In these cases, the consistent use of condoms helps, which massively reduces the risk of infection.

• Whenever cold sores are present, measures should be taken to avoid saliva exchange with others. This includes activities such as kissing, oral sex, and sharing food and other utensils.

• Mothers with the herpes simplex virus can continue to breastfeed if there are no lesions on the breasts and if lesions on other body parts are completely covered. If there are active lesions on the breast, the mother should temporarily stop breastfeeding from the affected breast and should not feed pumped milk from the affected breast. Before holding the infant, care should be taken to ensure appropriate hand hygiene.

• Antiviral medications are effective in reducing the duration and severity of outbreaks and are most effective when administered at the first sign of an outbreak. Antiviral tablets may be prescribed in certain cases so that the patient can take them as a prophylaxis against future outbreaks.

What is the prognosis for cold sores?

Cold sores are a chronic viral infection in which symptom-free intervals can alternate with repeated outbreaks. The course is variable from person to person. Some people may have frequent outbreaks, while others remain completely symptom-free. 1
Although herpes on the lips is contagious and painful, it is usually a harmless infection. However, it can have serious health consequences if it affects newborns or people with impaired immune systems.,

What are the complications for cold sores?

Cold sores generally have a low risk for complications.

If you think that you might have an infection, you can try using Ada App to find out more about your symptoms.

90,000 Genital herpes – treatment and symptoms, diagnosis of genital herpes in Moscow, Clinical Hospital on Yauza

Genital herpes during pregnancy

Is genital herpes transmitted from mother to fetus in pregnant women? If the primary infection with the virus occurs during pregnancy, especially in the first half of it, then there is a possibility of the virus penetrating the fetus with the development of intrauterine infection and impaired fetal development. This is a formidable complication of genital herpes and, fortunately, it is very rare.

If the virus was present in the woman’s body before pregnancy, then her immune system, already familiar with the herpes virus, effectively protects the fetus during pregnancy, and infection is possible only during childbirth, and then with the condition that at this moment the disease is in an active phase … Therefore, it is especially important not to miss the recurrence of genital herpes activity during pregnancy in order to start treatment on time and prevent the transmission of the virus to the child during childbirth.

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Diagnosis of genital herpes

Which doctor should I contact with genital herpes?

In the Yauza Clinical Hospital, this disease begins with a clinical examination by a specialized specialist (gynecologist or urologist), and is confirmed by laboratory tests.If necessary, consultation of related specialists (immunologist) is carried out.

What tests should I take for genital herpes?

Laboratory diagnostics solves 2 problems:

• to determine the presence of the herpes simplex virus or contact with it: for this, they examine the blood, vaginal discharge, urethra, semen, urine of the patient for the presence of antibodies to the herpes simplex virus, or particles of the virus itself;
• to prove the “involvement” of these rashes to genital herpes: the material taken directly from the vesicles or ulcers is being investigated.

Also, in order to select an effective therapy, it is necessary to accurately determine the type of pathogen – this question is answered by the polymerase chain reaction (PCR).

Make an appointment

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Treatment of genital herpes

How is genital herpes treated? Unfortunately, at the moment there is no way to completely destroy the virus in the body, to cure genital herpes once and for all. However, the specialists of the Clinical Hospital on Yauza have developed a treatment regimen that keeps the pathogen inactive and significantly reduces the likelihood of recurrence of genital herpes in men and women.

Treatment targets:

• Removal of local manifestations – rash, painful ulcers, itching.
• The earliest relief of relapse.
•  Strengthening immunity, maintaining long-term stable remission.

The complex of treatment measures includes:

• Antiviral drugs – oral and topical, which are selected individually. One of the most effective in the treatment of genital virus is acyclovir (tablets, injections, cream, ointment).
• Appointment of immunomodulators, immunostimulants.

Patients with rare exacerbations are treated with episodic therapy. Those who have a difficult disease (frequent relapses due to the individual characteristics of the immune system – its low activity against the herpes virus) are shown a long course of pharmacotherapy – systemic therapy.

Despite the fact that there are no methods for a complete cure for herpes, the doctor will select drugs that will reduce the frequency of relapses.Thus, you can live a fulfilling life without regular exacerbations of the disease. Make an appointment with a specialist to avoid complications and relapses.

Treatment of genital herpes during pregnancy

First of all, it should be noted that there is a group of antiviral drugs that can be used with complete safety for the developing fetus.

Indications for treatment:

• primary infection during pregnancy,
• the occurrence of relapses of the disease and
• prevention of relapse before childbirth.

Given the possibility of an asymptomatic course of the disease during a relapse, it is necessary to carry out periodic examinations of a woman throughout pregnancy and, especially in the last weeks before childbirth.

By contacting the Clinical Hospital on Yauza, you are guaranteed to receive qualified advice from a specialized specialist, error-free diagnosis of your condition, effective treatment of the identified disease, prevention of exacerbations of genital herpes and its complications.Take care of your health – make an appointment with your gynecologist or urologist right now!

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You can look at prices for services in the price list or check the phone number indicated on the website.

The article was checked by an obstetrician-gynecologist, Ph.D. Sazonova Yu.M. is for general informational purposes only and does not replace specialist advice.
For recommendations on diagnosis and treatment, a doctor’s consultation is required.

90,000 Herpes – causes, symptoms and treatment

Herpes is a viral disease that manifests itself as an infection that affects the surface of the skin and mucous membranes on the face and genitals of a person.

Herpes Symptoms

Once in the body, the herpes virus does not manifest itself for 2-10 days. However, after this time, an accumulation of tiny white bubbles appears on the designated areas, merging with each other and provoking itching and slight tingling.

In extreme cases, this symptom can be supplemented by others:

• headache;

90,025 general weakness in the body;

• rise in body temperature.

In even rarer cases, a complication may develop – herpetic meningitis, characterized by inflammation of the brain.

Do you have symptoms of herpes?

Only a doctor can accurately diagnose the disease.
Do not delay the consultation – call

+7 (495) 775-73-60

The causes of herpes

The herpes simplex virus can appear in the human body after contact with a sick person in the event that the latter has open affected areas of the skin.Herpes multiplies quite rapidly, so even a quick contact is enough.

There are a number of reasons that can affect the body and contribute to its infection:

• Frequent stress, depression;
• hypothermia of the body, staying outdoors for a long time during strong winds;
• acute respiratory viral disease;
• diseases affecting the suppression of the natural immune system of a person;
• alcohol abuse, junk food;
• severe poisoning of the body.

In addition to those listed, herpes can have other, more serious causes, for example, Alzheimer’s disease. Any of these reasons can trigger the appearance of herpes on the lips or body.

Herpes Treatment

It has been established that herpes treatment requires treatment depending on the specific cause that caused it.Therefore, it is especially important to consult an experienced therapist or pediatrician when it comes to a child.

The course of treatment is influenced by the frequency of relapses: for example, to get rid of a patient from acute or chronic herpes, some drugs are used, for a single case – others, more gentle.

Herpes on the lips and body is treated with the following drugs:

• antiviral agents used as “first aid” against the active development of the herpes virus;
• in serious cases, an anti-inflammatory agent for herpes is selected;
• vitamin support of the body during the period of its weakness is no less significant, therefore, vitamin supplements can be prescribed, and a special diet based mainly on protein foods, dairy products, herbs, vegetables and fruits;
• plentiful drinking is prescribed: mainly pure non-carbonated water, herbal teas, fruit drinks.

Regardless of the type of herpes, you should understand the reason that acted as a catalyst. Therefore, it is important that an experienced doctor is involved in the diagnosis.

You will find these very specialists in Medicina JSC (Academician Roitberg’s clinic), located in the center of Moscow at 10 2nd Tverskoy-Yamskaya Lane, a five-minute walk from Mayakovskaya metro station. You can make an appointment and quickly get to an appointment by calling the round-the-clock phone +7 (495) 775-73-60 or by leaving a request in the feedback form on the website https: // www.medicina.ru.

Herpes prevention

The most important step in the prevention of herpes on the body and lips is the general strengthening of the body and its immune system. These include the following factors:

• application of immunomodulators in the autumn-winter period;
• vaccination against the herpes virus;
• , if possible, quitting bad habits, such as smoking, drinking alcoholic beverages;
• strict restriction of sweets, fatty, fried, smoked food, fast food;
• complete, balanced nutrition;
• healthy sleep;

90,025 avoidance of stress and depression;

• selection of clothes according to weather conditions;
• compliance with all rules of personal hygiene;

90,025 use of contraceptives during intercourse.

90,000 An estimated two-thirds of the world’s population under the age of 50 are infected with herpes simplex virus type 1

\ n

\ n There are two types of herpes simplex virus – herpes simplex virus type 1 (HSV-1) and herpes simplex virus 2 (HSV-2). Both types of HSV-1 and HSV-2 are extremely contagious and incurable. HSV-1 is transmitted primarily through oral-oral contact and in most cases causes orolabial herpes, or “lip herpes” around the mouth.HSV-2 is almost always sexually transmitted through skin-to-skin contact and causes genital herpes.

\ n

\ nHowever, new estimates highlight the fact that HSV-1 is also a serious cause of genital herpes. About 140 million people aged 15-49 have genital HSV-1 infection, mainly in the Americas, Europe and the Western Pacific. In high-income countries, fewer people become infected with HSV-1 during childhood, probably due to better hygiene and better living conditions, but are at risk of sexual transmission from oral sex after they become sexually active.

\ n

\ n “Access to education and information about both types of herpes and sexually transmitted infections is essential to protect the health of young people before they become sexually active,” says Dr. Marilyn Temmerman, Director WHO Department of Reproductive Health and Research.

\ n

Significant number of genital infections

\ n

\ nAccording to WHO in January, 417 million people aged 15-49 had HSV-2 infection, which causes genital herpes.Together, these estimates found that more than half a billion people aged 15-49 had genital infection with either HSV-1 or HSV-2.

\ n \ n

\ n

“New estimates highlight the need for countries to improve data collection on both types of HSV and sexually transmitted infections in general.”

\ n

\ nDr. Marilyn Temmerman, WHO Director of Reproductive Health and Research \ n

\ n

\ n

\ n “New estimates highlight the need for countries to improve data collection on both types of HSV and sexually transmitted infections. the way, in general, ”says Dr. Temmerman.

\ n

\ n Given the lack of permanent and complete cure for both HSV-1 and HSV-2, WHO and partners are working to accelerate the development of HSV vaccines and topical bactericides, which will play an important role in preventing these infections in the future. Several candidate vaccines and bactericides are currently under study.

\ n

Regional estimates of infections

\ n

\ n Prevalence of HSV-1 by region among people aged 0-49 years in 2012:

\ n

\ n
• Countries of the Americas: 178 million women (49%), 142 million men (39%) 90,026 \ n
• Africa: 350 million women (87%), 355 million men (87%) 90,026 \ n
• Eastern Mediterranean: 188 million women (75%), 202 million men (75%) 90,026 \ n 90,025 Europe: 207 million women (69%), 187 million men (61%) 90,026 \ n
• Southeast Asia: 432 million women (59%), 458 million men (58%) 90,026 \ n
• Western Pacific: 488 million women (74%), 521 million men (73%).

\ n

\ n

\ nNew cases of HSV-1 infection among people aged 0-49 years in 2012:

\ n

\ n
• Americas: 6 million women, 5 million men

\ n

• Africa: 17 million women, 18 million men 90,026 \ n
• Eastern Mediterranean: 6 million women, 7 million men 90,026 \ n
• Europe: 5 million women, 5 million men 90,026 \ n 90,025 Southeast Asia: 13 million women, 14 million men

\ n

• Western Pacific: 11 million women, 12 million men

\ n

\ n

Symptoms

\ n

\ n Herpes is a lifelong infection with little or no symptoms but detectable as a result of the presence of antibodies to HSV-1 or HSV-2 in the blood.Determining the proportion of people worldwide infected with HSV who have a disease with clinical symptoms is difficult, as symptoms may be mild or not recognized as herpes. In the United States of America, approximately 15% of people with HSV-2 infection report a previous diagnosis of genital herpes.

\ n

\ nWhen genital herpes symptoms occur, they take the form of painful genital or anal vesicles or ulcers. Herpes symptoms can be treated with antiviral drugs, but symptoms may recur after the initial episode.HSV-1 genital herpes usually recurs much less frequently than HSV-2.

\ n

\ nThe transmission of HSV is usually asymptomatic. This virus can have a significant negative impact on the mental well-being and personal relationships of an infected person.

\ n

\ nPeople with orolabial herpes symptoms may experience social stigma and psychological distress as a result. In people with weakened immune systems, such as people with advanced HIV infection, HSV-1 can cause more severe symptoms and more frequent relapses.Rarely, HSV-1 infection can also lead to more serious complications such as encephalitis or eye disease.

\ n

\ nWHO is currently developing a global health sector strategy for the control of sexually transmitted infections (STIs), including HSV-1 and HSV-2, to be finalized for consideration at the 69th World Health Assembly in 2016 year.
\ n

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Rheumatoid Arthritis | Clinical Rheumatology Hospital No. 25

Rheumatoid arthritis is a chronic inflammatory disease.

• First of all, joint damage with rheumatoid arthritis – one or many joints can be involved in the process at once. Inflammation of the joints. Any joints can become inflamed: more often the small joints of the hands and feet, but also knee, elbow, hip, temporomandibular joints, intervertebral joints of the cervical spine and others.

• , the process progresses with the development of irreversible changes in the joints, that is, most likely this disease will remain for life and the condition of the joints will gradually worsen.The rate of joint destruction is different for each patient.

• rheumatoid arthritis disease periodically worsens under the influence of climatic conditions, hypothermia, trauma, psycho-emotional stress, physical activity, infections and concomitant diseases.
• In the course of the disease, damage to internal organs often occurs – blood vessels, nervous system, kidneys, heart, lungs. Then in the diagnosis appears the wording “rheumatoid arthritis with systemic manifestations.”Involvement of other organs also occurs in different ways and at different times from the onset of the disease. Various complications can occur at any stage of the disease, many of them are reversible with timely and adequate treatment.

Causes of rheumatoid arthritis. The impetus for the development of this disease can be one of the following factors or their combination:

• genetic predisposition – the risk of developing rheumatoid arthritis is increased by about 4 times in blood relatives of patients with rheumatoid arthritis.It is not the disease itself that is inherited, but the impaired response of the immune system to the action of infectious and other agents, during which arthritis develops.
• infectious agents – several infectious agents have been identified that can trigger the development of rheumatoid arthritis (rubella, herpes, Epstein-Barr viruses, retroviruses, cytomegalovirus, mycoplasma, etc.). However, none can be the only cause of the development of rheumatoid arthritis. They are only the starting mechanism of the pathological process.
• Psycho-emotional stress and excessive physical activity – childbirth or abortion, trouble in the family or social sphere, the effect on the body of chemical, radiation, toxic factors – also provoke the development of rheumatoid arthritis.

How does rheumatoid arthritis manifest? How to recognize rheumatoid arthritis? What are the symptoms of rheumatoid arthritis?

The main clinical manifestations of rheumatoid arthritis include:

• Morning stiffness – a feeling of stiffness in the affected joints, requiring them to “work out” especially in the morning.With multiple lesions of the joints, this can lead, during an exacerbation, to complete immobility of the patient, usually increasing from the middle of the night and reaching its peak to awaken the patient in the morning. Often the severity of morning stiffness corresponds to the level of activity of the inflammatory process. But in a small number of patients, it may appear slightly.
• Pain and deformity of the joints, swelling and limitation of the range of motion in the affected joints are unstable and depend on the severity of the inflammation and are especially troubling during exercise.However, with the development of pronounced destruction of the joints and the formation of contractures, the limitations of movement are already permanent. A feature of rheumatoid arthritis is the symmetrical damage to the joints (for example, the small joints of both hands).
• temperature, weight loss, general weakness – can appear at the onset of the disease even before the development of typical changes in the joints and increase with exacerbation of the disease.

THE DEVELOPMENT OF RHEUMATOID ARTHRITIS IS BASED ON autoimmune inflammation, as a result of which the immune system, due to dysfunction of its functions, instead of “attacking” the body’s enemies (microbes, viruses, tumor cells), begins to “attack” its own cells.An immune response is formed, leading to damage to one’s own tissues or organs. The cells of the immune system produce specific proteins – various antibodies against the body’s own cells – autoantibodies. Some of them are called rheumatoid factor (RF) and are regularly assessed in your blood when taking tests, not only when clarifying the diagnosis, but also during treatment. The level of rheumatoid factor characterizes the activity of the disease and helps to assess the effectiveness of therapy. In rheumatoid arthritis, the tissues of the joints are primarily affected.For many people, the initial symptoms of arthritis are very vague and include weakness, muscle pain, and fever.

CHANGES IN THE JOINTS in rheumatoid arthritis are the result of several processes:

1. A chronic inflammatory process leads to a gradually increasing destruction of cartilage and bones. The main destruction of joint structures in rheumatoid arthritis is caused by pannus, an aggressive tissue that begins to grow under the influence of factors produced by the immune system in the joint cavity.The mechanism of destruction is associated both with the mechanical pressure of the growing pannus and with the formation of a large number of various aggressive enzymes that “eat away” the joint tissues. And in the adjacent bone tissue, the same processes cause rarefaction – “periarticular osteoporosis.”

2. Under the influence of a large number of different substances that are produced by the cells of the immune system and are formed as a result of the destruction of joint tissues, the nearby soft tissues begin to change. There is a gradual muscle atrophy, contractures are formed.

All this leads to those external deformities of the joints, which are a characteristic feature of rheumatoid arthritis. In no other disease does the joints change so much. This occurs especially significantly in the small joints of the hands and feet.

90,000 clinic, diagnostics and tactics of ambulance

  with signs of focal or generalized herpes.The frequency of neonatal herpes, according to various sources, ranges from 1: 2500 to 1:60 000. The manifestations of neonatal herpes are expressed to varying degrees. The lowest degree is classified as a localized form with lesions of the skin, eyes and mouth (20-40% of cases of neonatal herpes without treatment in 50-70% of newborns, it can turn into a generalized form or encephalitis, often has a recurrent course in the 1st year of life). A more severe form is the lesion of the central nervous system - herpetic encephalitis (about 30% of neonatal herpes, the onset of clinical signs - at 2-3 weeks of life, in 40-60% of patients there are no specific rashes on the skin and mucous membranes).With the development of encephalitis, the mortality rate is 50%; surviving children have a high risk of developing further disorders of the central nervous system. The best prognosis is observed in the localized form, only 7% of children suffer from neurological and other complications in the future. And the third, most severe form is a disseminated disease involving many organs, such as the liver, lungs, various glands and the brain (this form accounts for about 20-50% of cases of neonatal herpes, onset on the 5-10th day of life, clinical symptoms it is nonspecific and resembles neonatal sepsis).With this form of the disease, mortality rises to 90%, and surviving children have certain complications. With HSV-1, the prognosis for life and health is better than with HSV-2 infection. HSV-1 infection usually presents as a localized form of neonatal herpes. HSV-2 often causes the development of a disseminated form of infection and herpetic encephalitis.
According to the WHO, mortality from herpes encephalitis and disseminated forms of the disease (15.8%) ranks second after influenza (35.8%) among all viral infections.5. BASICS OF SKIN STRUCTURE
The skin is composed of the epidermis and dermis. The skin is connected to the underlying tissues by subcutaneous fatty tissue (Fig. 1).
The epidermis comprises five layers of epidermal cells. The lowest layer, the basal layer, is separated from the dermis by the basement membrane. It is a single row of tall prismatic cells perpendicular to the basement membrane. Immediately above it lies a prickly layer (3-8 rows of cells with cytoplasmic outgrowths), followed by a granular layer (from 1 to 5 rows of flattened 8
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90,000 Herpes corona has become the embryo of Alzheimer’s disease in mice – Science

An international team of scientists has found an explanation for why herpes often accompanies the occurrence of amyloid plaques in the brain.It turned out that the viral particles work as a crystallization center, triggering the adhesion of beta-amyloid molecules. Another widespread virus affecting the human respiratory system may have a similar property.

Many scientists consider infection, bacterial or viral, to be one of the reasons for the development of Alzheimer’s disease. The suspects include, for example, the herpes virus: its presence in the human body correlates with the subsequent appearance of amyloid plaques in the brain – accumulations of improperly folded amyloid beta protein molecules.They accumulate in the nervous tissue and lead to the death of neurons and the destruction of connections between them. However, how exactly infectious agents provoke the formation of amyloid plaques is not very clear.

In their article in Nature Communications , the research team put forward a new hypothesis: one of the triggering factors may be viral particles. Unable to reproduce outside the cells, they nevertheless actively interact with the environment, traveling through the intercellular space.Proteins from blood and tissue fluid adhere to them, forming protein crown . Speaking to Stockholm University Press Office, lead study author Karim Ezzat likened the process to dipping a tennis ball into a bowl of cereal and milk. “The ball instantly becomes covered with sticky particles,” Ezzat described, “which remain on it when you pull it back.” It is possible that beta-amyloid molecules are also included in the protein corona, which thus receive support for aggregation.

See also: Portrait of a Mysterious Assassin. What is Alzheimer’s disease – an epidemic, a burden of old age, or a quality of life?

Experiments in vitro confirmed: herpes particles catalyze (that is, accelerate) the growth of amyloid aggregates and do this the more actively, the cleaner the solution. In blood serum, which contains many different proteins, amyloid aggregates grow much more slowly in the presence of a virus, probably due to competition for binding to the particle surface.

Formation of beta-amyloid filaments on the surface of a herpes virus particle. Kariem Ezzat et al. / Nature Communications / CC BY 4.0

Herpes accelerated the formation of plaques and in vivo : when researchers injected the virus into the brains of experimental mice, amyloid accumulations in the nervous tissue formed in just a couple of days. True, these were model animals, prone to the development of pathology, reminiscent of human Alzheimer’s disease, but in natural conditions they become ill only after a few months of life.

The very idea that infections can contribute to the development of Alzheimer’s disease is far from new. The search for candidates continues, among them there are not only the herpes virus, but also bacteria. Infection is usually considered as one of the reasons for the secretion of beta-amyloid by cells: it is believed that it can act as a defense against the pathogen. Now scientists note that regardless of whether the infection causes the production of beta-amyloid, viral particles can further provoke its aggregation.If so, then almost 70% of people on the planet who secretly or openly carry the herpes virus are at risk of developing Alzheimer’s disease.

In addition, the researchers found similar properties in another common pathogen – the respiratory syncytial virus. During the first two years of life, it infects 90% of children, and subsequently manifests itself in the form of mild local symptoms of the common cold.