A sore point

One in five people gets recurring cold sores.

Why do I get cold sores but my partner doesn’t?

Although around seven in 10 of us will be infected with the virus that causes cold sores, only a third of these will go on to develop visible sores, explains Marian Nicholson, Director of the Herpes Viruses Association (herpes.org.uk).

There are two strains of the herpes simplex virus and type 1 (HSV-1) is usually responsible for cold sores.

In many cases, people become infected during childhood and then, like the chicken pox virus, carry the virus for life.

Most experience no symptoms because the virus is dormant, hiding from the body’s immune system. In those who do get cold sores, a trigger causes the virus to reactivate.

Could I get genital herpes?

Yes. Both cold sores and genital herpes are caused by both types of herpes simplex virus – HSV-1 and HSV-2 – so can be caught by direct contact with the skin.

“So, if you have a cold sore, you should avoid oral sex as well as kissing,” says Marian.

Can I pick up the virus from cups or cutlery?

Despite scare stories, cold sores are only caught by direct skin-to-skin contact with the affected area – not through sharing cups, cutlery, towels, lipstick and the like – unless there is infected blister fluid actually on the item, explains Marian.

“Experts at the British Association of Sexual Health and HIV are very clear about this.”

What triggers cold sores?

This can vary between individuals but common triggers include illness, stress, tiredness, being run down, having a period, too much alcohol or ultraviolet (UV) light from the sun or sun beds. “It’s important to be aware that the trigger is the sun – not heat – so you should use a good quality sun block to protect your lips, particularly when skiing in the winter,” adds Marian.

How can I treat them?

Taking action at “prodromal” stage (a sensation of tingling, itching, stinging or soreness before the sore appears) can accelerate healing and, sometimes, prevent a full-blown

sore forming. Acyclovir creams, such as Zovirax, and the newer Fenistil, inhibit the infection from spreading further.

“If applied at the ‘tingle’ stage, they can shorten the outbreaks by 12 per cent,” says Marian.

Anaesthetic creams containing lidocaine, benzocaine and prilocaine have pain-killing ingredients.

“A small trial has shown that a lidocaine 5 per cent ointment prevented outbreaks in one in three of those testing it and shortened the outbreaks that did occur,” explains Marian. Cold sore patches, such as Compeed, contain an active gel that acts like a second skin, reducing contamination. Herpotherm – a lipstick-shaped device with a ceramic heated plate at the end – works by delivering concentrated heat (around 51C) to the affected area for three seconds at the tingling stage. In a small trial, it halved the duration of the sore in some cases.

If you get regular outbreaks, ask your GP about antiviral tablets, which are more effective than creams, suggests Marian.

answers your burning questions about the virus

Do home remedies work?

Some swear by a cold, damp tea bag, with anecdotal evidence suggesting that earl grey is better because it contains soothing bergamot oil as well as healing terpenes.

Interestingly, aloe vera gel, a natural antibacterial and antifungal, was found to inhibit HSV-1 virus growth in a small trial.