Cold sore virus can ‘wake up’ af­ter be­ing dor­mant for years

The Tribune (SLO) - - Sports & Weather -

Q: I have had a few cold sore flare-ups over the past few months af­ter years with­out get­ting any. What causes them to come back, and what’s the best way to treat them?

A: Cold sores are caused by the her­pes sim­plex virus. Once you’re ex­posed to the virus, which is typ­i­cally passed from skin-toskin con­tact, it’s present in your body for life. Af­ter the ini­tial in­fec­tion, the virus will travel to your nerves, where it re­mains dor­mant but may awaken pe­ri­od­i­cally. Of­ten, there’s a trig­ger that causes the virus to wake up, which leads to the de­vel­op­ment of cold sores. There’s no cure, but an­tivi­ral med­i­ca­tions can help cold sores heal more quickly and may re­duce how of­ten they re­turn.

A cold sore is a small, fluid-filled blis­ter – or more of­ten, a group of blis­ters – that typ­i­cally de­vel­ops on or around the lips. These blis­ters quickly dry out and form a scab. A day or two be­fore an out­break oc­curs, you may ex­pe­ri­ence a burn­ing, itch­ing or tin­gling sen­sa­tion on the area of skin where the sore even­tu­ally will ap­pear.

Com­mon trig­gers that can lead to cold sores in­clude stress; ill­ness, such as a cold or in­fluenza; ex­po­sure to sun­light, wind or other el­e­ments; a cut or in­jury to the skin; changes in the im­mune sys­tem; and hor­monal changes.

Most cold sores will heal on their own within a cou­ple of weeks. If the dis­com­fort both­ers you, a non­pre­scrip­tion pain re­liever such as ac­etaminophen or ibupro­fen may help.

A cool com­press or suck­ing on ice chips may min­i­mize any burn­ing or itch. You also may want to cut back on foods that can ir­ri­tate a sore, including foods that are salty or spicy, as well as acidic foods, such as toma­toes and cit­rus fruits. Ap­ply­ing petroleum jelly to the sore and sur­round­ing skin can re­duce dry­ness and crack­ing.

To re­duce the du­ra­tion of cold sores and re­lieve symp­toms, the non­pre­scrip­tion an­tivi­ral cream do­cosanol (Abreva) may be worth a try. Abreva is most ef­fec­tive if used when you first no­tice tin­gling or other early symp­toms that in­di­cate a cold sore is form­ing. How­ever, the ef­fect of the drug is lim­ited, only re­duc­ing the du­ra­tion of symp­toms by a mat­ter of hours.

If a cold sore per­sists for longer than two weeks or keeps re­turn­ing, see your pri­mary care provider or a der­ma­tol­o­gist for an eval­u­a­tion. He or she may rec­om­mend treat­ment with an an­tivi­ral med­i­ca­tion in pill form. Oral an­tivi­rals may take one to two days off of the du­ra­tion of an out­break.

If you have eczema or a weak­ened im­mune sys­tem, you may be prone to more se­ri­ous in­fec­tions and com­pli­ca­tions, and should con­sult your health care provider. Also, see your provider for treat­ment if any cold sores de­velop near your eyes or at the tip of your nose.

To keep the virus from spread­ing, avoid kiss­ing and other skin-to-skin con­tact with any­one else while you have a cold sore. Keep per­sonal items, such as tow­els and lip balm, sep­a­rate from other peo­ple in your house­hold dur­ing the time you have a sore. Do not share uten­sils, cups or other dishes.

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