Although it isn’t dangerous, herpes labialis remains inconvenient! Here are a few tips to avoid the unpleasantness of cold sores.
Cold sores: stubborn little blisters
Cold sores (also known as “herpes labialis” in medical terms) are caused by the presence of a virus in the body: the herpes simplex virus type 1 (HSV-1). According to the World Health Organization, it is estimated that 67% of people under the age of 50 are infected with HSV-1. Although it is most often contracted in childhood, this highly contagious virus can also be contracted later in life.
After infection, the virus remains "latent" and can cause periodic outbreaks if a person is exposed to certain triggers. It is estimated that roughly one out of four people experience recurrent episodes of cold sores. This means that many people are unknowingly carriers of the virus.
Herpes labialis triggers
Factors that can trigger cold sore outbreaks include:
- ultraviolet rays (from the sun or tanning beds)
- the cold
- dry skin on or around the lips
- fever, a cold or the flu
- stress
- fatigue
- menstruation
- trauma to the mouth (following an oral procedure)
Signs and symptoms of herpes labialis
Herpes labialis outbreaks, characterized by the eruption of a lesion, are usually preceded by certain predictive symptoms. A cold sore generally lasts 8 to 10 days in total (14 days maximum). Here is a description of the various stages of a cold sore:
Days 1–2: The tingling stage
Before any visible symptoms appear, you may feel a tingling, itching or burning sensation. This stage lasts about six hours. The infection is already contagious at this stage, so it is important to avoid close physical contact.
Days 2–4: The blister
The blister appears. A cluster of small painful vesicles multiply or grow. White blood cells travel to the blister and fight the infection. The blister fills with fluid (pus) and contains millions of virus particles. Herpes is very contagious during this stage.
Day 4: The ulcer
During the ulceration stage (typically the most painful), you will notice a thin cold sore forming. The inflammation can also cause a red ring around the affected area.
Days 5–8: The scab
As the cold sore dries out, a golden-brown crust appears on the ulcer site. As the scab hardens, painful fissures may appear and bleed. Significant itching or burning is also common.
Days 8–10: The healing stage
As the cold sore heals and the scab begins to detach, some dry scaling and residual swelling may occur. The skin may also remain slightly pink or red.
Preventive measures
HSV-1 is usually spread through close contact, such as kissing. It can also be spread through contaminated objects such a utensil, straw, lipstick, etc. If someone close to you has a cold sore, be careful to avoid becoming infected.
Frequent handwashing can help prevent contracting viruses, including HSV-1.
If you are prone to cold sores, here are ways to prevent them:
- Use a moisturizing lip balm regularly
- Protect your lips from the sun’s rays (some lip balms provide sun protection)
- Cover your mouth (e.g. with a scarf) when exposed to the cold
- Avoid stress and fatigue
- Avoid close contact with people with colds or the flu
Treatment options
There is currently no treatment available to permanently eliminate the HSV-1 infection. Fortunately, cold sores heal on their own over time. Prescription and over-the-counter treatments help reduce their intensity and duration. These medications come in topical (ointment or cream) or tablet formats.
If you have had a prescription in the last five years and the prescription is no longer renewable, ask your pharmacist if they can re-prescribe it. To do so, they must conduct a consultation with you to assess your situation and check whether or not they can prescribe the treatment.
Starting the treatment in the first days after the onset of a cold sore and, ideally, as soon as warning signs (such as tingling) appear, can significantly reduce the intensity and duration of cold sore symptoms.
Don't hesitate to speak to your pharmacist for additional information about cold sores or their treatment.