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Cold sores or fever blisters are caused by herpes simplex virus
infection. The first attack causes a severe infection in the oral
cavity (known as primary herpetic gingivitis) during infancy, probably
caught from mother or loving relatives passing on the virus while
kissing the baby square on the mouth!
The initial attack occurs 5-21 days after exposure to an infected
person. The infection can also pass through toothbrush, drinking
glasses, cups, face towels, pillows etc.
Herpetic whitlow is the herpes infection of the hand or finger. It
is sen typically in dentists and other health professionals and
children, when they innoculate themselves from their facial lesions.
Herpes genitalis is the infection affecting the genital area and is
sexually transmitted disease usually.
Cold sores near the mouth or lips are known as Herpes labialis.
The problem with herpes virus is its recurrent nature. The virus,
after the first attack, migrate through the nerve pathway and lodge
itself inside the neuronal ganglion cells. Whenever a triggering
incident occurs, the virus comes out of the nerve to the skin to
cause the visible lesions.
Symptoms
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There is a tingling or burning
sensation at the site
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An area of erythema appear soon,
followed by grouped vesicles
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These vesicles dry up and crust within
4-5 days
Tips on how to deal with cold sores
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Avoid triggering factors: Hot ,spicy
food, alcohol, stress, sun exposure etc
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Use a sun protection of spf 30 and
above if you have to go out during daytime. Put a thick layer over the cold
sore
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Avoid cross transmission: change
toothbrush, towels. Use disposable utensils for food and drinks
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Apply a drying salve over the lesions.
Zinc sulphate salve, betadine antispetic paint etc are effective.
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Acyclovir cream should be applied at
the earliest sign of eruption and continued every two hourly till the
lesions heal. This gives the best results.
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For severe attacks and very frequent
attacks, I advise Systemic antivirals like acyclovir or famcyclovir.
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Patient is also advised to apply a
stress management
program if the recurrences are high.
Frequently
Asked questions
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How
is herpes simplex transmitted?
Herpes Simplex Virus gets transmitted through direct contact. Broken
skin or mucosal surface favours transmission. The initial
lesions occur in 5-21 days after contact. HSV type 1 usually causes
herpes labialis while Type 2 usually attacks the genital region. It
can get transmitted through toothbrush, drinking glasses, face
towels etc. Dentists get it on their fingers from their patients if
they are not properly protected.
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When
is the Herpes Simplex infective?
Infectivity is more when the vesicles contain fluid. Once the
lesions dry up,
the infectivity reduces.
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What
should be the diet?
As recurrent herpes labialis has been found to occur after
particularly hot and spicy fried food, alcohol and coffee, these
should be avoided.
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What other preventive measures to be taken?
See the tips above.
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Dr.Hanish Babu, MD
