If you are lucky enough to have never experienced a cold sore, this article will probably be something that you will just pass by and most likely never give a second thought to. However if you are one of the 1 in 5 (UK stats) who does suffer from cold sores, chances are you will have already scrolled passed this sentence and are scanning the following text for new ways to help with these pesky little fellers!
Herpes Simplex Virus
Cold sores are caused by the Herpes Simplex Virus (HSV) and the most common form is Type 1 which occurs on the face. Type 2 occurs on the genitals and is a lot less common, for more details on type 2 click here. This article will focus on HSV type 1; it will look at how it occurs, treatments and possible prevention.
You may believe that each time you get a cold sore it’s because you have ‘caught’ the virus, but with cold sores that’s just not the case. Like the chicken pox (shingles) and glandular fever you only catch the virus once. Studies suggest that it’s usually caught in early childhood and doesn’t normally manifest until puberty. Because it’s so contagious it can be passed on by something as simple as a kiss from a family member with a cold sore. Once the you catch the virus it lies dormant, hiding in nearby nerve sheaths (called ganglions) and stays there until triggered. It’s thought that 6 in 10 people carry the virus but yet only a quarter of them actually get symptoms. Some people don’t suffer any symptoms at all (and never develop anything- oh how I wish!) whereas others go on to develop the occasional blister, some more frequently than others.
The list below shows the most common triggers and it’s worth looking at so you can work out what it is that’s likely to be causing your outbreaks. Recognising your triggers can help to prevent future blisters, by enabling you to mange your heath better (such as taking a supplement or eating better).
- Tiredness or lack of sleep
- Illness such as a cold or fever
- Poor diet
- Hormones / mensturation
- Strong Sunlight
- Being run down
- Poor immune system
The Cycle of a Cold Sore
When you break out in a cold sore you will usually experience a warning sign, such as a tingling or burning sensation or redness where the blister will eventually appear. They usually appear on the lip or around the mouth however 10% of people will develop them on the cheeks, chin or nose. Once it breaks out you will be left with a fluid filled blister; the severity depends from person to person and can last anything between 7-14 days. The blister is most contagious once it ruptures (around day 4) and will be sensitive to touch. Fluids will discharged from Inflamed tissues and blood vessels. In severe cases you may feel pain in the lymph glands under the jaw. Soon after this the blister will start to scab, forming a crust. This is blood serum containing proteins. Laughing, smiling and eating can cause the scab to split (depending on where it is) and make healing time last a little longer. The scab will eventually get smaller as the skin below begins to heal. Once the scab has gone you may have a red patch for a few days. As cold sores are so contagious a good hygiene routine is key to preventing it getting worse.
Hygiene and Care
It’s important to take care of a cold sore once it develops otherwise it can become infected or spread, needing treatment from a doctor. Herpes UK states that cold sore cannot be caught by sharing a glass or cutlery, however other medical sites suggest that it’s better not to share theses sorts of things, including face cloths and towels. The type of treatment you choose will depend on how bad your cold sore is. You may suffer very little with barely any pain, leaving it to heal on its own. Alternatively you may find you feel unwell, have cold like symptoms and suffer great pain. The cold like symptoms are not a cause of the HSV itself, but rather what causes the virus to be triggered. Which ever treatment you choose always remember to wash your hand before and after touching your cold sore.
Below are a number of tips and methods that can help treat/ heal and soothe a cold sore. It’s difficult to say which ones are best as it depends on your triggers and what your body responds to. What may work for one person may do nothing for another. (My husband swears that he can ‘will’ his away with the power of mental magic!!!).
Petroleum Jelly – research suggests that covering the blister with a little petroleum jelly can help to protect it from secondary infection from bacteria.
Sun Block – some people develop cold sores from bright sunlight; The summer months/using a sun bed or even going on holiday can cause an outbreak. If this is the case, use a SFP cream or block, with a minimal of protection 15. Be sure not to share sun block sticks / lipsticks.
Pain Killer – if you develop a cold or fever take paracetamol or a cold/ flu remedy for a few days (follow the instructions on the packet).
Ibuprofen – some people suffer with painful lymph glands and may get a sore swollen mouth, usually during the time the blister becomes an lesion. Taking ibuprofen can help reduce the swelling and the pain in the glands.
Creams, Lotions and Potions – there are a number of antiviral creams available over the counter for treating cold sores that contain Aciclovir (brand name Zovirax) or Penciclovir (brand name Brvectavir). They are most effective if applied as soon as you feel the tingle/ burning sensation before any blister has appeared. If applied after this time they are not as effective and won’t kill the virus but will stop it from multiplying.
Anti Viral Tablets – Aciclovir and Penciclovir are both available on prescription. You would need to see your doctor as they are usually only prescribed for people who suffer baldy with reoccurring or sever cold sores.
Cold Sore Patches – contains hydrocolloid gel which is used for treating skin wounds.
Topical Anaesthetics – Sometimes you may also suffer from ulcers inside the mouth. Treatments such as Rinstead, Anbesol and teething gels can help to numb the pain.
My top tips – (from experience)
I have suffered from HSV Type 1 since I was a child, then 4 years ago I developed Myalgic Encephalopathy, which can have an impact on the immune system. For a long time, while I struggled to manage my health I would develop cold sore after cold sore, some times getting one on either side of my lip at the same time! I now take lysine (see below) and rarely get them. However when I am unfortunate enough to get one I follow the tips below.
Try using a cotton bud to apply creams so that you never actually touch the blister. This can be helpful as the cotton bud can be thrown away and it’s better to dab than rub as the skin can be very sensitive
When you first feel the tingle, ice can be applied to help soothe the burning sensation you may get. Wrap a ice cube in a food bag and hold on the lip until it feels numb. Be careful with this method as you don’t want to be rubbing the ice around the lip, so not to spread it.
If possible – don’t stress! If you have a date, big day or something special, stressing about it will make it worse! If it’s out, it’s out and there’s NOTHING you can do about it. If you feel the need to cover it with make up do so carefully and using cotton buds. If using a lipstick or Chapstick do not rub direct onto the lip. Use cotton buds or a clean finger (then wash after).
Once the blister bursts and you get a scab form, try to keep it dry. It will heal quicker as the scab dries out, however if you laugh or smile a lot like I do, you may find it useful to apply a little petroleum jelly round the outside of the scab to prevent it from splitting when you move your lips.
There are literally hundreds of suggestions on the internet from fellow sufferers for ‘treating’ cold sores however they usually involve things such as applying aftershave or nail vanish remover! (Do NOT try at home). They are not proven and applying random liquids and solutions not intended for medical treatment could aggravate the blister and make it worse.
There is another way that can help cold sores and that is to prevent them from occurring. It may sound lame and not so much of a ‘cure’ but there has been a lot of of scientific studies carries out regarding dietary impact on cold sores and research has found that lysine and arginine, two amino acids, play a huge part in the development of cold sores.
What are Amino Acids?
Often described as ‘building blocks’ amino acids are chemicals that make up protein in the body. There are over 50 different kinds, with 20 of these defined as essential. Next to water, protein makes up the greatest proportion of body weight there’re its crucial to ensure a balanced diet as it could cause a deficiency of amino acids. Only 11 types of amino acids as synthetically made by the body, the rest have to come from your diet as the body cannot store them. If your body becomes in deficient it will draw on it’s own tissue proteins causing it to beak down its structure including healthy tissue. Each amino acid has a different function but to give an overall idea, they carry out functions such as helping the body to regulate water balance, assist in the exchange of nutrients between intracellular fluids and the tissues, blood and lymph and help to maintain an internal ph level. L- Lysine (usually called lysine) is defined as an essential amino acid and L- Arginine is classed as a conditional amino acid, as it’s essential more so in children than adults.
Lysine is necessary for proper growth. It assists in absorbing calcium, aids the formation of collagen, bones, connective tissue/ cartilage and skin tendons. It also helps in preventing infections, the production of carnitine, a nutrient responsible for converting fatty acids into energy and helping lower cholesterol.
L-Arginine, know as Arginine, helps in the production of spermatozoa in men. It helps with growth hormones and strengthens the immune system. It aids in ailments such as arthritis, has stress busting properties and improves metabolism. In the body, this amino acids changed into nitric oxide (NO) and is a powerful transmitter that helps the blood vessels to relax and improves circulation
So as you can see, both of these amino acids are important for the body. The problem however is that when your body develops an ailment such as a cold sore these amino acids compete against each other for absorption in the intestine therefore the right balance/ ratio of lysine to Arginine is important. During a cold sore Lysine levels needs to be higher and Arginine should be decreased, other wise the lysine will be less efficient at reducing the virus.
The best way to manage your arginine and lysine levels are through your diet. By knowing which foods to eat you will be able to help your body combat the onset of a cold sore. Research suggests that if you start taking a supplement after a cold sore has erupted it’s not effective. You can opt to take a supplement which you can buy from most health shops, but you should first try increasing lysine naturally by varying your diet and being conscious of your diet during times you that you feel may trigger a sore eg such as stressful/ busy periods or during the winter. However if you suffer from a health condition or a poor immune system, a supplement maybe what you need to boost your system. The journal Dermatologica found that patients who took a L-lysine supplement daily for six months experienced significant reductions in the frequency, severity and duration of cold sore outbreaks compared to patients who took a placebo.
Foods high in lysine
- Most vegetables and fruits particularly beets, avocados, mangos, tomatoes, apples,
- apricots, pears, figs and papaya
- Dairy products such as milk, yogurt and cheeses
- Brewer’s yeast
- Fish, particularly sardines and cod
- Chicken, beef and lamb
Foods high in arginine (Foods to decrease/limit)
- Nuts, including peanut butter
- Protein shakes and drinks that contain Arginine
- Oats, including porridge
- Muscle building formulas and multivitamins that contain Arginine
Another type of natural prevention that is worth mentioning is taking supplements for a weak immune system (such as those who have no particular health condition, but suffer with frequent illnesses such as colds and infections) and those who get stressed easy. We all know that it’s important to relax and unwind, which can help prevent stress but realistically there are periods during our lifetime when things are more stressful than others such as as new job, new/ difficult relationship / family crisis etc. Whatever the circumstances, some peoples body’s are weaker at dealing with these stresses and it can cause them to be more susceptible to viruses or breaking out in cold sores. If you can identify stress or a weak immune system as a trigger, then you can take something to help strengthen the body. The best way to chose a supplement is to look at what each of them is for and which you feel would suit you best. If buying from a health shop (such a holland and Barrett who have trained staff) you can be advised on the most suitable one for you and check for any interventions with any other supplements/ medication you may be taking. (If you take medication ALWAYS check with your doctor first)
So, to give a brief idea of what’s out there, I have listed three different supplements with a short description. There is so much information about them and there have been so many studies that I would probably have to do a whole separate post about them! So, rather than go on and on I have supplied a few links, words highlighted in green will open a separate page where you can find out more details.
Originally used by the native Americans this herb has became popular (by settlers in the USA) from as far back as the 1800’s. echinacea is commonly used to treat and prevent colds and flu although there are many other uses. Research by scientists at the university of Connecticut school of pharmacy carried out over a dozen studies. They found that the risks of catching a cold decreased by a massive 58%, they also found that when people did catch a cold it lasted a mere 1.4 days.
The term adaptogen is used to describe a remedy found in traditional Chinese, Tibetian, Ayurvedic and Native American medicne. It was originally termed by scientist Dr Nikolai Lazarev who was granted by the military to find a way to enhance the productivity and performance of soldiers without dangerous stimulants.
The various ingredients are used to improve the adrenal system, which is the body’s system that with the hormonal response to stress. These ingredients help to body to ‘adapt’ to stress, another reason why they are thought to be named adaptogens.
Adaptogens can be used on their own but are usually a combination of herbs mixed together. They help the body to deal with unwanted stressors, whether physical emotional, chemical or biological. For example they can be used to treat anxiety, fatigue, trauma and even have been used with cancer patients.
One of the most common adaptogens that you are likely to have heard of is Asian ginseng (Panax ginseng). Panax ginseng is an energy tonic to helps to regulate the human energy system. It stimulates and regulates the central nervous system and the endocrine system. It’s usually used to help with energy levels, fighting fatigue and coping with stress but if taking anti depressants or blood medication check with your doctor ad hey can have server interactions
This is a potent immune system tonic used for over thousands of years and is believe by Asian people to strengthen muscles and improve metabolic functions. It is said to clean the blood and spleen and is common in china. It enhances the function of the skin, helping eliminate toxins. For example, it’s has been used to help cold sores as it helps the skin to heal quicker and more efficiently.
Research by M.D Aderson, at the research centre at the university of Houston (the worlds largest cancer research institution) demonstrated clearly that astragalus improves the immune response in humans when he used it on patties undergoing chemotherapy and radiation treatment for cancer. The research ground that patients who took it whilst having treatment recovered faster at a higher rate and with fewer side effects.
Other natural suggestions can be found here.
Civitelli R, Villareal DT, Agnusdei D, Nardi P, Avioli LV, Gennari C. “Dietary L-lysine and calcium metabolism in humans.” Nutrition. 1992 Nov-Dec;8(6):400-5.
Emmert, DH (2000 Mar 15). “Treatment of common cutaneous herpes simplex virus infections.”. American family physician 61 (6): 1697–706, 1708. PMID 10750877.
Harmenberg, J.; Öberg, B.; Spruance, S. (2010). “Prevention of Ulcerative Lesions by Episodic Treatment of Recurrent Herpes Labialis: A Literature Review”. Acta Dermato Venereologica 90 (2): 122–130. doi:10.2340/00015555-0806. PMID 20169294.