Cold Sores
What happens when you get
   a cold sore?
Know what triggers cold
   sores
Cold sores are easily spread
Treatment options

To what extent do cold sores affect
you?
If cold sores are having a negative effect on the way you feel about yourself and your appearance, there are treatments that can help you manage your outbreaks. Talk your doctor to find out what you can do to manage cold sores.

Cold Sores: For Many, They're a Problem That's Hard to Face

What happens when you get a cold sore?

After infection – for example, by kissing an individual with a cold sore – the herpes simplex virus enters the skin surrounding the mouth or nose and travels into nerves near the skin surface. The virus then proceeds along nerve fibres to the trigeminal ganglion [?], a bundle of nerves located near the inner ear. There it hides in a dormant stage until something causes it to “wake up” and become active again. The reactivated virus then travels along branching nerves to the surface of the skin, causing an outbreak of cold sores.1

The first outbreak of cold sores is usually the most severe and may cause extensive blistering, especially in young children. Symptoms include:1

  • Sores in the mouth and on the gums
  • Sores near the back of the throat
  • Swollen glands, particularly the lymph nodes in the neck
  • Fever

The first outbreak may last longer than recurrent outbreaks, usually 2 to 3 weeks.

Recurring outbreaks tend to be less severe than the first, and they don’t tend to last as long. The reason for this is that your immune system developed antibodies to fight the first infection and this defense system remains in place, ready to fight the outbreaks that follow.1

Recurrent outbreaks usually occur at the same site as the first outbreak, although they may occur at other sites, too. Outbreaks typically proceed through stages, as follows:1

  • A tingling, burning or itching sensation is felt in the skin surrounding the mouth or nose (prodrome [?]).
  • The affected area becomes swollen and reddens, followed by the appearance of 1 or more fluid-filled blisters.
  • The blisters eventually erupt, leaving wet open sores.
  • After a few days, the sores begin to dry out, forming scabs that eventually fall off.
  • Without treatment, recurrent outbreaks may last between 1 and 2 weeks.

 

References

 
1. Sacks S. The Truth About Herpes. 4th Ed., 1997. Gordon Soules Book Publishing Ltd.

2. Ebel C, Wald A. Managing Herpes: How to Live and Love With a Chronic STD. Research Triangle Park, NC: American Social Health Association; 2002.

3. Patrick DM, Dawar M, Cook DA, et al. Antenatal seroprevalence of herpes simplex virus type 2 (HSV-2) in Canadian women. Sex Trans Dis 2001;28(7)424-8.

4. Whitley RJ, Kimberlin DW, Roizman B. Herpes simplex viruses. Clin Infect Dis 1998;26(3):541-53.

5. Aoki FY. Canadian Guidelines on Sexually Transmitted Infections 2006 Edition: Genital Herpes Simplex Virus (HSV) Infections. Public Health Agency of Canada http://phac-aspc.gc.ca/std-mts/sti_2006/pdf/sti2006_e.pdf. Accessed May 15, 2006.

6. Kemeny ME, Cohen F, Zegans LS et al. Psychological and Immunological Predictors of Genital Herpes Recurrence. Psych Med 1989;51:195-208.

7. Valtrex®  (valacyclovir hydrochloride) Product Monograph. GlaxoSmithKline Inc., May 2006.

8. Famvir®  (famciclovir) Product Monograph. Novartis Pharmaceuticals Canada Inc., January 2004.

Print l Email