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     Volume 4 Issue 52 | June 24, 2005 |

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There's more to
it than it seems ...

Cold sores (herpes labialis) are small blisters that tend to form on the lips or skin around the mouth, and in the nose. They are caused by infection with the herpes simplex virus (HSV). Occasionally, the eyes may be affected and the virus may cause an unpleasant ulcer on the surface of the eye, or cornea. Most people are infected during childhood, but develop an immunity that prevents the infection from breaking out on the skin, although the virus persists (remains latent) in that person for life. Estimates vary, but it is thought that around nine out of 10 people have herpes antibodies in their bloodstream.

For some people, the infection reappears in the form of cold sores, which erupt following a trigger event, such as a cold. This explains the term 'cold sore'. Other triggers that may cause an attack of cold sores include:
*Feverish illnesses, like influenza, or chest infections
*Exposure to windy conditions
*Hormonal changes, such as the menstrual period
*Emotional stress.

The herpes simplex virus is contagious, and can be spread by saliva. There is no cure.

The evolution of a cold sore includes:
*Localised itching and tingling a day or two before it appears
*Inflammation and a sensation of heat or burning
*Pain and tenderness
*A collection of small blisters
*Yellowish fluid in the blisters
*The blisters burst after a few days
*The site develops a crust
*The crust dries up and eventually falls off after about 10 days.

Genital herpes
Genital herpes is a sexually transmitted disease, also caused by the herpes simplex virus. Most cases of genital herpes are caused by the herpes simplex virus Type 2 (HSV-2), whereas herpes labialis is mainly Type 1 (HSV-1). Having one type does not automatically give immunity against the other; someone whose natural immunity can resist cold sore outbreaks can still catch genital herpes and develop the characteristic blisters.

Transmitting the virus
The herpes simplex virus is contagious and can be spread by saliva. The most contagious time is when the blisters are fresh -- kissing others or sharing toothbrushes, drinking glasses or cutlery should be avoided during this period. In particular, the infected person should be kept away from newborn babies, children with burns or eczema, and people with suppressed immune systems. However, it is possible for an infected person to pass the virus onto someone else without presenting any obvious symptoms. This is because the virus may be lying dormant in the skin cells of the lips. A person newly infected with the herpes simplex virus typically develops a mouth infection. The virus then inhabits the nervous system, and may or may not produce cold sores, depending on the individual's immune system. A person prone to cold sores should avoid kissing newborn babies.

Treating cold sores
Cold sores are not dangerous and do not cause any permanent damage to the skin. However, scarring is possible if the scabs are picked. The only effective treatment is creams containing the antiviral ingredients, acyclovir and penciclovir. These creams work best when applied to the skin at the earliest stages of cold sore development, when the area is tingling. They stall the cold sore by inhibiting viral replication. However, not everyone experiences warning signs of an impending cold sore -- the effectiveness of the creams depends on the individual. Povidone-iodine ointments dabbed onto the cold sores may be of some benefit.

Preventing an outbreak
There is no cure for cold sores. Suggestions to reduce the number of outbreaks include:
*Avoid known triggers, if possible
*Wear sunblock lotion on the face when outdoors
*Pay attention to general health and stress levels
*Avoid getting ill or run down.

Things to remember
*Cold sores are blisters around the mouth and nose, caused by the herpes simplex virus.
*Most people have been infected with the virus, but only some will develop outbreaks of cold sores.
*Cold sores are highly contagious, and can be spread even when blisters are not present.

Source: Better Health Living, Online

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