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Today in Health & Wellness

Cold Sores

Risk Factors
Commonly Prescribed Drugs
Treatment and Management
Home Remedies
Doctors to Consult

Common name

Fever blister, herpes labialis (Eng.), singaw (Fil.)

Cold sores are facial lesions that erupt around the lips and adjacent areas that are caused by HSV (Herpes simplex virus).

Cold sores are quite contagious, usually through direct contact. They are most contagious during the first 3 or 4 days, and the lesions last for 3 to 7 days.


Warning symptoms of itching, burning, increased sensitivity or tingling sensation may occur about 2 days before lesions appear.

  • Tingling of the lips
  • Small blisters on the lips and mouth that enlarge, burst, then crust over
  • Itching and irritation of the lips and mouth
  • Soreness of the lips and mouth
Risk Factors

Certain strains of the herpes virus cause cold sores.

  • HSV type 1 usually causes cold sores
  • HSV type 2 is usually responsible for genital herpes
  • Weak immune system
  • Cold or flu
  • Fatigue or stress
  • Food allergies


In rare cases, infections caused by a cold sore virus can lead to complications. Those who are particularly at risk are people with weak immune system such as those who are HIV-positive and those who are on chemotherapy.

Some possible complications are:

  • Secondary infections - the possibility that the virus can spread to other parts of the body.
  • Skin infections -occur if the virus comes into contact with broken skin or eczema.
  • Herpetic whitlow or painful sore and blisters on and around the fingers,
  • Herpetic keratoconjunctivitis or swelling and irritation on the eye area and presence of sores on eyelids. This may lead to blindness if left untreated.
Commonly Prescribed Drugs
  • Antiviral agents are used for the treatment of HSV infections. They work by inhibiting the reproduction of virus in cells without killing normal cells. The most common side effect of topical use is contact dermatitis.
  • Carbenoxolone sodium and Deproteinized calf blood extract treat mild lesions of the mouth. Applied topically in small amounts, they do not interact significantly with other medications. Side effects: allergic reaction, headache
  • Pain relievers will help relieve pain during a cold sore outbreak, but they are taken on an as-needed basis (e.g., paracetamol, ibuprofen). Side effects: Headache, stomach upset.
Treatment and Management
  • Avoid kissing and skin contact with people while blisters are present. The virus can spread as long as there are moist secretions from blisters.
  • Avoid sharing items. Utensils, towels and other items can spread the virus when blisters are present.
  • Frequent hand washing. Wash hands carefully before touching other parts of the body. The eyes and genital area may be particularly susceptible to spread of the virus.
  • Use sunblock. Apply sunblock to the lips and face before prolonged exposure to the sun to help prevent cold sores.
  • Eat right. Cold sores attacks are less frequent with intake of lysine-rich food, e.g., dairy products (milk, butter, cream), potatoes and brewer's yeast.
  • Relax. Stress can lead to recurrence of cold sores.
  • Avoid exposure to sunlight as much as possible.
Home Remedies
  • A diet rich in lysine (brewer's yeast, legumes, dairy, wheat germ, fish, and meat) and low in arginine may prevent recurrences of cold sores. 
  • Topical applications of Zn can reduce symptoms and prevent recurrences. It is applied directly to the skin at the site of the flare-up.
  • Lemon balm (Melissa officinalis) has antiviral properties. Lemon balm cream promotes the healing of blisters in as fast as 5 days and can decrease the frequency of recurrences.
  • Cold compress. Place a cool, wet towel on the sores three times a day for 20 minutes each time to help reduce redness and swelling.
  • Topical preparations containing emollients reduce cracking while those with phenol and camphor have a numbing effect. Dabbing with witch hazel or alcohol when a blister break helps in healing.
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