Practicing dermatology in the free world I was quiet
accustomed to seeing the very frequent cases of kissing sores, as around 90% of
the population in Europe & America’s is reported to suffer at the hands of the
pesky herpes labialis virus. Practicing in Jeddah considering the conservative
religious population I was not betting on seeing as much of the darned cold
sores. But, the gnarly, massive cold sore; which once you exhibit gets
passed on through awkward conversations, and the evil icy stares is an
incidence; which is being brought to derma practices in the region quiet
frequently. So read along as, its time to brush up & update medical
info. Herpes labialis is the infection of the lips, mouth, or gums with
the herpes simplex virus. It leads to the development of small,
painful blisters commonly
called cold sores or fever blisters.
The Cause &
Course:
Herpes labialis is caused by infection of the mouth area
with herpes simplex virus type 1. Most people in the United States and Europe are infected
with this virus by age 20.
The initial infection may cause no symptoms or mouth ulcers.
The virus then remains dormant (asleep) in the nerve tissue of the face. In
some people, the virus reactivates and produces recurrent cold sores that are
usually in the same area, but are not serious.
Herpes virus type 2, which usually causes genital herpes and can infect babies during birth to infected mothers,
can also cause herpes labialis.
Herpes viruses are contagious. Spread may occur through
intimate and personal contact, or through contact with infected razors, towels,
dishes, and other shared articles (razors, toothbrush, makeup brushes and sponges etc.). Occasionally, oral-to-genital contact can also
spread oral herpes to the genitals (and vice versa).
Symptoms
First symptoms usually appear within 1 to 3 weeks, after
contact with the virus. Sore throat and fever that can last up to 5 days may
occur before the blisters appear. There may also be swollen glands in the neck.
First episode may last 2 to 3 weeks. The lesions may be on
the gums, in the mouth and throat, or on the face. It may hurt to swallow. Later
episodes are usually milder.
An outbreak usually
involves:
- Skin lesions or rash around the lips, mouth, and gums
- Small blisters (vesicles) filled with clear yellowish fluid
- Blisters on a raised, red, painful skin area
- Blisters that form, break, and ooze
- Yellow crusts that slough to reveal pink, healing skin
- Several smaller blisters that merge to form a larger blister
Episode Triggers:
May be triggered by menstruation, sun exposure, fever, stress, or various other
unknown causes.
Warning symptoms of itching, burning, increased
sensitivity, or tingling sensation may occur about 2 days before lesions appear.
Exams and Tests
Diagnosis is made on the basis of the appearance or culture
of the lesion. Examination may also show swollen lymph nodes in the neck or
groin areas.
Viral culture, viral DNA test, or Tzanck test of the skin
lesion may reveal the herpes simplex virus.
Treatment
·
Untreated, the symptoms will generally go away
in 1 to 2 weeks. Antiviral medications taken by mouth may help the symptoms go
away sooner and decrease pain. Acyclovir, Famciclovir, and Valacyclovir are the
three oral treatments currently available.
·
Herpes sores often come back again and again.
The antiviral medicines work best if you take them when the virus is just
starting to come back -- before you see any sores. If the virus returns
frequently, your doctor may recommend that you take the medicines all the time.
·
Topical (rubbed onto the skin) antiviral cream
(penciclovir andaacyclovir) and Xerese (acyclovir 5% and hydrocortisone 1%) may
be used. Cream must be applied every 2 hours while you're awake. They are
expensive and often only shorten the outbreak by a few hours to a day.
·
Washing blisters gently with soap and water to
reduce the spread of the virus to other areas of skin. An antiseptic soap may also
be used to avoid further bacterial contamination of the open sore. Applying ice
or warmth to the area may reduce pain.
Tips To Prevent
Future Outbreaks:
·
Apply a sunblock or lip balm containing zinc
oxide to the lips when you're outdoors.
·
A moisturizing balm to prevent the lips from
becoming too dry may also help.
What Future Holds In Terms
Of Treatments:
Existing treatments can minimize or even prevent an
outbreak, but they do not kill the virus which lies dormant when it is not
activated. Scientists believe they have finally found a permanent cure for cold
sores. They say the treatment, a lotion, will be the first to kill the virus
that causes the sores.
A new treatment (NB001) lotion has been developed that not
only halts the attack, but also kills the virus. This treatment lotion has been
developed as a by-product of biological warfare technology, which actually
kills the virus by exploding it from the inside. It is made up of
nano-particles of detergent and solvents in emulsion. These particles are so
small that they penetrate the outer coating of the virus and destroy its
effectiveness. The lotion will also work for genital herpes, a sexually
transmitted disease, and it is being looked at as a potential treatment for a
range of other viruses, including HIV, Ebola and smallpox. Currently studies
are ongoing to assess the safety and efficacy of this new emulsion and we await
results.
Researchers have also been working on a twice-a-day pill to
prevent the cold sore from growing by attacking the DNA of the virus. The aim
is to meet the virus head-on as it emerges into the lip or skin tissue and to
stop it multiplying and forming bumps or blisters. The drug gets into the DNA
of the virus and turns off its ability to replicate, stopping it from
reproducing itself and expanding.
The bottom line
Your best bet is to treat cold sores at the first sign of
symptoms with topical or oral anti-viral treatment, and to prevent an outbreak
by getting enough sleep, eating a well-balanced diet and exercising (the same
way you would avoid coming down with any other virus).
Keep lips moisturized through lip balms and by drinking
plenty of water, and apply sunscreen regularly if spending time outside. While
you’ll carry the virus forever, you needn’t suffer because of it: just keep
your immune system boosted and treat cold sores immediately to reclaim control.
