Oral herpes

Often called cold sores, oral herpes affects one out of every five people. Although there is no way to get rid of this contagious disease, you can learn how it is triggered and how to prevent the virus from being transmitted.

What is oral herpes?

Oral herpes, commonly referred to as cold sores or fever blisters, is caused by the herpes virus. Unfortunately, once you’re infected, there is no cure for herpes. For most people, sores may unexpectedly reappear throughout their lives, although the rate at which oral herpes recurs is unpredictable and varies from person to person. Some people will have multiple outbreaks in one year, while others may only have one episode in their entire lives.

A typical outbreak consists of a number of blister-like, reddish sores that are grouped together and that can ooze a clear fluid. These sores generally develop around the mouth near or on the lips, or sometimes on the chin, on the cheeks or inside the nose. Warning signs of an outbreak include a tingling or burning feeling, after which the blisters start to appear. After several days, the blisters dry and form scabs or crusts, which then disappear after a few more days, with or without treatment. Once the sores have disappeared, the virus becomes dormant until it is reactivated.

What triggers oral herpes?

Many situations can reactivate the virus and make cold sores appear. Here are some of the most common triggers, which vary from person to person:

• Physical trauma, such as dental work or surgery.
• Mental stress (school, work).
• Strong emotions.
• Fatigue.
• Menstruation or other hormonal changes.
• Raised body temperature (from fever).
• Cold weather.
• Dry or cracked lips (using a lip balm keeps your lips moistened and prevents sores).
• Exposure to sun (using a lip balm with an SPF 30 or more helps prevent or at least reduce the possibility of an outbreak).

Preventing cold sores starts with identifying your triggers and avoiding them whenever possible.

Recognize the warning signs

Most people who suffer from cold sores can recognize the “prodrome,” or the period when the warning signs appear. In most cases, this period includes tingling, itching or burning sensations approximately 12 to 24 hours before the blisters start to form. It’s important to recognize these warning signs because the sooner you start treatment, the fewer blisters you’ll have and the less severe your symptoms will be.

How to prevent the spread of oral herpes

A cold sore is highly contagious and can spread to other parts of the body (although this is rare) or to other people. Herpes transmission can occur through direct contact, such as kissing, or indirect contact from shared items, such as infected drinking glasses, towels, or utensils.

The herpes simplex virus (HSV) type 1—the virus responsible for cold sores—can be spread to the genitals of both men and women through oral sex. If this happens, it becomes a case of genital herpes.

Although the virus can be transmitted from person to person at any time, the most acute infection period is when the sores are visible. Once the sores have crusted over, oral herpes is no longer contagious.

Follow these tips to keep the infection from spreading:

• Wash your hands immediately after touching the sores or before touching another person.
• Abstain from intimate contact until the sores have dried and scabs have formed.
• Do not share utensils, drinking glasses, napkins or other items that may have been in contact with a cold sore.
• Do not touch, rub or scratch sores.
• Do not touch your genitals or eyes after touching a cold sore; the cornea is extremely sensitive to infection from the herpes virus.
• Stay away from people for whom a herpes outbreak could have serious consequences (children, pregnant women, people with weakened immune systems).

How to relieve the pain and discomfort

You can make herpes sores dry up faster and stop the tingling and burning sensation by applying Dermburo^TM compresses for ten minutes, three to four times a day, as soon as the sores appear. When the sores have scabbed over, use a lip balm to prevent the discomfort of split and cracked lips and promote healing.

In the case of severe pain, you can take ibuprofen, naproxen or acetaminophen. Ibuprofen and naproxen are thought to be more effective, as they reduce inflammation. Generally, topical analgesics are not recommended to soothe the pain of sores. Their effect is short-lived, and prolonged use can trigger an allergic reaction. It’s better to relieve the pain by applying an ice pack for a few minutes, as often as necessary.

Oral herpes treatment

Cold sores heal by themselves in seven to ten days. Treatments don’t prevent cold sores from appearing; they simply heal them faster and make herpes symptoms less severe. Oral medications can decrease healing time by four to ten days and are more effective than topical products.

Whether you treat the sores or not, you still need to clean them with mild soap and water to prevent infection.

People who get several outbreaks of oral herpes per year may consider antiviral drugs. This oral medication can be taken daily for a certain period to prevent a new outbreak. If you get multiple outbreaks a year, ask your pharmacist or doctor whether antivirals are a good option for you.

Over-the-counter (OTC) medication

Some topical OTC products are available for cold sores. To be effective, these products should be applied several times a day at the onset of herpes symptoms. Only docosanol 10% cream (Abreva^TM) has been shown to both reduce healing time and relieve symptoms. As of yet, no study has fully proven the effectiveness of other OTC products.

Prescription medication

Other products require a doctor’s prescription. Acyclovir (Zovirax^TM) is available as a cream or ointment and may reduce healing time by about half a day. Like OTC products, it must be applied several times a day from the onset of herpes symptoms to be effective. Your doctor may also prescribe an oral antiviral drug, three of which are currently available: acyclovir (Zovirax^TM), famciclovir (Famvir^TM) or valacyclovir (Valtrex^TM). Their doses and uses vary, but they are similarly effective. When taken at the onset of symptoms, they can alleviate pain and speed up healing faster than topical products.

Quick fact
Under the provisions of Bill 41, pharmacists can prescribe medication for certain conditions that have already been diagnosed by a doctor. If your doctor has given you a prescription for oral herpes medication in the past, your pharmacist may be able to prescribe a treatment to alleviate your symptoms.

Use caution with home remedies

Several popular home remedies supposedly get rid of sores faster or prevent them from coming back. However, applying bleach, alcohol, iodine or starting fluid to the sores may aggravate the condition or delay healing. These remedies are therefore not recommended.

As always, the best option is to talk to your pharmacist, who can tell you about available solutions to treat your cold sores and relieve your symptoms.