Cold Sores
Cold Sores
Kiss Them Good-Bye
Any woman who has suffered the pain and embarrassment of one cold sore has probably been through the misery many times and knows the symptoms all too well: that slight, tingly, itchy, hot sensation at the edge of your lip. Maybe you feel feverish, like you have a touch of the flu.
Worse, cold sores seem to strike when they're least welcome--before a New Year's Eve party or some other special occasion. The usual herpes simplex I virus that causes cold sores is like annoying houseguests who just keep coming back, no matter how inconvenient you found their last visit.
What Women Doctors Do
Heavy-Duty Protection Geraldine Morrow, D.M.D. For Geraldine Morrow, D.M.D., past president of the American Dental Association, a member of the American Association of Women Dentists and a dentist in Anchorage, Alaska's beauty sometimes takes her breath away. She moved to Alaska from Boston and relishes the solitude, journeying 325 miles a week to deliver dental care to villagers in far-flung towns. Still, the state's climate can be harsh and the life rugged. When Dr. Morrow's resistance is down, or when she is exposed too long to the stark elements of cold, ice, wind and sun on snow, she sometimes feels a telltale tingle that means a cold sore is on its way. Here's what she does about it. "If I keep the area covered with a heavy, greasy type ointment--either Carmex or DCT Blistex--it tends to almost prevent an imminent outbreak," she says. As a preventive tactic, Dr. Morrow smooths her lips with either one of those ointments every night. "I find it to be very valuable in keeping them away."
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Cold sores spread through direct contact with someone who has them. Maybe you kissed someone who had an active cold sore, or you could have gotten the virus merely by touching the hand of someone who touched her own cold sore a few minutes before.
The first cold sore that you experience is probably the worst. Afterward, the virus lurks in your system forever, lying dormant among the nerve ganglia beneath your skin's surface, waiting to be reactivated, says Lenore S. Kakita, M.D., clinical assistant professor of dermatology at the University of California, Los Angeles, and an adviser to the American Academy of Dermatology. The good news, says Dr. Kakita, is that most women develop a slight immunity to them over the years, making outbreaks fewer and farther between.
In women stress is the biggest trigger for cold sores--although weather changes, especially excessive sunlight, can bring on outbreaks, says Dr. Kakita. When you get stressed, your resistance to disease drops, and that can awaken the dormant herpes virus within your nerve ganglia cells, prompting an outbreak.
Menstruation can also instigate cold sores in some women, but probably more as a result of stressful feelings at that time of the month rather than a direct result of hormone levels, adds Dr. Kakita.
BOLSTER YOUR DEFENSES
Left alone, a cold sore will normally last 10 to 14 days, says Dr. Kakita. Aside from taking the prescription drug acyclovir (Zovirax), here's what else you can do to minimize the discomfort on your own or shorten the duration of an attack. (For practical ways to manage canker sores, which affect the inside of your mouth and aren't caused by a virus, see page 103.)
Grab an ice cube. Applying ice directly to the sore can bring the swelling down and provide temporary relief, says Geraldine Morrow, D.M.D., past president of the American Dental Association, a member of the American Association of Women Dentists and a dentist in Anchorage, Alaska.
Dab on some lip balm with sun protection. If you have had an outbreak of cold sores in the past, you should wear a lip balm with a sun protection factor (SPF) of 30 at all times, but especially when you are outdoors in the sun, to prevent a cold sore, says Dr. Kakita. You can find lip balms with high SPFs in sporting goods stores and drugstores.
If you have an open cold sore, don't use the balm stick directly on your lips, or you'll spread the virus around, says Dr. Kakita. Instead, use a cotton swab to apply balm not only to your lips but also to the skin around the outside border.
Keep your hands off. People just don't realize how highly contagious cold sores are, says Dr. Morrow. "If you have a cold sore on your lip, don't pull it, don't stretch it, don't touch it." You could get "very, very painful" cold sores on your hands, especially if the fluids from the blister get under a hangnail, she says.
When To See A Doctor
Prescription medications such as acyclovir (Zovirax) are available to fight the herpes simplex I virus responsible for cold sores, and they can stop a cold sore in its tracks, says Lenore S. Kakita, M.D., clinical assistant professor of dermatology at the University of California, Los Angeles, and an adviser to the American Academy of Dermatology. If you're bothered by frequent, severe cold sores, it makes sense to see your doctor. Even if the cold sore develops, most women find that the outbreak will be milder, less painful and shorter if they're taking the medication.
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Give lysine a try. Dr. Kakita recalls that before the advent of acyclovir, people swore by the preventive and healing properties of lysine, an amino acid that counteracts arginine, a substance in various foods that in some people seems to trigger cold sores. "Some people still take lysine tablets," she says. You can find it in health food stores or drugstores.
Sleep upright. If you have a cold sore, Dr. Kakita recommends propping a few pillows behind your head at bedtime, letting gravity help the blisters drain. Otherwise, fluid may settle in your lip during the night.
Reschedule your dental appointment. The last thing that you want to do when you have a cold sore is "open wide," says Dr. Morrow. The movement will stretch your lips, aggravating your tender cold sore, and it could cause it to break open and spread.
