One topic that is very common and can be quite distressing for patients is ‘cold sores’ sometimes referred to as ‘fever blisters’. A very common presentation to the doctor!

What are cold sores?

- Small fluid filled blisters appear on the skin, often in patches.

- Usually on the lips, chin or cheeks, or nostrils.

- Sometimes can occur in the roof of the mouth or gums.

- Often start with tingling or itching. Over 48 hours blisters develop, then burst and ‘crust over’, and dry out.

- Can take 2-3 weeks to heal completely.

- Occasionally you also get a temperature, sore throat, and headache.

What causes them?

- They are caused by a virus – herpes simplex virus 1.

- They can be spread through close contact – kissing, shared utensils, towels.

- More likely to spread when the blisters burst.

- The virus can hide in nerve cells and be triggered by:

- Stress, fatigue, fever, trauma, sun, or wind.

How do you treat them?

- They get better over 2-3 weeks.

- Use sunblock lip balm outside.

- Paracetamol can help the pain.

- Avoid salty food. Also, ice or warm flannels.

- You can be prescribed or buy antiviral cream from a chemist to speed up the healing.

Is there anything else I should think about?

- It’s important to avoid close contact such as kissing, touching, or sharing towels when you have cold sores.

- They can recur and be triggered, so avoid trigger factors if possible – sun, stress.

- There is a natural remedy: kanuka honey-based cream shown to be effective.

- See your GP if it’s not healed within 14 days, occurs near the eye, very large, or you have other issues such having chemotherapy.

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