Baby cold sore pictures

Cold Sores in Children: About the Herpes Simplex Virus

A child's toddler and preschool-age years are filled with new experiences, like a first playdate or first tricycle. Often by around age 5, however, a less-than-fun first also may pop up: a child's first cold sore.

What are Cold Sores?

Cold sores (also called fever blisters or oral herpes) start as small blisters that form around the lips and mouth. They sometimes appear on the chin, cheeks, and nose, too. After a few days, the blisters usually begin to ooze, then form a crust and heal completely in one to two weeks.

Despite their name, cold sores actually have nothing to do with colds. In children, cold sores are usually caused by the herpes simplex virus type 1 (HSV-1). Genital herpes is usually caused by a different strain, herpes simplex virus type 2 (HSV-2), although both virus strains can cause sores in any part of the body.

Most people are first exposed to HSV between ages 1 and 5 years of age, and more than half of people in the United States are infected with it by the time they become adults. Beyond the uncomfortable sores that the virus can cause, HSV is usually harmless.

How Do Cold Sores Spread?

Cold sores are highly contagious. They can spread through saliva, skin-to-skin contact, or by touching an object handled by someone infected with the virus.

When a child develops a cold sore for the first time (also called primary HSV), the blisters often spread beyond the lips to the mouth and gums. A child may also have a fever, swollen and tender lymph glands, sore throat, irritability and drooling. Sometimes symptoms are so mild, though, parents may not even notice any of them.

When problems can arise:

The virus from cold sores can spread to the eyes, which can lead to HSV keratitis, an infection of the cornea—the clear dome that covers the colored part of the eye. The infection usually heals without damaging the eye, but more severe infections can lead to scarring of the cornea or blindness. HSV keratitis is a major cause of blindness worldwide.
HSV is especially dangerous to babies under 6 months of age. Parents or relatives with cold sores should be especially careful not to kiss babies—their immune systems are not well developed until after about 6 months old. Signs that a baby may have been infected with HSV include low grade fever and one or more small skin blisters. These symptoms can occur 2 to 12 days after HSV exposure. If these occur or if you have any concerns, call your pediatrician.

Do Cold Sores Come Back?

After a child's first cold sore, the virus settles into bundles of nerve cells in the body—causing no symptoms unless it activates and travels back up to the skin's surface. While the virus remains in the body for the rest of your life, the recurrence of cold sores is highly variable. Some children may never get another cold sore, while others may have multiple outbreaks a year. When the virus does reactivate, cold sores tend form again at the same spot but usually not inside of the mouth.

The first signs of a flare up include tingling, itching, or burning where the cold sore moves toward the skin. Parents might notice their child keeps touching or scratching a spot on the lip that starts to swell and redden before sores form.

Common Cold Sore Triggers:

Once a child is infected with the cold sore virus, it is more likely to return during times when the body's immune system is run down or the skin becomes irritated from other causes.

Common cold-sore triggers for children previously exposed to the virus include:

Fatigue and stress
Exposure to intense sunlight, heat, cold, or dryness
Injuries to or breaks in the skin
Illness (i.e., cold or flu)
Dehydration and poor diet
Fluctuating hormones (i.e., during a teen's menstrual periods, etc.)

What Parents Can Do:

Although there is currently no cure for cold sores, the good news is that they go away on their own. Some may take a little longer than others to heal. Cold sores are typically not treated, because the medications currently available only slightly speed up healing time. Parents can protect against the cold sores' spread, help relieve the child's discomfort during a flare-up, and try to avoid possible triggers.

Stop the spread.

Try to prevent your child from scratching or picking at cold sores. This can spread the virus to other parts of the body, such as fingers and eyes, as well as to other children who touch toys and other objects they play with. Wash hands and clean toys regularly.
During a cold sore flare-up, don't let your child share drinks or utensils, towels, toothpaste or other items to avoid spreading the infection through saliva. Also, wash items such as towels and linens in hot water after use.
Children usually can go to child care or school with an active infection, but your pediatrician may suggest keeping them home if they drool a lot or are having their very first HSV outbreak. See When to Keep Your Child Home from Child Care for more information.
If your child participates in sports that involve skin-to-skin contact such as wrestling, he or she should sit out during an active cold sore infection. Make sure mats and other equipment are cleaned regularly after use.

Ease discomfort.

Apply ice or a warm washcloth to the sores to help ease your child's cold sore pain.
Chilled or icy treats such as smoothies may be soothing to tender lips and can help avoid dehydration.
Avoid giving your child acidic foods during a cold sore outbreak (e.g., citrus fruits or tomato sauce). These can irritate cold sores.
If your child's cold sores continue to hurt—especially if he or she does not want to eat or drink because of mouth pain—ask your pediatrician about giving a pain reliever such as acetaminophen or ibuprofen. Your pediatrician may also suggest an over-the-counter cream or a prescription anti-viral cream to help reduce cold sore symptoms and shorten outbreaks by a day or two.

Avoid triggers.

Skin irritation can bring on a cold sore outbreak, so be sure your child uses lotion and a lip balm containing sunscreen or zinc oxide before heading outdoors.
Make sure your child gets enough sleep, exercise, and eats a well-balanced diet.
Help your child manage stress, which can increase the likelihood of cold sore outbreaks.

When to See Your Pediatrician:

During your child's first cold sore infection: This is especially recommended if your child has a known difficulty in fighting infections or a chronic skin condition such as eczema.
If your newborn develops a blister-like rash or fever: This could be symptoms of a dangerous, neonatal herpes simplex infection.
If there are sores or blisters near your child's eyes: HSV is the most common cause of corneal infections.
If your child develops a headache, combined with confusion, seizure or fever during a cold sore outbreak: This could signal a dangerous brain infection caused by the virus, including meningitis or encephalitis.
If the sores do not heal on their own within seven to 10 days: Your pediatrician might want to rule out a secondary bacterial infection and/or any other medical condition.
If skin surrounding cold sores becomes reddened, swollen or feels hot to the touch: This may be signs of a secondary bacterial infection. Infection that spreads to the bloodstream and body-wide (sepsis) can also be a concern for children whose immune systems are weakened by certain diseases and medications.
If your child gets frequent cold sores: Children with more than five or six outbreaks a year might benefit from antiviral medications. Talk to your pediatrician about a prescription if your child's outbreaks are frequent.

Additional Information & Resources:

Germ Prevention Strategies
Reducing the Spread of Illness in Child Care
Hand, Foot & Mouth Disease: Parent FAQs
Herpes Simplex Virus in the Newborn (New York State Department of Health)
Basics of HSV (Herpes Simplex Virus) Keratitis (Centers for Disease Control and Prevention)

The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.

Pictures of What They Look Like

Medically Reviewed by Nayana Ambardekar, MD on November 13, 2021

Cold sores -- you might hear them called fever blisters -- are proof that life can be unfair. Some people get them, others don’t. If you get them, don't worry. There are ways to treat and prevent them.

Despite the name, that isn’t what causes them. The herpes simplex virus type 1 (HSV-1) is most often the cause. You get it from contact with an infected person’s skin or body fluids. The virus damages your skin as it reproduces. That leaves behind weepy sores that last about a week. Between outbreaks, HSV-1 hides inside nerve cells, so it’s never completely cured.

About two-thirds of us have been infected with the HSV-1 virus. It usually comes via well-meaning kisses from relatives or romantic partners. So why do only an unlucky few get cold sores? The answer may be in your genes. Most of the people who get cold sores share genes that may relate to how HSV-1 acts in your body. This could be what causes outbreaks.

HSV-1 lives in your nerves. It’s pretty quiet most of the time, but you may have triggers that bring it out of hiding and cause cold sores. They can range from sunlight or a fever to stress and getting your period. Some people get cold sores twice a year or less. For others, it’s a monthly ordeal.

Cold sores usually appear on your lip. Canker sores affect the inside of your mouth. They don’t involve the herpes virus and aren’t contagious. No one knows what causes them. Cold sores generally signal their arrival with a warning period of red, irritated skin. Blisters form, burst, and then crust over before they heal.

From the time your skin turns itchy or red, the virus is likely present and you can spread it. You’re most contagious when blisters show up and just after they burst. Once your skin is completely healed and looks normal again, you can’t spread it that way. But you can still pass the virus through your saliva at any time, even when you don't have a cold sore.

Through body fluids. It’s usually present on an infected person’s lip, even if there’s no obvious sore. Kisses are the main method. Because the virus often lives in saliva, you can also spread it if you share kitchen utensils or drinking glasses. Oral sex sometimes leads to infection of your partner's genitals.

Yes. Use caution while you have a sore. Don’t kiss, and don't share toothbrushes, silverware, or glasses. Skip oral sex. That will reduce most of the spread of HSV-1, although you may not be able to control the spread completely.

While the first outbreak can last up to 2 weeks, the ones after that may not be longer than a week. There’s no cure for cold sores, but some over-the-counter creams and gels can ease symptoms like burning and pain. You can also try hot or cold compresses.

They often shorten the time it takes a cold sore to heal. But they work best if you put them on at the very first sign of an outbreak. Docosanol cream is available over the counter. Acyclovir (Zovirax) cream and penciclovir (Denavir) cream are available by prescription.

They can lower the amount of healing time when you take them at the first sign of a cold sore -- like tingly, red, or itchy skin. You’ll start acyclovir before cold sores fully flare and take it five times a day for 5 days, or you can take valacyclovir (Valtrex) at the first sign of a cold sore and then 12 hours later. Famciclovir (Famvir) can be given as a single dose of medicine. So can acyclovir buccal (Sitavig), but instead of swallowing it you place against your gums and it releases the medicine as it dissolves.

What about a cold sore that isn’t on your lip? They aren’t as common, but they can pop up anywhere on your face, like your cheek, chin, or nose. Most people’s cold sores reappear in the same area each time.

Yes, but it’s rare. It can happen if you touch a cold sore, then touch an area of broken skin or a mucous membrane (that’s the moist, protective lining found in places where your body opens to the outside -- mouth, nose, genitals). That can lead to a herpes skin infection. To prevent this, wash your hands and don’t touch the cold sore.

Your eyes: This is called ocular herpes, and it most often affects the cornea. It’s the leading infectious cause of corneal blindness in the U.S., so get treatment as soon as possible. Herpetic whitlow is a painful condition that affects your fingers. Kids often get it when they have a cold sore and suck their fingers or thumb.

It’s tough to hold them off entirely, but there are things you can do to help keep them at bay. Learn what your triggers are and avoid them. Stay out of the sun, or use sunscreen and UV-blocking lip balm. Figure out what works to manage your stress. Keep your immune system healthy with plenty of sleep and daily exercise.

Make an appointment if:

You have a weakened immune system.
The cold sores don't heal within 2 weeks.
Your symptoms are severe.
Your eyes are irritated.
You have severe or frequent cold sore outbreaks.

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SOURCES:

American Academy of Dermatology: "Viral Infections: Herpes Simplex."

University of Illinois at Chicago, Department of Ophthalmology and Visual Sciences: "Ocular Herpes Simplex. "

Cernik, C. Archives of Internal Medicine, June 9, 2008.

American Dental Association: "Canker Sores and Cold Sores."

Kriesel, J. Human Genome Variation, published online Nov. 20, 2014.

National Eye Institute: "Facts About the Cornea and Corneal Disease."

Xu, F. JAMA, 2006.

Corey, L. New England Journal of Medicine, 1986.

Pope. L.E. Antiviral Research, 1998.

Spruance, S.L. New England Journal of Medicine, 1977.

UpToDate: Treatment of herpes simplex virus type 1 infection in immunocompetent patients.”

Merriam Webster: “Mucous Membrane.”

Mayo Clinic: “Cold Sore: Symptoms.”

full description, symptoms and causes

The earliest mention of it in the literature according to various sources refers to 1770-1772. [2]

Causes of a cold

Speaking of the common cold today, we usually mean the course of an acute respiratory disease caused by the penetration of a virus into the human body. Does cooling help? Not always.

Classification

There are many classifications of viral diseases. The most significant for young children are those that cause acute respiratory infections and gastroenteritis. Often, viral infections are accompanied by a rash that makes it difficult or vice versa helps in diagnosis.

Children 1-5 years old get colds 6-8 times a year [3,4]. In the first or second years of attending a kindergarten, the incidence is 10-15% higher than in children who do not attend childcare facilities. But they are more likely to get sick in the first school years [5].

Symptoms of a cold

The clinical picture of viral diseases is diverse, let's touch on those that are associated with the word cold, namely: redness of the mucous membranes, watery eyes, runny nose, sneezing, coughing and fever. Along with respiratory manifestations, there are symptoms that characterize the defeat of the mucous membranes of the gastrointestinal tract, such as diarrhea, abdominal pain, nausea and vomiting. The latter may be nonspecific manifestations of intoxication and fever.

The timing of illness and fever is variable, and its height, as a rule, does not indicate the severity of the course, but puzzles and frightens many parents. In this regard, it should be noted that lowering the temperature in children older than 3 months in the absence of chronic pathology is advisable at temperatures above 39 - 39.5 ° C. It is worth giving a new dose only when the temperature rises, and not in advance. [5,6,7].

It is important to understand that if febrile fever (above 38C) persists for 3 or more days, it is advisable to conduct a diagnostic search to exclude a bacterial infection in order to prescribe antibiotic therapy in a timely manner. For this you need to see a doctor.

Cold diagnosis

The etiological diagnosis of "colds" is not justified, since the specification of the pathogen usually does not affect the choice of therapy. In some cases, when characteristic symptoms are detected, for example, influenza and / or severe course, laboratory diagnostics are carried out, as well as express testing. [13, 8].

Cold treatment

Colds usually go away on their own, and treatment is to relieve symptoms. To do this, in the home first aid kit and when planning trips, it is desirable to have such drugs as antipyretics (paracetamol or ibuprofen) [5,6,7], decongestants (nasal agents to facilitate breathing) [13], saline solutions for oral rehydration. The appointment of immunomodulatory, herbal, homeopathic preparations has no proven effectiveness [9,10,11]. Numerous “throat” products in the form of lozenges, sprays, gargles usually do not lead to a faster recovery and have no proven effectiveness, but in some cases they can relieve discomfort and can be used according to the manufacturer's instructions [13].

Prevention of cape cold

It is important to remember that a number of viral infections, for which vaccination is included in the National Immunization Schedule, begin as a cold. Therefore, you can not neglect the opportunity to protect your child.

Timely vaccination against known infections, including influenza, should be carried out in a timely manner [12].

Terminals

Colds, SARS are topics that cannot be covered in one small article, they can be described in general terms. Each virus is unique, each child is unique. The same pathogen can cause a variety of manifestations, depending on the individual characteristics of the organism.

If anxiety grows, relief does not come - this is an occasion to consult a doctor.

List of sources

Ozhegov S. I., Shvedova N. Yu. Explanatory dictionary of the Russian language: 80,000 words and phraseological expressions / Russian Academy of Sciences. Institute of the Russian Language. V. V. Vinogradova. - 4th ed., supplemented. — M.: Azbukovnik, 1999.
N.I. Novikov. Experience of the historical dictionary about Russian writers // Novikov N. I. Selected works. M.; L.: Mrs. Publishing House of Artists. lit., 1951.
Hay AD, Heron J, Ness A, ALSPAC study team. The prevalence of symptoms and consultations in pre-school children in the Avon Longitudinal Study of Parents and Children (ALSPAC): a prospective cohort study. Family Practice 2005; 22:367–374. 4.
Fendrick A.M., Monto A.S., Nightengale B., Sarnes M. The economic burden of noninfluenza-related viral respiratory tract infection in the United States. Arch Intern Med. 2003 Feb 24; 163(4):487-94.
. Union of Pediatricians of Russia, International Foundation for Maternal and Child Health. Scientific and practical program “Acute respiratory diseases in children. Treatment and prevention". M., 2002
Tatochenko V.K. Respiratory diseases in children. M. Pediatrician. 2012
A.A. Baranov (ed.). Guide to outpatient clinical pediatrics. M. Geotar-Media. 2nd ed. 2009
Jefferson T, Jones MA, Doshi P, et al. Neuraminidase inhibitors for preventing and treating influenza in healthy adults and children. Cochrane Database Syst Rev. 2014; 4:CD008965
Lissiman E, Bhasale AL, Cohen M. Garlic for the common cold. Cochrane Database Syst Rev 2009; CD006206.
Jiang L., Deng L., Wu T. Chinese medicinal herbs for influenza. Cochrane Database Syst 24 Rev. 2013 Mar 28;3:CD004559. doi:10.1002/14651858.CD004559.pub4
Steinsbekk A., Bentzen N., Fønnebø V., Lewith G. Self treatment with one of three self selected, ultramolecular homeopathic medicines for the prevention of upper respiratory tract infections in children. A double-blind randomized placebo controlled trial. Br J Clin Pharmacol. 2005 Apr;59(4):447-55.
Prutsky G.J., Domecq J.P., Elraiyah T., Wang Z., Grohskopf L.A., Prokop L.J., Montori V.M., Murad M.H. Influenza vaccines licensed in the United States in healthy children: a systematic review and network meta-analysis (Protocol). System Rev. 2012 Dec 29;1:65. doi: 10.1186/2046-4053-1-65
Union of Pediatricians of Russia. Clinical guidelines Acute respiratory viral infection (ARVI) in children. M., 2021

All symptoms of swine flu in one picture: how to understand that you have influenza A (h2N1) - December 8, 2022

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Only a doctor can make an accurate diagnosis 9006

: Roman Danilkin / 63.RU

Influenza and SARS continue to spread in Russia: according to Rospotrebnadzor, the incidence of SARS and influenza increased by 23.3% last week compared to the previous one. Among the viruses currently circulating, experts distinguish rhinoviruses, RS viruses, metapneumoviruses, adenoviruses and influenza, including serotype A (h2N1) - the so-called swine flu. It is the flu that is considered the most dangerous among seasonal viruses, so it is important to see a doctor in time if you feel signs of illness.

The symptoms of swine flu are similar to those caused by other strains of influenza

Infographics: Vitaly Kalistratov / City portals

— The flu has come in earnest this year. The most unpleasant thing in this situation is that exactly the version of the flu that causes the most serious damage to health has come, ”Anna Popova, head of Rospotrebnadzor, said in an interview with Russia-1 TV channel. - This is the influenza A (h2N1) virus of the pandemic 2009, the first time in 2009In the same year, it emerged as an influenza with a high potential to spread and caused a pandemic in 2009-2010.

Popova noted that swine flu, all viral respiratory infections and today's covid begin the same way.

- They begin with weakness, fever, general malaise, discomfort in the throat and nose. With a headache, maybe with muscle pain. There are no specific symptoms, Popova said.

Nevertheless, doctors note that influenza is often characterized by a rapid onset of the disease - high fever and symptoms of intoxication (muscle and headaches, weakness, aches), as a rule, appear already in the first hours of illness.

“In my experience, the classic flu is a maximum temperature and a minimum of symptoms,” says Ivan Skorokhodov, a general practitioner. - Most people complain of a very high temperature, as a rule, more than 39 degrees, sometimes even closer to 40, while the general onset of the disease is abrupt. Well, the general symptoms are weakness, malaise, severe aches, pain in the joints, muscles, headaches. From the side of the upper respiratory tract, the symptoms are very non-specific. As a rule, the throat may hurt, there may be hoarseness. Cough often with discomfort behind the sternum, because the throat, larynx, trachea are involved in the process.

Ivan Skorokhodov — practicing therapist, allergist-immunologist. Member of the Russian Association of Allergists and Immunologists.

The doctor says that patients, as a rule, focus not on cough, but on temperature and general condition.

“The temperature frightens everyone, the state is terrible, the chills are simply amazing – not in the sense of being magnificent, but in the sense that the patients are shaking,” says Skorokhodov. - This is typical for influenza, including A (h2N1). There may not be any special symptoms, because everything depends on the human immune system.

One way or another, it is impossible to diagnose only by symptoms - by observing a large number of cases, you can identify symptoms that are more common in a particular viral disease, but at the individual level this does not at all allow differentiating diseases. In addition, a person can develop several diseases in parallel.

“Mixed infection, when the disease is caused by several viruses at the same time, is not uncommon,” says Nikolai Kryuchkov. - That is, a person can be infected with the flu and rhinovirus at the same time, for example.