Cold sores not from herpes

Cold sore - Symptoms and causes

Overview

Cold sore

Cold sores, often called fever blisters, are clustered, small, fluid-filled blisters. You may feel a tingling on your lip before a small, hard, painful spot appears (top). In a day or two, blisters form, which later break and ooze (bottom). Healing usually occurs in two to three weeks without scarring.

Cold sores — also called fever blisters — are a common viral infection. They are tiny, fluid-filled blisters on and around your lips. These blisters are often grouped together in patches. After the blisters break, a scab forms that can last several days. Cold sores usually heal in two to three weeks without leaving a scar.

Cold sores spread from person to person by close contact, such as kissing. They're usually caused by herpes simplex virus type 1 (HSV-1), and less commonly herpes simplex virus type 2 (HSV-2). Both of these viruses can affect your mouth or genitals and can be spread by oral sex. Cold sores are contagious even if you don't see the sores.

There's no cure for cold sores, but treatment can help manage outbreaks. Prescription antiviral pills or creams can help sores heal more quickly. And they may reduce the frequency, length and severity of future outbreaks.

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Symptoms

A cold sore usually passes through several stages:

Tingling and itching. Many people feel itching, burning or tingling around the lips for a day or so before a small, hard, painful spot appears and blisters erupt.
Blisters. Small fluid-filled blisters typically erupt along the border of your lips. Sometimes they appear around the nose or cheeks or inside the mouth.
Oozing and crusting. The small blisters may merge and then burst, leaving shallow open sores that ooze and crust over.

Signs and symptoms vary, depending on whether this is your first outbreak or a recurrence. The first time you have a cold sore, symptoms may not start for up to 20 days after you were first exposed to the virus. The sores can last several days, and the blisters can take two to three weeks to heal completely. Recurrences typically appear at the same spot each time and tend to be less severe than the first outbreak.

In a first-time outbreak, you also might experience:

Fever
Painful gums
Sore throat
Headache
Muscle aches
Swollen lymph nodes

Children under 5 years old may have cold sores inside their mouths and the lesions are commonly mistaken for canker sores. Canker sores involve only the mucous membrane and aren't caused by the herpes simplex virus.

When to see a doctor

Cold sores generally clear up without treatment. See your doctor if:

You have a weakened immune system
The cold sores don't heal within two weeks
Symptoms are severe
You have frequent recurrences of cold sores
You experience irritation in your eyes

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Causes

Cold sores are caused by certain strains of the herpes simplex virus (HSV). HSV-1 usually causes cold sores. HSV-2 is usually responsible for genital herpes. But either type can spread to the face or genitals through close contact, such as kissing or oral sex. Shared eating utensils, razors and towels might also spread HSV-1.

Cold sores are most contagious when you have oozing blisters because the virus easily spreads through contact with infected body fluids. But you can spread the virus even if you don't have blisters. Many people who are infected with the virus that causes cold sores never develop signs and symptoms.

Once you've had an episode of herpes infection, the virus lies dormant in nerve cells in your skin and may emerge as another cold sore at the same place as before. Recurrence may be triggered by:

Viral infection or fever
Hormonal changes, such as those related to menstruation
Stress
Fatigue
Exposure to sunlight and wind
Changes in the immune system
Injury to the skin

Video: 3 things you didn't know about cold sores

Cold sores on the lips can be embarrassing and tough to hide. But, turns out, you might not have a reason to be embarrassed.

"About 70-plus percent of the U.S. population has been infected with herpes simplex 1. Now, a very small percentage of those people will actually develop cold sores."

Dr. Pritish Tosh, an infectious diseases specialist at Mayo Clinic, says, genetics determines whether a person will develop cold sores.

"A proportion of the population, they don't quite have the right immunologic genes and things like that and so they're not able to handle the virus as well as other people in the population."

The problem is people can spread the herpes virus whether they develop cold sores or not. Herpes virus spreads through physical contact like kissing, sharing a toothbrush — even sharing a drinking glass — or through sexual contact.

"Since the number of people who are infected but don't have symptoms vastly outnumber the people who are infected and have symptoms, most new transmissions occur from people who have no idea that they are infected. "

For the Mayo Clinic News Network, I'm Ian Roth.

Risk factors

Almost everyone is at risk of cold sores. Most adults carry the virus that causes cold sores, even if they've never had symptoms.

You're most at risk of complications from the virus if you have a weakened immune system from conditions and treatments such as:

HIV/AIDS
Atopic dermatitis (eczema)
Cancer chemotherapy
Anti-rejection drugs for organ transplants

Complications

In some people, the virus that causes cold sores can cause problems in other areas of the body, including:

Fingertips. Both HSV-1 and HSV-2 can be spread to the fingers. This type of infection is often referred to as herpes whitlow. Children who suck their thumbs may transfer the infection from their mouths to their thumbs.
Eyes. The virus can sometimes cause eye infection. Repeated infections can cause scarring and injury, which may lead to vision problems or loss of vision.
Widespread areas of skin. People who have a skin condition called atopic dermatitis (eczema) are at higher risk of cold sores spreading all across their bodies. This can become a medical emergency.

Prevention

Your doctor may prescribe an antiviral medication for you to take on a regular basis if you develop cold sores more than nine times a year or if you're at high risk of serious complications. If sunlight seems to trigger your recurrences, apply sunblock to the spot where the cold sore tends to erupt. Or talk with your doctor about using an oral antiviral drug as a preventive if you expect to be doing an activity that tends to trigger your condition, such as intense sunlight exposure.

To help avoid spreading cold sores to other people or to other parts of your body, you might try some of the following precautions:

Avoid kissing and skin contact with people while blisters are present. The virus spreads most easily when the blisters leak fluid.
Avoid sharing items. Utensils, towels, lip balm and other personal items can spread the virus when blisters are present.
Keep your hands clean. When you have a cold sore, wash your hands carefully before touching yourself and other people, especially babies.

By Mayo Clinic Staff

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.

IMAGES PROVIDED BY:

(1) Stockbyte

(3) Jose Luis Pelaez Inc / Getty

(4) Bernd Opitz / Riser

(7) Cormac Hanley / The Image Bank

(8) Steve Mason / Getty

(9) Studio MPM / Photonica

(11) Jupiter Images Unlimited

(13) Alain Daussin / Riser

(15) Thomas Northcut / Riser

(16) Normann Hochheimer / Doc-Stock

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.”

Herpes simplex virus

herpes simplex virus

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Herpes simplex virus

Key facts

There are two types of herpes simplex virus (HSV): HSV-1 and HSV-2.
HSV-1 is transmitted primarily by oral contact and causes oral herpes (which may present as "fever on the lips"), but can also cause genital herpes.
HSV-2 is a sexually transmitted infection that causes genital herpes.
An estimated 3.7 billion people under the age of 50 (67%) worldwide are infected with HSV-1.
An estimated 491 million people aged 15 to 49 (13%) worldwide are infected with HSV-2.
Most HSV infections are asymptomatic, but herpes can present with symptoms such as painful blisters or sores that may recur over time.
HSV-2 infection increases the risk of HIV infection and transmission.

General information

Infection with the herpes simplex virus (HSV), commonly referred to as herpes, is widespread throughout the world. HSV type 1 (HSV-1) is usually transmitted by oral contact, causing an infection in or around the mouth (oral herpes), but can also cause genital herpes. HSV-2 is transmitted mainly through sexual contact and causes genital herpes.

Both oral herpes and genital herpes are mostly asymptomatic or go unrecognized, but can cause symptoms such as painful blisters or sores at the site of infection, in both mild and severe forms. The infection is present in the body for life, and its symptoms may recur after many years. There are drugs that reduce the severity and frequency of symptoms but do not cure the infection.

Recurrent symptoms of oral and genital herpes can cause significant discomfort. The presence of genital herpes can also lead to stigmatization and negatively affect sexual life. However, over time, most carriers both types of herpes adapt to life with infection.

Magnitude of the problem

In 2016 (latest year for which estimates are available), 3. 7 billion people under the age of 50, or 67% of the population, were infected with HSV-1 (in the form of oral or genital herpes). In most cases, HSV-1 infection occurs in childhood.

The number of people with HSV-2 genital herpes in 2016 was estimated at 491 million people aged 15-49 years (13% of the global population). Women are infected with HSV-2 almost twice as often as men, since the infection is more easily transmitted sexually from a man to a woman. The prevalence of this infection increases with age, although the greatest number of new infections occurs among adolescents.

Signs and symptoms

Oral herpes is usually asymptomatic, but may be accompanied by painful blisters or open lesions (sores) in or around the mouth. Before lesions appear, infected individuals often experience tingling, itching, or burning in the mouth. These symptoms may recur periodically, and the frequency of their occurrence varies from person to person.

Genital herpes can be asymptomatic or with mild symptoms that go unrecognized. When symptoms appear, genital herpes is characterized by the formation of one or more blisters or sores in the genital or anal area. areas. In addition, a new infection may present with fever, body aches, and swollen lymph nodes. After the initial episode, which may be severe, symptoms may reappear. For genital herpes caused by HSV-1, frequent relapses are not typical. In the case of HSV-2, recurrence of symptoms occurs frequently. Such relapses, however, are often milder than in the first episode and tend to subside over time.

Transmission

HSV-1 is transmitted primarily through contact with the virus present in lesions, saliva and surfaces in or around the mouth. Through oral-genital contact, HSV-1 can also enter the genital area and cause genital herpes. It can be transmitted through a surface of the mouth or skin that appears normal, but the risk of transmission is highest when active lesions are present. Those already infected with HSV-1 cannot be re-infected, but nonetheless are at risk of HSV-2 infection.

HSV-2 is transmitted primarily through sexual intercourse through contact with genital or anal surfaces, skin, lesions, or fluids of a person infected with the virus. HSV-2 can even be transmitted through the skin, which appears normal, and is often transmitted in the absence of symptoms.

Rarely, herpes (HSV-1 and HSV-2) can be passed from mother to child during childbirth and lead to neonatal herpes.

Possible complications

HSV-2 and HIV infection

The presence of HSV-2 increases the risk of HIV infection by about three times. In addition, people infected with HIV and HSV-2 are more likely to transmit HIV to others. HSV-2 is one of the most common infections among HIV-infected individuals.

Severe disease

People with weakened immune systems, including those with advanced HIV infection, often have herpes with more severe symptoms and more frequent recurrences. Rare complications of HSV-2 include meningoencephalitis (infection of the head brain) and disseminated infection. Rarely, HSV-1 infection can also lead to more severe complications such as encephalitis (brain infection) or keratitis (eye infection).

Neonatal herpes

Neonatal herpes can occur when a newborn comes into contact with HSV during childbirth. Neonatal herpes is rare, with an estimated 10 out of 100,000 births worldwide. However, this severe condition can lead to persistent neurological disability or death. The greatest risk of neonatal herpes occurs when a woman first becomes infected with HSV late in pregnancy.

Treatment

Antivirals such as acyclovir, famciclovir and valaciclovir are the most effective drugs for people infected with HSV (see WHO recommendations). They help reduce the severity and frequency of symptoms, but do not cure the infection.

Prevention.

Persons with active symptoms of oral herpes should avoid oral contact with other people (including oral sex) and sharing objects that have come into contact with saliva. Individuals with symptoms of genital herpes should refrain from sexual activity during the period of symptoms. Both HSV-1 and HSV-2 are most contagious during the presence of lesions, but can also be transmitted when no symptoms are felt or observed.

The most effective way to prevent genital herpes and other STIs in sexually active people is to use condoms systematically and correctly. At the same time, however, HSV infection through contact with unprotected condom sections of the genitals and anal area. Medical male circumcision can provide men with lifelong partial protection against HSV-2, as well as HIV and human papillomavirus (HPV).

Individuals with symptoms suggestive of genital herpes should be offered HIV testing.

Pregnant women with symptoms of genital herpes should inform health care providers. Prevention of HSV-2 infection is especially important for women in late pregnancy, as during this period there is the highest risk development of neonatal herpes.

WHO activities

WHO is working to raise awareness of HSV infection and its symptoms, increase access to antiviral drugs, and promote HIV prevention efforts among people with genital herpes, in particular through pre-exposure prophylaxis.

WHO and partners are also promoting research to develop new tools for the prevention and control of HSV, such as vaccines and microbicides.

8 myths about herpes - GBUZ "Crimean Central District Hospital" MH KK

Herpes is a common viral disease, with a characteristic rash of clustered blisters on the skin and mucous membranes. The famous ancient Greek historian Herodotus wrote about this unpleasant disease even before our era. It was he who gave her the appropriate name (from the Greek "herpein" - to crawl), thanks to the ability of herpetic ulcers to "spread" in different directions from the primary bubble. For many centuries of "communication" with herpes, humanity has recreated many myths about this disease, the most common of which we asked to comment on the acting head of the Health Center of the State Budgetary Institution of Health "TsOZiMP" of the Ministry of Health of the Territory Irina Volkova.

Myth 1. Herpes is not contagious.

- Exactly the opposite. Herpes is transmitted by airborne droplets (when coughing, sneezing, talking), contact (when kissing, using common utensils, lipstick) and sexually. Perhaps also infection of the child from the mother at birth.

Myth 2. Herpes is a manifestation of the “cold”.

- In fact, herpes is an independent disease that predetermines the herpes simplex virus. It is usually activated during hypothermia, stress, overwork, exacerbation of chronic diseases or a decrease in general immunity.

Myth 3. If a rash appears on the lips, the cold subsides.

- A common point of view, which, however, has nothing to do with reality. The appearance of a rash means that a respiratory infection has weakened the immune system, and this has given the herpes virus the opportunity to actively act.

Myth 4. If the rash is gone, herpes is cured.

- That would be great, but, unfortunately, it is impossible to remove the virus from the body. He stays with a person for life, and you can only force him to be in a "sleeping" state.

Myth 5. You can get herpes only if you have a rash.

- Indeed, in the active phase of the disease, a greater number of viral particles are released and the likelihood of infection is higher. But the infection can be transmitted at any time through invisible microtraumas of the skin and mucous membranes.

Myth 6. A condom completely protects against infection with genital herpes.

– A condom does reduce the risk of infection, but, unfortunately, it does not give a 100% guarantee. Transmission of the virus can take place through parts of the body that are not covered by a condom.

Myth 7. The best treatment for herpes is cauterization with alcohol, iodine or brilliant green.

- Cauterization does not affect the herpes virus and its activity, but it is very easy to burn damaged skin and mucous membranes in this way. It is better to gently lubricate the rash with an antiseptic that does not contain alcohol so that a purulent infection does not join.