Cold Sores - What to do if you have a cold sore




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Cold sores

What to do if you have a cold sore
Get early treatment. The earlier you treat a cold sore, the better. In fact, the best time to start treatment is as soon as you feel the telltale tingle. The standard treatment is aciclovir cream, applied five times a day for 5 days. If your cold sore is on the lips, you may have to reapply the cream after eating or drinking. Aciclovir is an antiviral drug that prevents the virus from multiplying and speeds up healing. You can buy it from pharmacies without a prescription. (Another antiviral cream, penciclovir, is available, but requires a doctor’s prescription in the UK, and needs to be applied more frequently than aciclovir.)

Do not expect miracles from the cream. If you start treatment early enough, it will shorten the attack from about 8 days to about 6 days (Journal of Family Practice 2004;53:923–4). If you often get recurrences, it makes sense to ensure that you have a supply of antiviral cream in readiness, so that you can start treatment promptly.

Dry the sore up or keep it moist? This is a dilemma, because a sore that is oozing does not look very nice. Some people like to dry it by dabbing on surgical spirit or witch hazel (from a pharmacy), or even gin or vodka. However, it is possible that cold sores heal better when they are kept moist. Of course, aciclovir cream will keep it moist as well as having a specific antiviral action. Tea tree oil, or oil from a vitamin A or vitamin C capsule, are other methods of keeping it moist and may reduce inflammation slightly.

Be hygienic. Hygiene is important, because you do not want a bacterial infection to move in.

Try not to touch the sore with your hands.
If you apply any cream or oil to the sore, use a new cotton-wool bud each time.
To wash the area, dab it gently with a moistened tissue. Do not apply any disinfectant, because this may be too harsh for the damaged skin.

Protect your eyes. Herpes simplex can cause a nasty eye infection, so take care.

Be careful when applying eye make-up – it is easy to touch your cold sore without realizing it.
Wash your hands very thoroughly before putting in contact lenses (this is one reason why you should never use saliva to moisten contact lenses).
If your eye does become sore, see your doctor straight away.

Do not infect anyone who is vulnerable. Although herpes simplex is not normally a damaging virus, it can cause serious problems in people whose immune system is poor.

Keep away from babies.
Do not kiss anyone who is unwell for any reason, or who is pregnant, old, or has eczema (herpes can cause a nasty infection in skin already affected by eczema).
Do not share your toothbrush or eating utensils with anyone (because the virus can be passed in saliva).
Do not give oral sex to anyone until the sore has healed completely, or you could be giving them genital herpes.

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