What Are Cold Sores?

Painful, unsightly and highly contagious, cold sores can be a significant problem for the people they afflict. In severe cases they can affect the sufferer’s ability to eat and talk.

Cold sores are also emotionally painful with social consequences, since the patient is likely to be stigmatized by visible lesions in plain view of everyone they come in contact with. Sufferers complain of self-consciousness and a loss of self-esteem, to the point of staying at home from work at times. Cold sores can be socially humiliating for sufferers since they are both unattractive and easily spread.

Cold sores are small lesions that appear on the lips or surrounding skin. These lesions initially form as clusters of tiny blisters that burst and then crust over. They can last for 6-10 days. They are painful to touch and can interfere with normal activities.

Cold sores are caused by the Herpes Simplex Virus 1 (HSV-1), which can remain dormant in the body for long periods of time. The initial HSV infection manifests as a flu-like illness and generally occurs in early childhood, although some people may contract a primary infection as an adult. The virus is spread through contact with the fluid from the cold sore blisters or with the saliva of an infected individual. The virus is most easily transmitted when the blisters have first formed but the lesions remain contagious until they have healed completely.

After the initial infection, some people may develop an effective immunity to HSV-1. However, for most of the infected individuals, the virus will remain latent in the nerve cells and can potentially be re-activated by such triggers as stress, fever, sunlight, trauma, infection by another pathogen or hormonal fluctuations, thus resulting in the eruption of a cold sore lesion. For 20-40% of the infected population, these distressing outbreaks are recurrent. People with compromised immune systems, such as cancer patients, AIDS patients and recent organ transplant recipients are prone to more frequent and severe bouts of cold sores. For these patients, cold sores can become a serious health risk.

In recurrent cases, the appearance of lesions is preceded by prodromal symptoms of tingling, itching or burning around the lips. These onset symptoms usually occur 24-48 hours prior to the eruption of a lesion, giving the sufferer advanced warning and providing a window for preventative therapy.