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March 26, 2009

Is a cold sore always permanent?

Posted: 12:57 PM ET

As a new feature of CNNhealth.com, our team of expert doctors will answer readers’ questions. Here’s a question for Dr. Gupta.

Asked by Kaley, Tucson, Arizona

“Dr. Gupta,

My roommate has been getting cold sores around her mouth since she was a little girl. I have never had one until very recently. Is it true that once you get a cold sores, you’ll get them for the rest of your life? What can I do to avoid getting another one? Thanks.”

Answer:

Hi Kaley. Thanks for writing in. Cold sores – also known as fever blisters – are highly contagious. The virus can live on towels, razors, cooking utensils, cups among other everyday household places. So you can imagine how easy it is to pass to a roommate, as in your situation, or to a family member.

Fever blisters are the result of virus known as herpes simplex virus one (HSV-1). While the thought of the virus infecting your body may seem really serious, its actually relatively harmless and quite common. Eight in 10 Americans are HSV-1 carriers, according to the National Institutes of Health.

There is no currently no cure for cold sores. Once you have the virus, you have it for life. HSV-1 moves around your body and “sleeps” in your nerves cells until something triggers it to “wake up.” The virus will then move to the surface. Some people will go years without having an infection, while other people will experience them frequently.

You can limit your overall risk by identifying what triggers your cold sores. The most common reasons are exposure to the sun, stress, a low immune system or toothache. Even certain foods can be the trigger.

Some believe foods such as olive oil, citrus fruits, sea salt, garlic, asparagus as well as  soft drinks and chocolate can trigger a cold sore.   If your cold sore already is already formed, some of these foods may aggravate the infection. The best thing to do is eat a balance of these foods. Eating or drinking any of these items from time to time is not problematic, just be mindful of the triggers and eat a balanced diet.

And it’s worth noting that your body will give you warning signals when the cold sore is on the way. The infected area will feel warm, tingling, perhaps even itchy up to two full days before you see the physical signs. If you begin treatment during this early stage, you’ll limit the severity of the outbreak.

When the small red blisters bumps begin to surface on your lip, or corner of your mouth, it’s critical to not touch the area at all. This is most contagious stage and the fluid in those bumps will infect other areas of your body and the people around you.

The best treatment option in the early stages is a prescription antiviral medication. These come in pill or ointment form and will help limit the growth of the virus. There are some ointments to help relieve the pain and itchy senstations available over the counter. People often get relieve from a cool compress on the area for about 20 minutes.

So Kaley, although cold sores are often a nuisance phyiscally, there are several ways to limit the frequency or severity of a potential outbreak. Your doctor can help determin the best treatment option for you.

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Filed under: Dr. Gupta • Expert Q&A


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carol porter   March 26th, 2009 3:34 pm ET

I have been getting cold sores for years. My husband of 25 years has never had them. My three sons-21,19,15- never have had them. However, when I was pregnant with all three, I got the blisters. I strongly believe that I passed on some type of immunity to them for this ailment.

Bella   March 26th, 2009 6:09 pm ET

HSV1 can also be transferred to the genitals as well. There is also asymptomatic shedding in those who are affected. You do not need to have a lesion to transmit the virus.

HSV1 and HSV2 can be located anywhere on the body. Although there are classic locations and symptoms. Most people do not get symptoms but will shed the virus.

Doctors do not include HSV testing in your standard STD screening exams. This is why the prevalence of HSV is increasing. Women and kids are most affected by this disease. Women can pass it vaginally while giving birth as well.

It is important to support HSV research as much as you can. Cutting edge technology is not funded by NIH nor are they supported by Big Pharma.

Simone   April 1st, 2009 2:31 pm ET

I started getting cold sores when I was 20 years old (I am now 50). I was getting at least 2 cold sores every year. 3 years ago I started taking L-Lysine. I have not had ANY cold sores since taking this supplement. It's an amino acid and is available OTC.

I take 500 mg of L-Lysine every day with no side effects. This works well for me!

Laura   April 2nd, 2009 7:15 am ET

I had never gotten fever blisters until a couple of years ago and then the outbreak on my mouth was so severe I had to go through 5 doctors just to have number 6 figure out that it was fever blisters. My lips were completely swollen and weeping. The final doctor recognized what the problem was and he bombarded my system with Valtrex for 6 months and they went away. Now if I sense an outbreak is coming on I take Valtrex for a few days and I barely have any symptoms. I do notice that exposure to sun or a tanning bed can provoke an outbreak so I'm on the look out for a good lip sunscreen.

countrygirl   April 2nd, 2009 11:22 am ET

I have cold sore for the last 40 years and my daughter too.
But not my son and my husband.
I have core sore or mouth ulcer almost every month and it lasts for more than 10 days.
It hurts when I eat, drink and even at night.
Two years ago, my Dermatologist prescribed Valtrex 1GM for both of us.
My daughter and I have been noiticed that cold sore doesn't come that often any more and it lasts for a shorter period.

Kay   April 3rd, 2009 8:23 am ET

L-Lysine! L-Lysine! L-Lysine! L-Lysine.!!!!! This supplement is great for cold soars. I've had really bad outbreaks since I was 4 years old and L-Lysine is one of the few things that is really effective in both prevention and healing. If you take it once you already have a sore, it tends to slow the growth and start the scabbing sooner.
The other thing I find effective but difficult to do is relaxing. When I feel a cold sore coming on I tend to start worrying about how big and ugly it will be, who I have to see in the next week with it, going to work with it, etc. If I am able to just relax and completely forget about the impending sore, it will often not develop.
Cold sores are a curse for sure- but they are a manageable one as well.

Dr. J   April 9th, 2009 2:23 pm ET

L-lysine does help for prevention and healing. Take early as possible after outbreak. Also one ingredient that Dr. Gupta didn't mention is caffine. Caffine can trigger the cold sore outbreak. Next time you get one try to remember if you drank too much caffine hours before the outbreak. Then stay away from it for prevention.

Dale Hesse   April 9th, 2009 9:31 pm ET

I started getting fever blisters at a very young age. How embarassing to attend school or just being in public in general, not to mention the discomfort that goes along with them. I am now well into my seventies and have not had an outbreak in many years. Several years ago, someone told me the very minute I felt one coming on, to wrap a couple of ice cubes in a wash cloth and hold it on the affected area for at least thirty minutes. The longer the better. Not once since I have been doing this, have I ever had the sores break out. Hope this turns out to work as well with all as it has for me.

Pam   April 13th, 2009 3:07 pm ET

My son and I have had cold sores for years, my husband who doesn't mentioned eating a couple of pieces of broccoli a day. The only time we get them now is if we don't eat broccoli for a couple of weeks

Mandy   April 13th, 2009 4:10 pm ET

A friend of mine has a 13 year old son who gets cold sores. She gives him Xocai which is "healthy" chocolate made from Caucao and the Acai berry which are two of the worlds Antioxidant super foods. She noticed that before he was taking the chocolate the cold sores would last 10-14 days and after taking the chocolate his "outbreaks" are less frequent and tend to last only 3-4 days...check out turningpointchocolate.com for more information.

Ry   April 13th, 2009 7:02 pm ET

What has worked for me is Oil of Oregano and Bitter Melon supplements.

Brenda Jean   April 16th, 2009 4:37 pm ET

You forgot one important item – when taking L-Lysine, you should also take vitamin C tablets with it to make it the most effective. Also, I strongly agree that stress contributes to it. I lived with an abusive husband for eight years and constantly had cold sores.

When I woke up and smelled the coffee and realized he wasn't going to change, I divorced the jerk and have not had a cold sore ever since. (That was seven years ago!)

debbie   April 17th, 2009 2:00 pm ET

Something else that prevents outbreaks is eating spinach once a week. I have not had one in over 10 years since practicing this.

But if I forget and I feel one coming on, I take 2 tylenol and use abrevo and if I have an outbreak at all, it is so small and short that it is not noticable.

Christina   April 23rd, 2009 12:05 pm ET

I have been getting cold sores since I was in grammer school. Aloe is a natraul anti viral and aids in the prevention of virus multiplication. In any health food store there is a drinkable form of Aloe. I also increase my vitamin C and drinks with anti oxidents (llike black tea). L-Lycene also helps. It has been almost a year since my last out break.

Ann   April 23rd, 2009 4:20 pm ET

I have had cold sores since i can remember. I have been marrid for 22 years and anytime I even thought I might be getting one I would refrain from kissing my husband until it was completely gone. I have 4 children ages 20-14 and none of them have gotten a cold sore either. Since they were little they have known not to drink from mom's cup no matter what without asking. I also refrained from kisses goodnight when i thought I might have one but could still give hugs. While cold sores are highly contagious the spread of them can be avoided with diligence.

Nik   April 23rd, 2009 4:41 pm ET

I have had cold sores since I was a kid. So has my mom. When I noticed a cold sore coming on, I take Valtrex. This prevents the cold sore from surfacing. The only draw back to Valtrex is that it is expensive and requires an Rx. Also putting OTC cold sore medicines before it surfaces helps as well. I am 24 and still get cold sores at least 4 times a year.

Marcia   April 23rd, 2009 10:47 pm ET

My daughter has had cold sores since a little girl also. We went on L-lysine and she broke out like she had measles. It was very scary for her, and we discovered she can not use it at all. So be careful!

cynthia   April 28th, 2009 12:51 pm ET

I've been getting cold sores since I was 5 years old. I am now 50 years old and the last 10 years I have been taking L-lysine and I rarely ever get them. It really works!

Larry   May 5th, 2009 1:30 pm ET

I've had cold sores for years. As soon as you feel it, apply ice, the longer the better. I'll get a bowl of ice and a towel, turn on the TV and sit there for an hour with ice on the blister. Regardless of how far the blister is advanced it will stop it and begin healing from that point.

August   May 7th, 2009 11:41 am ET

When I workout heavy with weights I tend to get them more frequent. The only stuff I have ever seen really work to heal the blisters is Viroxyn.

Kathie   May 7th, 2009 1:58 pm ET

Foods are a huge trigger for me. Lysine is wonderful, but I really noticed a difference when I stopped eating peanuts.

Pete   May 7th, 2009 3:40 pm ET

As Dr Gupta said, although not "serious" per se, cold sores are an extremely annoying, embarrassing condition. And as someone else smartly pointed out, great care should be taken while an outbreak is in progress, in order to not spread it to the genital region (either your own, or your partner's).

I unfortunately drank from the same cup as my mother when I was 5 yrs old, and caught her cold sores accidentally. I get them about 2-3 times per year...mostly after a bad cold, but sometimes at random. Could be worse – one poor fellow I used to work with would get them every 2-3 MONTHS! He eventually got some prescription ointment and meds from a physician.

It really is a shame that medicine hasn't yet been able to isolate and destroy this virus that lives in our nerve cells.

Bob   May 8th, 2009 7:55 pm ET

I have always had cold sores and I have found the best way to eliminate them quickly. I take a hair dryer and blow the hot air onto the cold sore for a short period of time. The cold sore then generally goes to the last stage of it's infection in about a day. Without doing this, it can last and be contagious for several days.
You must heat the cold sore several times a day for the first day and continue if it appears to be a stuborn one.
Do not put hot or cold water on the cold sore as this may make it spread, only hot air. Also, be careful not to breath the air from the hair dryer (use a tissue to cover your nose) or you might dry out your nose and create other problems. Also, be careful not to burn yourself, but try and get the cold sore as hot as possible for about 10 seconds.
I have had cold sores for most of my life and only discovered this about 10 years ago. It really works fo move the cold sore to its final stage.

Lynn   May 11th, 2009 10:33 am ET

Lysine is an amino acid that fights the virus causing cold sores, and arginine is the the amino acid that aggravates it. Lysine is found abundantly in dairy products, and arginine is especially abundant in nuts. Increase dairy and cut back or omit nuts when you feel an pending outbreak.

ben   May 15th, 2009 1:17 pm ET

L-LYSINE 1000mg Tablets.

It amazes me that no doctor ever promotes the use of this Vitamin. Take 3 or 4 of these tablets daily and it will slam that cold sore into remission. Take one daily for life to dramatically reduce their recurrence. The antiviral meds take weeks! The tablets are seriously miraculous.

John   May 15th, 2009 2:18 pm ET

I take 2,000mg Lysine daily. Since I started this regimen about five years ago, I went from getting cold sores every 2-3 months like clockwork (since I was a kid), to having only one cold sore - ONE - in the past five years. And that one time was when I had gone a week without taking Lysine after running out and forgetting to buy more.

I have a Valtrex script as well on hand, which is good to make outbreaks really short if you get one, but I haven't even needed to refill that in years.

Lysine is the best cold sore suppressant available, no question.

Cold sores   July 27th, 2009 1:41 am ET

Cold sores occur due to herpes simplex virus. The symptoms are itching, tenderness, soreness in skin. Some herbs are effective in treating it like, echinacea, liquorice, goldseal, chapparel and lomatium. Many prefer vitamin E oil, alcohol or ice. Lysine, Vitamin B, arginine is also effective. But one should always consult doctor first before using mentioned all above remedies. To get more tips on infant cold sores, refer http://www.zippy-health.com/innate-cures-to-infant-cold-sores/

Ron Shepherd   July 27th, 2009 10:29 am ET

The simplest and quickest cure is to dab the sore with a q-tip dipped in acetone. This dehydrates the virus and it clears up in just a day or two.

Liz   August 28th, 2009 1:12 pm ET

I've heard that cold sores can be 'woken up' by a Vitimin C deficency. I've been getting them ever since I was a little kid, and as a musician they can be really annoying.
Problem is, some doctors believe that cold sores are actually micro-ulsers, so citric acid seems to make them worse, like in oranges. (hey, I could be wrong- I'm no doctor.)
But I started taking once-daily Vitimins a while ago and haven't had one since, so I'd really sugest taking just a simple vitimin your can buy at your local drug store, no perscription neccary.
Worked for me, hope it helps you!

Sandra   September 9th, 2009 9:29 am ET

I never any cold sores till recently (am 53). have had one since July though and it refuses to go away. it is not an opn sore, just red, bit tingly and feels tight. Have tried heat treatment, aromathreapy, supplements, over the counter antiviral remedies, but nothing works so far. Will try the Lysine, but most stuff seems to only work when you first get it. or on open sores. I did not know it was a cold sore for ages as thought it was eczema or something like that and that is why i did nothing about it initially. Has anyone experience cold sores that have gone on for months? Will lysine work if you have had a cold sore for such a long time?

Jes   September 22nd, 2009 4:30 pm ET

I been getting cold sores since I was 12. So imagine the horror goin to high school and dealing with it.....Frist thing to prevent the things is L-Lysine, 1000mg twice a day.....If you feel the tingling take 5 or 7 , 1000 mgs a day. and apply ice for ten minutes on and ten minutes off and keep applying for an hour......Trust me this works......

Sandra   September 23rd, 2009 10:28 am ET

Thanks Jes. Am on on the L-Lysine but does not work so far. Problem is that Idid not take anything early enough as i thought it was eczema. Am going to get anti viral drugs from GP which will hopefully remove it for a while. Will keep taking the Lysine and will try the ice next time it i feel the first sign as will know what it is!

Sue   October 22nd, 2009 1:45 pm ET

Sandra, be sure and check to see if your diabetic or not. With diabetes it seems that all healing slows down. NOTE: Diabetes runs in my family and so I kept having my urine check every time I went to the doctor. The results were always negative. Then I spoke with an aunt who has it and she told me that it never showed up in her urine either, but when she had a glucose test done, it was confirmed. Good luck as I am sitting here with a red nose right now and worried that I didn't realize the cold sore was coming on and may have transmitted to my husband. My throat feels weird too. Has anyone ever had a cold sore in their throat? Geez, I'm so scared and doing a lot of praying it is not there too. My nose had been itchy, but I thought is was just a cold.

Stacey   November 18th, 2009 10:35 am ET

To Sandra,

If you haven't been to your doctor about your cold sore, please do so. It may not be a cold sore at all, and could potentially be something much more serious. Best to rule anything else out and not just continue to assume it's a harmless cold sore before moving on to some of the strategies listed above.

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