Cold Sores Clearing Up a Pesky Problem

Clearing Up a Pesky Problem

Like many frustrated youngsters, Brad couldn't understand why he, of all people, kept getting one cold sore after another. ''I don't even remember how young I was when I had my first one, but it was a real bummer having them recur as I was growing up,'' he says. ''Every time I had an important exam or, as I got older, a big date, I could almost guarantee that I would get one.''

Now as an adult, Brad Rodu, D.D.S., is a dentist whose passion is helping kids--including his own two children--avoid the cold sore anguish he suffered. It's a tough assignment because it's just about impossible to prevent exposure to the herpes simplex virus that causes cold sores (also known as fever blisters). ''Herpes simplex is so prevalent that virtually all of us come in contact with at least one strain of the virus before our fifth birthday,'' says Dr. Rodu, professor and chairman of the Department of Oral Pathology in the School of Dentistry at the University of Alabama at Birmingham.

''A grandmother who has a cold sore, for example, transmits the virus to her grandson when she smothers him with kisses,'' he notes. And that is just one way the virus is typically spread. It also can be passed along by shaking hands or sharing common household items like towels or dining utensils.

Once exposed, your child may get sick with a fever, fatigue and headache. Those symptoms subside after a week or two. After that, one of two things can happen, according to Dr. Rodu.

If your child is lucky, the virus will lie dormant in a nerve, perhaps for his entire lifetime, without causing any further trouble. On the other hand, one in ten children will develop a patch of itchy blisters on the lips, gums, fingers, nostrils or even the eyes anytime from weeks to years after exposure to the virus. These small blisters rupture to form one large blister that eventually breaks and oozes, forming a yellow-crusted cold sore. After about seven to ten days, the sore disappears. Fortunately, many kids who experience this will never have another outbreak. But some children do continue to get them, off and on, for years afterward.

Often, these recurring cold sores appear during stress or illness or after exposure to sunlight or a cold wind. Once a sore forms, little can be done to shorten its stay. But there are some ways to prevent them and to make your child more comfortable if he gets one.

Try a tannic terminator. Studies conducted by Dr. Rodu show that over-the-counter drops (such as Zilactin-L) that contain tannic acid can, if applied soon enough, prevent a cold sore from forming or at least reduce its size. The key is getting your child to tell you when he begins feeling a tingling sensation in his lip. That's an early warning sign that a cold sore may appear in the next 4 to 12 hours, Dr. Rodu says.

''I tell my patients if they feel a cold sore coming on to put drops on early and often,'' he says. ''If you apply the medication at the first sign of tingling and reapply it every hour, it will keep the sore very small.''

Press a tea bag into service. Like some over-the-counter drops, tea contains tannic acid, a plant-derived substance that's used in tanning and dyeing as well as medicine. Researchers suspect that tannic acid has anti-viral properties. The over-the-counter medications are more effective, but you may want to try putting a wet tea bag on the sore for a few minutes once every hour to provide temporary relief until you can get to a drugstore.

Chill out the tingly spot. ''If you put ice on your child's lip as soon as he tells you about the tingling, you'll slow the metabolic rate in the skin tissue where the herpes virus is growing. That could prevent a cold sore or at least re-sult in a less severe outbreak,'' says Michael A. Siegel, D.D.S., associate pro-fessor of oral medicine and diagnostic sciences at the University of Maryland School of Dentistry in Baltimore. He suggests putting an ice cube on the affected spot for five to ten minutes, repeating about once every hour when possible.

Lubricate the site. Moisturizing ointments such as petroleum jelly help soothe the pain and prevent cracked and bleeding skin, Dr. Rodu says. Apply them as needed.

Send nourishment through a straw. '' When a kid has a sore on his mouth, he tends to stop eating and drinking. That can lead to dehydration,'' Dr. Siegel says. ''To insure that he gets an adequate amount of fluids and essential vitamins and minerals, give him things like sports drinks or liquid diet supplements that are essentially meals in a can. He can drink those through a straw so they don't come into contact with his sore lips.'' If your child is under four years old, however, be sure to check with your pediatrician before giving him a liquid-diet drink.

Keep those little hands busy. Urge your child not to touch the sore. He can not only spread the virus to other children that way but also, by touching the cold sore, he might cause a bacterial infection to develop at that site. ''Kids naturally want to touch or pick at the sore, but you really need to make an effort to help them understand that doing so will only make the sore worse,'' says Ronald C. Hansen, M.D., professor of pediatrics and dermatology at the University of Arizona College of Medicine in Tucson.

Tell your child to ask you for more medication if the sore is bothersome, says Dr. Hansen. But also try to keep him occupied with distracting activities such as coloring or playing with building blocks.

Wash away the virus's chance to spread. If your child does touch the sore, make sure he washes his hands with soap and hot water immediately, says Dr. Siegel. Otherwise, he might spread the virus to others or to other parts of his body, such as the eyes or nose. In addition, wash all of his glassware, plates and eating utensils thoroughly in hot water or in a dishwasher to prevent exposing the next person who uses those items to the virus.

Go back to good-health basics. To help prevent new cold sores, make sure your child eats a balanced diet, gets regular exercise and plenty of sleep at night. ''The healthier your child is, the less likely he is to get a cold sore,'' Dr. Rodu says.

Block out the sun. Fun in the sun can trigger a cold sore outbreak. To prevent it, make sure your child wears a lip balm that contains a sunscreen with a sun protection factor (SPF ) of at least 15, Dr. Hansen advises. Reapply it every hour as necessary.

Bundle up against wintry blasts. Cold, windy weather is another infamous spark for cold sores. If your child is prone to developing sores, he should wear a ski mask or cover his face with a scarf when the wind howls and temperatures plunge, says Dr. Rodu.

Know when to stay at arm's length. If you get a cold sore, avoid direct contact with your child, including kissing, until it subsides. ''Like the common cold, the cold sore virus is easily transmissible to someone else,'' Dr. Siegel explains. ''Just because your child may have been previously exposed to the virus doesn't necessarily protect him from developing a fever blister.''