Cold Sores
Cold Sores
17 Hints to Heal Herpes Simplex
That tingling you feel just above your upper lip is unmistakable. Oh, cripes. You know what that is—the start of another cold sore or fever blister.
You've gone through this routine before. First it gets red. Then that itchy, tingly area puffs out. The more water the blister draws to itself, the bigger it gets, and the more embarrassed you feel.
For some reason you can't stop checking yourself out in the mirror. (Maybe you're hoping against hope each time you look that the cold sore has disappeared, that it only existed in your imagination. But no such luck.) Why, you wonder, does it have to happen to me?
Cold sores are caused by the herpes simplex virus. In all likelihood, some relative of yours infected you when you were a child by kissing you at a time when his herpes simplex was infectious.
The virus scooted right into your mouth and sought a hospitable host cell, probably a nerve cell that would let the virus move right in. The virus then "ordered" the DNA in its host cell to make lots more viruses exactly like it.
For the most part, those viruses are homebodies. They stay put. But from time to time, the virus family likes to take a little vacation. So it cruises down the nerve highways until it reaches the skin surface. And when that happens, you start to feel that awful tingling sensation that signals the start of another you-know-what.
What can you do about it?
Keep the cold sore clean and dry. "If the cold sore isn't really bothersome, just leave it alone," says James F. Rooney, M.D., a clinical virologist at the Laboratory of Oral Medicine at the National Institutes of Health. "Make sure to keep the sore clean and dry. If it becomes pussy—and this rarely happens—seek medical attention to make sure the bacterial infection is properly treated."
Replace your toothbrush. Your trusty toothbrush can harbor the herpes virus for days, reinfecting you after the present cold sore heals.
Researchers at the University of Oklahoma exposed a sterile toothbrush to the virus for 10 minutes. Seven days later, half of the disease-producing viruses remained, says Richard T. Glass, D.D.S., Ph.D., chairman of the Department of Oral Pathology at the University of Oklahoma College of Medicine and College of Dentistry.
How do you counter the infectious toothbrush? Get rid of it. Dr. Glass recommends that you throw your toothbrush away when you notice you're just beginning to get the virus. If you still develop the cold sore, throw your toothbrush away after the blister develops. That can prevent you from developing multiple sores. And once the sore has healed completely, replace your toothbrush again. Dr. Glass said that patients of his who tried this found that it cut way down on the number of cold sores they typically experienced in a year.
Don't keep your toothbrush in the bathroom. A nice wet toothbrush in a moist environment like your bathroom is as cozy an environment as the herpes simplex virus could hope for. That moisture helps prolong the life of the herpes virus on your toothbrush. That's why Dr. Glass recommends that you store your toothbrush someplace dry.
Use small tubes of toothpaste. Toothpaste can transmit disease, too, says Glass. Think how often you put the brush that's been in your mouth right up to the opening of the tube. If you use small tubes of toothpaste, you'll be sure to replace it regularly.
Protect with petroleum jelly. You can protect your cold sore by covering it with petroleum jelly, says Dr. Glass. Be sure not to dip back into the jelly with the same finger you used to touch your sore. Better yet, use a fresh cotton swab.
Zap it with zinc. Several studies show that a water-based zinc solution, applied the minute you feel that tingling, helps speed healing time.
In a Boston study of 200 patients who were followed over a six-year period, a 0.025 percent solution of zinc sulfate in camphorated water was found very effective. Sores healed in an average of 5.3 days. The solution was applied every 30 to 60 minutes during the onset of the cold sore.
Researchers in Israel also found a 2 percent water-based zinc solution, applied several times a day, to be very helpful, says Milos Chvapil, M.D., Ph.D., professor of surgery and head of the Surgical Biology Section at the University of Arizona College of Medicine.
How does zinc help? Dr. Chvapil says that zinc ions crosslink with the DNA molecule of the herpes virus and prevent the double helix from splitting. That means the virus can't get the DNA to help it replicate.
Dr. Chvapil says that zinc gluconate is kinder to the skin than zinc sulfate. The mineral is available at health food stores.
Lick it with lysine. Dermatologist Mark A McCune, M.D., chief of dermatology at Humana Hospital in Overland Park, Kansas, advises patients who have more than three cold sores a year to supplement their daily diets with 2,000 to 3,000 milligrams of the amino acid lysine. He also recommends that they double up on the dosage when they feel the itching and tingling that signals the development of another cold sore. (Of course, don't use this or any supplement without the advice and consent of your doctor. This is especially true for pregnant women and nursing mothers. Some animal studies have shown that excess lysine can interfere with normal growth.)
Not all studies have found lysine helpful for cold sore sufferers. But in one study of 41 patients, Dr. McCune and his colleagues found a daily dose of 1,248 milligrams of lysine helped subjects reduce the number of cold sores they have in a year.
Good food sources of lysine include dairy products, potatoes, and brewer's yeast.
Identify the pattern. What was going on in your life just before you got your last cold sore? What about the cold sore prior to that? If you do some sleuthing, you just might figure out what triggers a cold sore for you. If you can find a trigger, take additional lysine when you're most prone to cold sores, says Dr. McCune.
Freeze-dry it. Some of Dr. Rooney's patients reach for ice when they first feel the tingling. "I'm not sure that it works, but if I were to speculate, I'd say that ice does decrease inflammation. And if inflammatory substances aid the reactivation process, this could help."
Dab on witch hazel. "Some patients claim that breaking a sore and using witch hazel or alcohol to dry it really helps," says Dr. Rooney.
Soften it with an OTC. There are numerous products that claim to heal cold sores. In general, they contain some emollient to reduce cracking and soften scabs, and a numbing agent like phenol or camphor.
Phenol may have some antiviral properties, says Dr. Rooney. "It does denature proteins. Theoretically, it is possible that phenol is capable of killing the virus."
Block that sun (or wind). Protecting your lips from trauma like sunburn or wind exposure was cited by all our experts as a key to preventing cold sores.
Avoid arginine-rich foods. The herpes virus needs arginine as an essential amino acid for it metabolism. So cut out arginine-rich foods such as chocolate, cola, peas, grain cereals, peanuts, gelatin, cashews, and beer.
Perfect your coping skills. Studies have shown that stress can trigger recurrences of the herpes simplex virus. High levels of stress are not necessarily the culprit, says Cal Vanderplate, Ph.D., an Atlanta psychologist specializing in stress-related disorders. "How you cope with the stress—how you perceive it—is what's important. Stress is not a tangible thing; it's a concept."
His number one stress deflator is "maintaining a loving social support system. This is the number one thing you can do to protect yourself from high stress," he says. "A sense of control is also very important. If you take a positive attitude toward your health, you'll be more able to influence your symptoms."
Relax. "By the time symptoms appear, it's too late to intervene in stress reduction," says Dr. Vanderplate. "But you may be able to reduce the severity by doing some relaxation exercise." He favors deep muscle relaxation techniques, biofeedback, visualization, and meditation.
Exercise. "There is some evidence that exercise actually helps bolster the immune system," says Dr. Vanderplate. The stronger your immune system, the better able it is to defend you against viruses. Exercise is also a super way to relax, he says.
Correct your perception. No one likes getting a cold sore. But if you've got one, focusing on it and worrying about how you look can make it worse. "Minimize any negative perceptions you have about it," says Dr. Vanderplate. "Tell yourself that 'this is just like a pimple and it won't interfere in my life in any way.' "
PANEL OF ADVISERS
Milos Chvapil, M.D., Ph.D., is a professor of surgery and head of the Surgical Biology Section of the University of Arizona College of Medicine in Tucson.
Richard T. Glass, D.D.S., Ph.D., is chairman of the Department of Oral Pathology at the University of Oklahoma College of Medicine and College of Dentistry in Oklahoma City.
Mark A. McCune, M.D., is a dermatologist in Overland Park, Kansas. He is chief of dermatology at Humana Hospital in Overland Park.
James F. Rooney, M.D., is a clinical virologist and a special expert in the Laboratory of Oral Medicine at the National Institutes of Health in Bethesda, Maryland.
Cal Vanderplate, Ph.D., is a clinical psychologist specializing in stress-related disorders. He is on the clinical faculties of Georgia State University and the Emory University School of Medicine, both in Atlanta.
