| COLD SORE (HERPES INFECTION ON THE LIP) |
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 WHAT IS A COLD SORE?
A cold sore (herpes labialis) is an infection with the herpes simplex virus. Usually, a blister forms on the lip, which later turns into a painful sore. It goes away on its own, but it is annoying and can keep coming back.
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herpes simplex labialis (HSV-1) |
herpes simplex labialis (HSV-1) |
herpes simplex labialis (HSV-1) |
Photos: Metju12, CDC Atlanta, and Ben Tillman
- Wikimedia (Creative Commons License
1.0 /
2.0).
HOW DOES A COLD SORE DEVELOP?
A cold sore (also known as a fever blister) is caused by herpes simplex. There are two different types of herpes simplex virus: type 1 causes herpes on the lips and face, while type 2 causes herpes on and around the genitals.
Most people with cold sores first contracted the herpes simplex virus type 1 at a young age without noticing, often as early as kindergarten (thanks to kissing grandmothers and aunts). The virus then hides in the body in a dormant form. It enters the local nerve endings and travels along the nerve pathways to the corresponding nerve node. In the Netherlands, 50-70% of the population carries the virus. Under certain circumstances, usually when you are not feeling well (e.g., with a cold or flu with fever), the virus reappears and causes a 'cold sore' or 'fever
blister'.
So you are not infected again and again. You carry the virus yourself, and under certain circumstances it reappears. How often this happens varies from person to person. Some people who are infected with the virus never get a cold sore, some get one or two a year, and the unlucky ones get one every month.
WHAT ARE THE SYMPTOMS?
Herpes simplex type 1 can occur anywhere on the body, but it is most commonly found on the lips or around the mouth. It can also occur in or on the nose. First, small blisters appear, which feel painful or burning. Later, the blisters dry into scabs, which fall off spontaneously after a while. The course of
herpes on the lips is often very mild, but sometimes the pain is severe and cosmetically unsightly skin abnormalities develop.
HOW DOES THE FIRST HERPES SIMPLEX INFECTION PROGRESS?
The first infection often occurs at a young age and usually progresses without symptoms, without being noticed. People become infected through contact with people who have a cold sore. After 3 to 9 days, symptoms such as inflammation of the cheek mucosa, gums, tongue, or lips, swollen lymph nodes, and sometimes general symptoms of illness and fever may develop. The virus then settles in the nerve fibers. Later, under various circumstances, including fever, sunlight, menstruation, or stress, the virus can become active again and move from the nerve node to the originally infected area of the skin or mucous membrane, causing a new fever rash.
HOW DOES INFECTION OCCUR?
Infection mainly occurs through direct contact with a carrier of the virus. Infection is possible through direct skin or mucous membrane contact (kissing, sexual contact), but also through certain utensils. The virus can also be transmitted by touching the herpes rash with your fingers.
HOW IS THE DIAGNOSIS MADE?
The diagnosis of an HSV infection of the skin and mucous membranes is usually made on the basis of how it looks (the symptoms
that are present). If there is any doubt, a culture can be taken.
HOW IS A COLD SORE TREATED?
Because a cold sore goes away on its own, treatment is not necessarily required. An antiviral cream (aciclovir cream, Zovirax) can be applied, which is available at the chemist or pharmacy. These products are available without a prescription. In severe cases, often in patients with a compromised immune system, antiviral medication in tablet form can be prescribed. If the cold sore recurs very often, for example every month, these antiviral medications can also be given preventively, every day for months. Special lip plasters are available to camouflage the sores (Compeed).
HOW CAN I PREVENT THE SPREAD OF THE VIRUS?
Do not touch herpes spots with your fingers, so do not scratch the scabs. When applying a cream or ointment to herpes, it is best to use a cotton swab. When applying or removing cosmetics to the face, avoid any contact with the herpes. Do not use lipstick while you have herpes on your lips. When washing, avoid any contact between the herpes and the washcloth or towel. Wash your hands immediately after contact with herpes.
HOW CAN I PREVENT OTHERS FROM BECOMING INFECTED?
If you have a cold sore on your lips, keep toiletries, eating and drinking utensils strictly for private use. Make sure no one else uses them and wash them thoroughly immediately after use. Avoid direct
contact with other people's lips; for example, avoid kissing or cuddling babies. Stay away from pregnant women if you have a cold sore, especially if the pregnant woman has never had a cold sore herself. Also be careful with children or adults with atopic eczema. In atopic eczema, the herpes virus can spread rapidly across the skin and cause sores everywhere.
WHAT IS THE PROGNOSIS?
Once infected with the herpes virus, you will carry it for life. Most people are not bothered by it at all. In some people, the virus becomes active from time to time, causing the symptoms to return. In a very small group of people, this happens so often and so severely that it really bothers them. Eventually, however, the attacks decrease in severity and number, even in these people.
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