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Cold sores also known as fever blisters are grouped blister filled sores that can affect any part of the body, but most commonly affect the face and lips. They can appear as a single lesion, or as a cluster or group of vesicles.
These sores are caused by a virus known as Herpes Simplex Virus (HSV). There are two types of this virus, HSV1 and HSV2. HSV1 is the most common, usually acquired from close contact with family members or friends through touching, kissing, or sharing utensils or towels. HSV2 is more commonly known to be transmitted sexually; although it is possible to get cold sores that are of the type 2 strain. With this said, it is also possible for type 1 infections to occur in the genital area after oral sex exposure with an individual who has cold sores of the face.
The skin outbreak can be episodic, often occurring after extreme sun exposure, a high fever from a viral infection, hence the term fever blister or cold sore. It can develop surrounding the menstrual period, trauma to the skin after wrestling, (herpes gladiatorum) or after extreme emotional stress. Taking immunosuppressive drugs as with cancer therapy or having an immunosuppressive state as is found with cancer or AIDS can predispose one to the spread of the virus. The virus will disappear from the skin and hide in the dorsal root ganglion of the nerve to reappear at a later date. Once one is infected, the virus cannot be eradicated from the skin, however there are medications which can prevent an outbreak or speed resolution once the lesion appears. Though frustrating and embarrassing, luckily this virus does not affect one’s general health. Pregnant women with active genital infection will need to undergo a C section to prevent spread of infection to the newborn once labor ensues.
The condition typically begins with a prodrome or series of symptoms such as extreme itch, tingling, stinging or burning at the same site from a previous outbreak. This is followed about 1-3 days later with a single or a grouping of fluid filled blisters. The condition is typically diagnosed by its appearance on the skin. When needed, the skin can be cultured and sent to the laboratory for analysis. There are also blood tests, which can confirm the presence of antibodies against this virus. This is helpful if the lesion has dried up, making culture of the site difficult. Such tests can reveal to your medical provider whether the infection is presently active or if you were exposed in the past. Although some will have only one occurrence in their lifetime, reoccurrence of these blisters is common.
While there is no vaccine or cure for this condition, there are antiviral medications, both oral and topical which can prevent or lessen the duration of an outbreak. Medicines taken orally can be dosed for initial infection, episodic infections or recurring infections. Speak to your medical provider to determine which treatment option is best suited for you.