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Cold sores are a common and annoying condition. They can recur repeatedly as the herpes virus ‘hides’ in the nerve cells, triggered by factors including cold weather, fever, illness, and fatigue.

A tingling sensation in the affected area is often the first sign of an emerging cold sore.

Triggers for cold sores can include; sunburn (or too much sun), stress, cold weather, menstruation, fever, some foods, tiredness and exposure to wind.

There are four main stages of the cold sore virus:

  1. Prodomal stage — when the cold sore virus is activated, people may feel a tingling, burning feeling around the lips or nose.
  2. Blister stage — as the virus multiples, small red swollen areas appear on the skin. These then turn into blisters, which may last for a few days.
  3. Ulceration stage — the blisters burst and fluid seeps out. At this stage the virus is very contagious.
  4. Crusting stage — the blister dries up and becomes crusty, with the scab usually clearing up within seven days.

Cold sore – Wikipedia

Your local chemist can help

According to the new National President of the Pharmacy Guild of Australia, Professor Trent Twomey, at the first sign of a cold sore it’s a good idea to speak to your community pharmacist for personalised treatment advice.

While cold sores are usually just an annoying (and often unsightly) problem, people with some types of immune-suppression are at additional risk of the sores spreading. This may result in severe symptoms which may require special medicine.

Complications that require treatment include bacterial infections (characterised by redness around the blisters), as well as fever and pus developing within the blisters.

Professor Twomey warned that cold sores can spread to the eyes, fingers or other parts of the body. ‘A cold sore in the eye requires immediate medical attention as sight can be affected if it is left untreated,’ he said.

‘Avoiding cold sores is difficult as there is no cure for them but we can reduce the risk by avoiding known triggers.

‘Wearing sun screens on the face, avoiding stress and getting run down, and looking after your general health are good basic defences,’ said Professor Twomey.

Professor Trent Twomey

Avoiding cross-infection

Another defence is avoiding activities which transmit the virus – especially in the first few days when the blister begins to form, which is when it is at its most infectious. Direct contact or via saliva are among the most common ways of transmitting the virus.

Kissing and contact with the blisters should be avoided but also people with cold sores should not share toothbrushes, cups and glasses, cutlery, and towels.

While people are often infected with the virus when they are very young, not all people will get cold sores.

Research shows that nearly everyone is infected by the virus during childhood but despite this almost blanket infection rate, some people may only get one or two attacks, while others get cold sores more regularly. Between 25–50 per cent of people develop secondary or recurrent herpes simplex infections after the first infection.

By the time we reach adulthood, more than 90 per cent of us have anti-bodies which show the presence of a herpes simplex infection at some time in the past.

Most cold sores usually go away on their own within 7–10 days, but it’s important to get on top of them to avoid complications. Professor Twomey said pharmacists were always looking for ways to help patients.

‘With cold sore for instance we advocated for a long time for better access to medicines and as a result patients can now get some anti-viral medications without having to go the doctor first for a prescription,’ he said.