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FEVER BLISTERS OR COLD SORES

Remember differences What you can do
Causes Drugs for Cold Sores
Stages of Cold Sore Updates
Symptoms More on Canker Sores
Recurrence   

  Both of these conditions cause small sores to develop in or around the mouth, and often are confused with each other.

Remember....... canker sores occur inside the mouth.............. cold sores usually occur outside the mouth!

Find out about the new medical treatment  for cold sores.

 

  1. Canker sores occur only INSIDE the mouth-on the tongue and the inside linings of the cheeks, lips and throat.  They are small ulcers with a white or gray base and red border.  They are common and often recur. They are NOT CONTAGIOUS and are caused by bacteria.

  2. Fever blisters are painful fluid filled blisters or "cold sores" that usually occur OUTSIDE the mouth-on the lips, chin, cheeks or in and on the nostrils.  If they do occur inside the mouth, it is usually on the gums or the roof of the mouth.  Inside the mouth, fever blisters are smaller than canker sores, heal more quickly and often begin as a blister. About 50%**80% of the population have the virus (HSV1), which hides in the nerve cells of our face.  They are VERY contagious.  Cold sore virus infects up to 90% of those older than 50**.  Only 20-40% of those infected develop the sores. The others can transmit the virus but never experience symptoms.  They usually do not last longer than two weeks.  If a cold sore appear inside the mouth, usually it appears on the non-movable parts such as the roof, rather than the tongue or soft palate.

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Fever Blisters or Cold Sores

     They are caused by a contagious virus called herpes simplex.  There are two types of herpes simplex virus.

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Type 1-95% of recurrent fever blister outbreaks are caused by this virus  

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80% of the population carry HSV-I infection

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Type 2-genital herpes 5-10% of the cases

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Most people get infected during infancy or childhood from an infected family member or friend.  This is when the worst symptoms are experienced.**  After the sores heal the virus slips into nerve cells in the skin and lie dormant until something weakens the immune defenses and awakens the virus.

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Due to the societal revolutions both virus are found in the mouth.++

   

    Herpes simplex virus is highly contagious when fever blisters are present and is frequently spread by kissing.  Most people with type 1 virus become infected before the age of 10.  It is not caused by exposure to germs but results of a reactivation of dormant viruses in the body.

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Stages of a Cold Sore:

  Day 1: Tingle (itching or burning sensation beneath the skin) Stage-occurs BEFORE the cold sore has formed, usually around the mouth or base of the nose.  Applying anti-viral medication during this stage can help alleviate cold sore symptoms.

  Day 2: Blister Stage-a day or two after the warning signal of tingling an outbreak of fluid filled blisters will occur.

  Day 3: Ulcer or weeping stage-is the most contagious and painful stage when the blister rupture, leaving a shallow reddish open sore.

  Day 5-8: Crusting Stage-blisters dry up and form a yellow or brownish crust and eventually fall off.  During this stage it is important to care for the scab so it will not crack or break.

  Day 9-12: Healing Stage-a series of scabs will form on the lesion and eventually flake off.  Each new scab will be smaller than the one before until the cold sore heals, usually without scarring. 

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     In initial infection for most people have no symptoms.  15-30%, however, develop:

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Fluid-filled blisters inside and outside their mouth 3-5 days after they are infected (this fluid is full of viral particles)

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Fever

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Swollen neck glands

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General aches

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Blisters merge than collapse

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A yellowish crust forms over the

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Healing occurs within 2 weeks without scaring

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This virus stays in the body

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Recurring blister tend to erupt at the outside edge of the lip/edge of nostril

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Recurrent fever blister attacks are less sever than the initial infection

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Recurrences appear less after age 35

Once a person has a primary herpes infection the virus stays in the body and may cause recurrent attacks.

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     Cause for a recurrence of fever blister:

  1. Emotional stress

  2. Fever

  3. Illness

  4. Injury to the mouth

  5. Exposure to sunlight

  6. Menstruation or pregnancy

  7. Infection

  8. Fatigue

  9. Excessive heat

  10. Common cold

  11. Mouth

  12. Food allergies

  13. Respiratory illness

  14. Oral or facial wounds...shaving, dental work, cosmetic procedures

  15. Immune system deficiency

  16. Wind burn

  17. Skin trauma around lips due to shaving

     Treatment: Viroxyn is a single dose medication. 

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     Some medication will relieve some of the pain and discomfort associated with the sores.  There is no cure.  

Here is what you can do:

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Antibiotics to control secondary bacterial infection

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Ointments to soften the crusts of the sores

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Keep blisters clean and dry to prevent bacterial infection

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Eat a soft, bland diet to avoid irritating the sores

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Do not touch the sores and spread the virus to new sites

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Avoid kissing others ( saliva contains the virus) or touching the blisters and touching others, this will infect others

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Avoid sharing eating or drinking utensils during an outbreak

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Sunscreen on lips can prevent sun-induced recurrences of herpes

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Reapply sun block factor of 15 or higher frequently during sun exposure

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Avoid excessive exposure to sunlight

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Reduce stress in life

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Topical applications of zinc can reduce symptoms and prevent
recurrences. It is applied directly to the skin at the site of the
flare-up. 

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Avoid sexual contact including oral sex which can transmit the virus to the genital area.

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A diet that is high in lysine and low in arginine has been found to be helpful. In vitro studies indicate that the amino acid arginine is required by the herpes virus to replicate. Since lysine competes with arginine for intestinal transport, a diet rich in lysine (brewers yeast, legumes, dairy, wheat germ, fish and meat) and low in arginine may have an antiviral effect. Chocolate, peanuts and almonds are high in arginine and should be avoided. Herpetic ulcers outbreaks may be lessened or prevented by
antivirals or by taking Lysine.

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Try using Tooth and Gum Toothpaste and/or Squigle - Both are sodium lauryl sulfate free

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Try over-the-counter products such as anesthetic skin creams containing benzocaine like Nupercainal.*

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Try pain relievers such as acetaminophen or ibuprofen.  They will ease the discomfort but will not help healing the sores.

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Replace your toothbrush.

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Shave with a disposable razor during outbreak. 

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If the sores do not heal in 14 days contact your doctor.

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If you have more than 6 outbreaks a year, ask your doctor about taking Acyclovir regularly.  It can reduce the number of episodes by up to 80%*

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OTC Products
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Inhibit: Viroxyn. ~ Use Viroxyn.  Click here to get information about Viroxyn, the single dose one application cold sore medicine:  Viroxyn, cold sore treatment.  It stops the pain in minutes and stops the swelling and destroys the growth of the virus.

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Numbing: Campho-phenizue  Bayer.com;   Orajel Mouth Aid  orajel.com;  Phenol.

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Limit Formation: Herpecin-L  chatteminc.com;  Pure Lip Solution Pack (Zinc);  Tannic Acid.

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Moisturizer  Abreva (Allotonin) it is docosanol cream to accelerate healing  smithklinebeecham.com;  Carmex  carmalab.com.

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Sunscreens: Burt's Bees.com (zinc oxide)

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Herbal Remedies Tea Tee Oil

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Zilactin-L liquid medication ~

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Nutritional Supplemental: Herpetrol Tablets;  Lysine, an over the counter supplement, may reduce outbreaks in some people. 

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House hold Remedies: Ice, tea bags, or petroleum jelly

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Prescription:
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Zovirax, antiviral medication in pill form can help treat recurrent severe cases. Try Denavir, an antiviral cream which can help speed healing.

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Systemic Medications: Famvir (famcyclovir) Valtrex (valcyclovir)- 500mgm; 4 tabs stat then 4 tabs 12 hrs later

Drugs for Cold Sores
Drug Cost of
Treatment
Efficacy
(faster healing in days)
Convenience Comments
Pills (RX)        
Valacyclovir (Valtrex) $35 One Twice a day for 1 day Most convenient
Famciclovir (Famvir) $120 One Twice a day for 7 days Most expensive, with no proven advantage
Acyclovir (Zovirax) $45-85 Possibly little or none Twice a day indefinitely for prevention Use for prevention, not recommended for treatment
Application RX        
Penciclovir (Denavir) $24 One Every 2 hours while awake for 4 days Lease expensive of drugs that may work best.  May be more effective than others when started late.
Docosanol (Abreva) $16 One-half Five times a day until sore heal Least expensive but may be slightly less effective
Viroxyn $35 One One time  

Consumer Reports on Health Pg 10 10/05

Remember that these lesions are contagious and you must practice good hygiene during attacks.

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 Click here to learn more about Canker sores....

Viroxyn is a unique approach to treating cold sores/fever blisters. For most people, Viroxyn is a single-application treatment, and has been proven to shorten the duration of outbreaks from 10 days to three to four days. Many patients report pain relief within minutes of application.

The active ingredient in Viroxyn is considered by the FDA to be safe and effective when used as a germicidal treatment of open skin wounds. Viroxyn is applied topically, and works by acting directly on the mature virus.

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Updates

Emotional stress (60 percent) was reported by patients to be the most common trigger, and pain or discomfort (81 percent) was their primary concern. Acyclovir ointment was the most common antiviral drug recommended or prescribed by health care professionals (60 percent).

Treatment Modalities and Medication Recommended by Health Care Professionals for Treating Recurrent Herpes Labialis - Raborn G.W., Chan K.S., Grace M. JADA January 2004

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Herpes simplex and aphthous ulcerations: presentation, diagnosis and management; Dr. Sciubba ; General Dentistry pg 510-515 January 2004.
Ulcer Management; Ms McManus, Ms Pittman, Dentistry Today pg 47-51 January 2004
Cold Sore, AGD Impact Fact Sheet, pg 26 February 2003
*Source: Consumer Reports on Health Feb 2001 and National Institute of Dental Research.
** Academy of General Dentistry, Plant Aloe Vera: Relieve a Cold.
~Common Mouth Sores, JADA, Vol. 132, November 2001

~~We have NO financial interest in this product.

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February 06, 2008

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