Unsightly, sore and highly contagious – cold sores, sometimes called fever blisters, are groups of small blisters on the lip and around the mouth. They are filled with liquid and can be very painful. Read on to find out how you contract them and how to prevent them.

Cold sores are unpleasant and unfortunately tend to reoccur. They scab over quickly and take up to two weeks to heal, but flare up frequently. More than one cold sore may appear on the face at any time. They can also be found in the mouth, although this is less common.

How you get them

The herpes simplex virus (HSV) causes cold sores – the most common cause being the herpes simplex virus type 1, or HSV-1. It’s a cousin of herpes simplex type 2, which causes the sexually transmitted genital herpes. Most people are first infected with HSV-1 before the age of 10.

Dr Debbie Rabinowitz, a Cape Town-based general practitioner, explains: “It is passed from person to person, either directly through kissing and skin contact or indirectly by drinking from the same cup or using the same utensils.”

Once contamination has occurred, the virus hides in nerve cells, where it remains dormant until something causes it to flare up. When the virus is activated, it travels back to the skin and there may be a tingling or burning sensation before there are any other visible signs.

Dr Rabinowitz says: “During the first (primary) infection a child may be asymptomatic or may show signs of a fever and fatigue with multiple painful ulcers on the lips and tongue. Symptomatic first infections usually spontaneously subside after about 10 days, though it may take up to six weeks to heal completely.”

“Recurrent attacks of the virus give rise to what we call fever blisters,” says Dr Rabinowitz. “These infections usually “crust” within four days and heal completely within ten days.”

Gone, but not for good

There is no cure for fever blisters. Dr Rabinowitz points out the following that can precipitate them: colds, fever, stress (mental and emotional), sun exposure and low immunity, but they can flare up for no known reason. “It tends to be a lifelong condition,” says Dr Rabinowitz.

What can help?

Most sores will go away without treatment, but medicines may reduce the duration of the blisters. Topical antiviral creams can ease the pain and itching and speed up the healing time, if applied early enough. Dr Rabinowitz adds that these medicines have little effect if started once the blisters are already present. Oral antiviral agents are available by prescription and are used in specific cases only.

Dr Kerri Sacks, a homeopathic practitioner in Gauteng, suggests the following supplements:

• Vitamin C boosts the immune system and helps the body to fight the virus.
• L-lysine has antiviral properties and helps fight the herpes virus.
• A vitamin B complex supplement for sufferers who lead stressful lifestyles.

Dr Sacks says there are also homeopathic remedies, which can also be very effective. However, if symptoms persist, it’s best to consult your homeopathic practitioner for a specific remedy.

Dr Rabinowitz suggests you consult your doctor if the fever blisters make it difficult to eat or speak or if they take longer than a week to heal.

Keep them at bay

• If your child has open or weeping fever blisters, many crèches prefer you to keep them at home until the blisters have healed and they are no longer contagious. The weeping stage is the most contagious.
• Encourage frequent handwashing.
• Do not share utensils or cups with a person who has a fever blister.
• Do not kiss someone with a fever blister.
• It is a good idea to clean children’s toys regularly with disinfectant.
• A good sunscreen may prevent the recurrence of fever blisters precipitated by sun exposure.