▎ WuXi AppTec content team editor
There is a Chinese proverb called "anxious to be full of bubbles", which describes a person as very anxious and anxious.
I believe that many people have had the experience of growing "small blisters" on the mouth, lips, and nostrils, there are burning pains, itching, and scabs, and in a few days, they will be fine, and some people may not take it seriously.
▲ Typical early stage of cold sores (Image source: References[6])
But in reality, this is mostly caused by herpes simplex virus (HSV) infection , cold sore , also known as oral herpes.
Although seizures are not severe, they can be uncomfortable when eating. For some beauty lovers, they will also worry about affecting their appearance, and they will quickly put on the mask as soon as they have a seizure.
Today we will take a look at what cold sores are all about.
Why does cold sores grow?
There are two types of herpes simplex virus that causes cold sores, most of them are HSV-1; but a few are HSV-2 (HSV-2 mainly causes genital herpes, although it may also cause primary cold sores, but rarely recurs).
Today we will talk about HSV-1 separately.
The virus is mainly transmitted through mouth-to-mouth contact (there is a virus on the skin surface around the mouth, on the mucous membrane of the mouth, on the ulcer surface, in saliva), such as kissing, mouth-to-mouth feeding, sharing utensils, sharing towels, etc. – especially for children, these are dangerous actions.
▲ Adults and babies infected with HSV are actually very dangerous (Image source: 123RF)
Neonatal HSV infection is quite serious and can lead to persistent neurological dysfunction or death, new parents and the elderly at home must pay attention!
People who have never been infected with HSV-1 before, or who have weak immune systems (such as diabetics, HIV-infected people, or cancer patients during chemotherapy), are susceptible people.
The World Health Organization estimates that 2 out of every 3 people under the age of 50 worldwide (67%, 3.7 billion) are infected with HSV-1. Therefore, this probability is quite high.
People who haven't blistered on their mouths don't get lucky, maybe you're already infected, but most people don't have symptoms.
However, as long as the virus is in your body, it will be carried for life, and you are a walking "source of infection". When there are symptoms (active ulcers), they are most contagious.
Studies have found that the first infection with HSV-1 is generally before the age of 20, and about 80% of adolescents have antibodies to the virus present in the body.
Many people are entangled in it in childhood. However, in recent decades, with the improvement of living conditions, the age of initial infection has been postponed.
In addition, due to the existence of some kind of eroticism ... HSV-1 may also infect intimate areas, causing genital herpes.
(But there's a peculiarity: people who already have HSV-1 infection in their mouths are less likely to reinfect HSV-1 in their genital areas afterwards, but are at risk of contracting HSV-2.) ）
So, how does the HSV-1 virus fight an "ambush war" in the human body?
First of all, after the first infection of the human body, it will hide from the sensory nerve into the ganglia (usually the trigeminal nerve), and lurk for many years.
When the owner has a cold and fever, an upper respiratory tract infection, or is exposed to the sun, fatigue, stress, lip injury, oral treatment, facial plastic surgery or laser treatment, eating certain foods, menstruation (hormonal changes) in women, etc...
These stimuli can "wake up" the HSV-1 virus and "kill" epithelial cells from the sensory nerves again — a recurrent infection. (Winter and spring have large temperature changes, which is the high incidence of colds, so cold sores are also easy to attack at this time.) ）
At the time of the first infection (primary infection), some people are asymptomatic, but others may have all of their oral mucosa affected.
For example, primary infection in young children will cause herpetic stomatitis, starting fever, small blisters and ulcers of 2 to 10 mm in the front and surrounding parts of the mouth, tongue, and lips; adult symptoms are sore throat and swollen lymph nodes in the neck.
However, in recurrent infections, the scope is narrowed and may only occur in the mucous membrane of the hard palate; in older children and adults, it may only occur around the lip junction, with papules, blisters, and crusting, which usually resolve within 10 days. There are also people who have been carrying the virus but will not relapse.
▲What it looks like during the scab of cold sores (Image source: References[7])
Of course, there is also good news for you - after the age of 35, the onset of cold sores may become less common.
How is cold sores treated?
If you find symptoms of cold sores, you have to go to the hospital to see a dermatologist.
Since it is a viral infection, the main thing is to use antiviral drugs:
Oral medications: acyclovir, famciclovir, and valacyclovir (all prescription drugs), the most effective drugs available to people infected with HSV;
Topical: acyclovir cream (over-the-counter), docosanol cream (prescription).
These drugs can help reduce the severity and frequency of symptoms, but they still cannot completely eradicate the HSV-1 virus.
If the condition suddenly erupts and symptoms are severe and cannot be relieved by these drugs, the dermatologist may prescribe intravenous fluids, such as sodium foscarnet or cidofovir injection, which require close observation during the administration.
For patients with frequent relapses and weak immune systems, doctors may also prescribe topical spiroxylvir cream (prescription drugs), which can reduce the number of cold sore attacks.
In addition, if it is too painful, the doctor may prescribe docaine gel, local anesthesia to relieve pain.
What should I pay attention to in the life of people with cold sores?
During an episode of cold sores, patients can do these relief symptoms:
Sun protection: Regardless of whether the attack occurs or not, pay attention to the mouth sunscreen when going out, and apply sunscreen lip balm with a sunscreen index (SPF) of ≥30;
Wash your hands frequently: wash your hands with soap and water, especially before and after applying ointment;
Pain relief: if the pain, redness and swelling are unbearable, acetaminophen or ibuprofen can be taken (children can eat ibuprofen suspension), or ice to relieve the pain;
Wet compresses: To minimize redness and irritation, apply a clean, cold, damp towel to the affected area several times a day for 5-10 minutes;
Moisturizing: Drink plenty of water, to avoid dry and cracking skin, you can gently apply vaseline to the ulcer and surrounding skin.
These things can't be done:
Do not kiss or have intimate contact with anyone, before the cold sores is completely healed, avoid sexual life of the mouth;
Do not share with others anything that may have touched your affected area and saliva (such as ointment, towel, razor, toothbrush, cutlery or lipstick);
Do not share food or drinks;
Don't eat foods that are too sour, too salty, or spicy, such as tomatoes and citrus fruits (such as oranges and grapefruit), to prevent stinging in the mouth;
Do not apply the medicine when applying, it should be gently patted on, or gently smeared with a clean cotton swab;
Do not touch the affected area except when applying the medicine, and if you do, wash your hands with soap immediately.
Image credit: 123RF
If the patient has children at home, pay attention to these details:
Do not kiss the baby and feed mouth to mouth;
Wash your hands with hand sanitizer before holding your child;
If there is herpes on the breast of a lactating woman, do not feed the baby, do not indirectly milk the baby to avoid infection, and the breast pump should be thoroughly cleaned.