How many people get cold sores? Dr. Benjamin Barankin responds to popular questions about those uninvited lip guests
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A lot of this time, I write about what interests me, and this unfortunately is no exception.
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On Christmas Eve, my boyfriend mentioned I had a small pimple on my lip. That immediately drew my attention to a familiar feeling — a tingling sensation at the corner of my mouth.
I’ve had cold sores for as long as I can remember and know about a prescription drug that when taken within the first signs of a cold sore can hinder its growth. However, many pharmacies are closed on Christmas Day. I drove to the closest open pharmacy which was 45 minutes away as I know what can be unleashed on my face if I don’t take valacyclovir, the antiviral medication used to treat herpes, within the first signs of a cold sore.
I connected with Dr. Benjamin Barankin, a renowned Toronto dermatologist and medical director and founder of the Toronto Dermatology Centre, to discuss facts about cold sores, some more fun than others. To learn how to prevent outbreaks, what to do once one occurs and more about cold sores, read the full interview below.
Q&A with Dr. Benjamin Barankin about cold sores
Q: What causes a cold sore?
A: A cold sore, also referred to as a fever blister or medical term herpes labialis, is a common sore most commonly noted around the mouth or lips due to the herpes simplex virus.
Q: What causes a flare-up of a cold sore?
A: The most common triggers are: stress, fatigue, illness, too much sun, hormonal changes (e.g. pregnancy, premenstrual) and surgical or other trauma to the typically affected area.
Q: How do I prevent cold sores?
Q: Knowing that cold sores come from the herpes virus, can mouth herpes spread to the genitals and vice versa? If so, how do I prevent the spread?
A: Yes, there are two types of herpes simplex virus (usually HSV1 on lips/mouth and HSV2 around genitals). HSV1 can be spread to the genitals through oral sex, and much less commonly HSV2 can cause sores on the mouth and lips.
Q: Once I have a cold sore, how long do I wait before kissing/sharing drinks, etc.?
A: Avoid kissing, sharing utensils, oral sex etc. during the entire process of a cold sore developing and healing. So, from initial tingling or discomfort until the scabs come off — which is typically about two weeks.
Q: Will cold sores scar? If so, how do I prevent scarring?
A: Cold sores don’t usually scar. However, if the outbreak is large or longer-lasting, or very frequent, or if the area is picked at, or gets infected or traumatized, then mild scarring is more likely.
Q: Do topical cold sore treatment work? If so, which ones?
Q: What’s the best prescription to get for cold sores? When should I take the medication?
A: If less than six episodes per year, then you can treat episodically at the earliest tingle/burning/itching, discomfort or skin change. Valacyclovir is used most commonly. If more than six episodes per year, then we are more likely to recommend you take valacyclovir as a daily preventative therapy. This is a very safe treatment.
Q: Are there any surprising facts about cold sores? If so, what are some?
A: The sooner you apply a topical or take the oral medication, the more effective the response.
Two-thirds of people have HSV1, but less than one in 10 recall ever having a cold sore. Thankfully, if there are no symptoms or rash, the risk of asymptomatic transmission is incredibly low.