Doctor Dear

I’ve been having cold sore since I was eight or so years old. It’s like a “normal” happening for me, usually surfacing during summer, when it’s way hot. No big deal, it just disappears after a while, anyway, with me not even having the need to do anything. I was recently told (and by a date at that!) that what I have is actually herpes, which isn’t really what you want a date to tell you. Was he truthful, or is this just his was to tell me he doesn’t like me?

A few weeks back, these blister-like thingies started growing just under my nose. They weren’t itchy or anything, but I pricked them anyway, causing the water in them to just flow. Now, as the wound I may have made starts to dry off, even more of the blister-like thingies grow around those I’ve already pricked. What are these?

I only recently started having cold sores. And while I know how I got them (i.e. that cute guy I picked in Bed who attributed that wound-like thing on his lip due to accidental biting), I don’t know how to deal with them. Some help please...

Cold sores, these are what you have.

Cold sores – those “small, painful, fluid-filled blisters or sores that appear on the lips, mouth, or nose,” states emedicinehealth.com. Cold sores are caused by the herpes simplex virus of HSV, type I or II (though usually, type I), with infections “categorized into one of several distinct disorders based on the site of infection, i.e. oral herpes, colloquially called cold sore, which infects the face (including mouth, nose, et cetera); genital herpes, or just herpes, which infects the genitals, obviously; herpetic whitlow, a painful infection usually affecting the fingers or thumbs, or on the toes or nail cuticle; herpes gladiatorum, commonly spread among those participating in contact sports, with the symptoms including skin ulceration on the face, ears, and neck, as well as fever, headache, sore throat, and swollen glands; and ocular herpes, a special case also known as herpres keratitis, which affects the epithelial cells on the surface of the eye and retrograde infection of nerves serving the cornea.

For this discussion, the focus is on herpes simplex a.k.a. cold sore.

Not “typically life-threatening for immunocompetent people (e.g. people with HIV and AIDS),” states Wikipedia.org, herpes simplex is, unfortunately, “not completely eliminated by the body’s defences, (and) for this reason, often recur in “more or less the same place. Such recurrences may happen often (for example, once a month) or only occasionally (for example, once or twice a year),” adds emedicinehealth.com.

How this affects the body is, after the first infection, “the virus enters the nerve cells and travels up the nerve until it comes to a place called a ganglion. There, it lays quietly in a stage that is called a ‘dormant’ or ‘latent’ period. At times, the virus can start multiplying again and travel down the nerve to the skin, causing new cold sores. The exact way this happens is not clear, but it is known that some conditions seem to be associated with recurrences, including fever, colds, or the flu (thus it’s also called fever blisters); ultraviolet radiation; stress; changes in the immune system; hormonal changes; and trauma to the skin. However, sometimes, there is no apparent cause of the recurrence.”

Worse, infections are contagious – the virus is “spread from person to person by kissing or other close contact with sores, or even from contact with apparently normal skin that is shedding the virus. Infected saliva is also a means of transmitting the virus,” emedicinehealth.com further adds.

As there currently is no cure for herpes simplex (not even a vaccine is available), treatments are, fortunately, on hand.

Even if they only providing symptomatic relief, there are over the counter (OTC) topical (creams or ointments rubbed directly on the sore) medications, such as benzocaine (5% to 20%), lidocaine (0.5% to 4%), tetracaine (2%), or dibucaine (0.25% to 1%) – brand-specific, there are Abreva (docosanol, 10% cream) and Zovirax (acyclovir, 5% cream).

The thing with cold sore is, even if avoiding those that supposedly trigger it, doesn’t prevent outbreak; nor does taking medication frequently. It usually is treated as it happens.

If attacks are severe – or if in doubt – contact a doctor (especially for those with immune weak systems).

Dr. Dear is, obviously, a doctor of sorts, and is the regular medical voice of the gayzine. Ask, he said, and you'll get your answers “in print so everyone can share – and perhaps even learn from what it is you want/need to know about.”