Cold sores are small, potentially painful blisters that can form around the mouth or lips. They are the manifestation of the herpes simplex virus which resides in our sensory neurones. Usually, this infection is life-long and there is no current cure to get rid of cold sores forever. Recent research has utilised novel techniques to eliminate the latent virus in our neurones.1,2 This could lead to similar techniques being used as cures for the herpes simplex virus. Therefore, this could get rid of cold sores forever.
This article will explore what cold sores are, what causes them, and how we might be able to get rid of them forever.
What is a cold sore?
Cold sores are a type of blister that is caused by the herpes simplex virus. They are usually preceded by a feeling of burning, tingling, or itching. This feeling is likely caused by the virus affecting sensory neurones. The blister will then start to form over the next 48 hours before breaking and scabbing over. Over the next 10 days or so, this blister will start to heal and disappear. However, while they heal, they may be irritating or painful. In addition, these blisters usually form around our mouths or face.
Cold sores can form throughout our lifetime and can break out more frequently in some people. There can also be more than one cold sore appearing at once depending on the severity of the outbreak. Usually, our first outbreak of the herpes simplex virus is the most severe and will grow more mild and infrequent over time.
Cold sore symptoms
As previously mentioned, cold sores are small blisters that can form around our mouths. They are accompanied by several symptoms as well. These symptoms include:
- Burning, tingling, or itching that precedes the cold sore in the area in which it will appear
- The small red blister is known as the cold sore
- Bursting of the blister which will scab over
- Irritation or pain in the area of the blister when it forms and while it is healing
What are the causes of cold sores?
Cold sores have one singular cause, the herpes simplex virus which exists in our sensory neurones. There are two known types of this virus named type-1 and type-2. Type-1 is the form of herpes that affects the mouth and the face and is the more common type. Type-2 is the form of herpes that affects the genitals. In addition, herpes is highly contagious and can be transmitted without symptoms though the greatest risk is when cold sores are present. This rate of transmission is referenced by the fact that it is estimated that 3.7 billion people under the age of 50 have herpes simplex type-1.4 The route of transmission is by skin contact and herpes type-1 is usually acquired during childhood. For example, simply an auntie kissing a newborn is enough to transmit the virus.
There are several ways by which you can prevent getting herpes if you don’t already have it. For oral herpes, you should minimise oral-to-oral contact and the sharing of objects that are contaminated with someone else’s saliva. For genital herpes, you should avoid oral, genital, and anal sex and use protection such as condoms if you do. You should be extra careful if you are a woman as male-to-female transmission occurs more easily.
Cold sore risk factors
Everyone is at risk of being infected with the herpes simplex virus but there are some factors that have been found to increase the risk of being infected. One study found that risk factors include increasing age, lower socio-economic status, and lower levels of educational attainment.5 In addition, once you are infected, there are several risk factors that can trigger the development of cold sores. These risk factors include:
- Another infection, fever, or cold
- Sun exposure (e.g. outdoor job)
- Mental stress (e.g. fatigue)
- Menstruation
How to get rid of cold sores forever
Currently, there is no way to get rid of cold sores forever. They are a lifelong condition that presently has no known cure. This is due to the ability of the virus to reside in a latent form within sensory neurones.3 However, there is hope that a cure may be produced in the future. Studies have been performed that have been able to remove a significant amount of the virus in animal models.1,2 Using novel approaches, researchers can edit the genetic code of the virus causing a disruption or elimination of the virus. Therefore, this would lead to a decrease in the reactivation of the virus, leading to cold sores or even possibly curing the virus. However, this approach is not perfect and only eliminates 90% of the virus. It still needs work before it can completely cure the virus.
How to maximize hygiene and minimize infections
Treatment and Prevention
While a cure may be here yet, there are still several treatment options for those with cold sores. One treatment option is the prescription of antiviral drugs which fight the virus. These will decrease the severity and the frequency of cold sores but not completely get rid of them. These can be taken when the sore appears or continually to prevent the sore from appearing. In addition, a doctor may give patches that are applied to the cold sore to help with the healing process. However, without treatment, the cold sores will usually clear up within 10 days.
As previously mentioned, there are several ways to prevent infection of cold sores. To reiterate these include:
- Minimising oral-to-oral and avoiding objects that have touched someone else’s saliva
- Minimising sexual contact and wearing protection during intercourse
When to seek medical attention
Treatment for herpes should always be sought if it is suspected. If you have consistent tingling feelings in one area and a previous history of cold sores then you should seek a doctor. They will be able to provide you with treatment to minimise the pain or irritation from the cold sore. In addition, you should be able to seek a sexual health clinic if you believe you have genital herpes.
Summary
Cold sores are a surprisingly common infection,n, with around 3.7 billion people living with herpes simplex virus type-1. They are small blisters that can cause irritation and pain but will usually clear up after 10 days. There are treatment options available in the form of antiviral medicine and cold sore patches but they do not cure the infection. However, new approaches to curing the disease may be on the horizon and we might see a cure that gets rid of cold sores forever in our lifetime.
References
- Aubert M, Strongin DE, Roychoudhury P, Loprieno MA, Haick AK, Klouser LM, et al. Gene editing and elimination of latent herpes simplex virus in vivo. Nat Commun [Internet]. 2020 [cited 2023 Mar 2]; 11(1):4148.
- Yin D, Ling S, Wang D, Dai Y, Jiang H, Zhou X, et al. Targeting herpes simplex virus with CRISPR-Cas9 cures herpetic stromal keratitis in mice. Nat Biotechnol [Internet]. 2021 [cited 2023 Mar 2]; 39(5):567–77.
- Nicoll MP, Proença JT, Efstathiou S. The molecular basis of herpes simplex virus latency. FEMS Microbiol Rev [Internet]. 2012 [cited 2023 Mar 2]; 36(3):684–705.
- Wald A, Corey L. Persistence in the population: epidemiology, transmission. In: Arvin A, Campadelli-Fiume G, Mocarski E, Moore PS, Roizman B, Whitley R, et al., editors. Human Herpesviruses: Biology, Therapy, and Immunoprophylaxis [Internet]. Cambridge: Cambridge University Press; 2007 [cited 2023 Mar 2].
- Forbes H, Warne B, Doelken L, Brenner N, Waterboer T, Luben R, et al. Risk factors for herpes simplex virus type-1 infection and reactivation: Cross-sectional studies among EPIC-Norfolk participants. PLOS ONE [Internet]. 2019 [cited 2023 Mar 2]; 14(5):e0215553.
