From the Guidelines
Oral cold sores, also known as fever blisters, are small, painful fluid-filled blisters caused by the herpes simplex virus type 1 (HSV-1), which is highly contagious and spreads through direct contact with infected saliva or skin, as stated in the study by Cunningham et al. 1. The primary cause of oral cold sores is HSV-1, but the epidemiology has changed dramatically in recent decades, with HSV-1 infection becoming the most common cause of primary genital HSV infections, according to the study published in the Journal of Clinical Virology 1. Some key points about oral cold sores include:
- They are highly contagious and spread through direct contact with infected saliva or skin
- The virus remains dormant in nerve cells and can reactivate periodically, causing recurrent outbreaks
- Common triggers include stress, illness, fatigue, sun exposure, hormonal changes, and weakened immune system
- Cold sores typically progress through stages: tingling or burning sensation, blister formation, ulceration when blisters burst, crusting as they dry out, and finally healing
- Most cold sores heal within 7-10 days without treatment, though antiviral medications like acyclovir (Zovirax), valacyclovir (Valtrex), or famciclovir (Famvir) can reduce healing time and symptom severity when started at the first sign of an outbreak, as discussed in the study by Cunningham et al. 1. It is essential to note that the aim of antiviral therapy is to block viral replication to enable shortening the duration of symptoms and to accelerate healing of the lesions associated with herpes labialis, as stated in the study published in the Journal of Clinical Virology 1. To prevent spreading the virus, it is recommended to:
- Avoid kissing or oral contact during outbreaks
- Don't share items that touch your mouth
- Wash hands frequently after touching a cold sore The most effective way to manage oral cold sores is to start antiviral therapy as soon as possible, ideally within the first 24 hours of onset, to reduce the duration and severity of symptoms, as recommended by Cunningham et al. 1.
From the FDA Drug Label
Patients should be advised to initiate treatment at the earliest symptom of a cold sore (e.g., tingling, itching, or burning). There are no data on the effectiveness of treatment initiated after the development of clinical signs of a cold sore (e.g., papule, vesicle, or ulcer).
The definition of an oral cold sore is not explicitly stated in the provided drug labels, but it can be inferred that it is a condition characterized by symptoms such as tingling, itching, or burning, which may progress to papule, vesicle, or ulcer stages. The cause of oral cold sores is not directly stated in the provided drug labels, but it is implied to be related to the herpes simplex virus (HSV), as the drug labels discuss the treatment of herpes labialis (cold sores) with valacyclovir, an antiviral medication 2, 2.
From the Research
Definition of Oral Cold Sore
- An oral cold sore, also known as herpes labialis, is a viral infection caused by the Herpes Simplex Virus (HSV) 3, 4, 5, 6, 7
- It is characterized by the appearance of watery blisters on the skin, lips, tongue, buccal mucosa, or genitals 3
Cause of Oral Cold Sore
- The primary cause of oral cold sore is the Herpes Simplex Virus (HSV), mainly HSV-1 3, 4
- The virus can be acquired in the absence of visible signs and symptoms, yet still result in lifelong infection 4
- Once the HSV virus enters the human body, it cannot be completely eradicated because HSV viruses are able to change into their latent form, which can survive treatment 3
- The virus resides in the trigeminal ganglia of the host, making the host vulnerable to the reoccurrence of the disease throughout their lifespan 3