How to Treat a Cold Sore or Fever Blisters

Steps

1. Make sure you have cold sores. A cold sore is the same as a fever blister, but it is not the same as a canker sore. Canker sores are mouth ulcers that occur inside the mouth. While cold sores may on occasion develop inside the mouth, they are usually smaller than canker sores, and they start as blisters. Canker sores are not contagious, and they are not caused by a virus, so treatment differs from that for cold sores. Check with your doctor, who can determine which problem you have either by looking at it or performing a test.
2. Recognize the signs of an impending outbreak. Before you can actually see a cold sore, you will probably be able to feel a slight tingling or burning somewhere around your mouth where the cold sore will erupt. You may also be able to feel a small bump or hardness in the skin at this point. The earlier you can detect an outbreak, the quicker you can take action to hasten your recovery.
3. Quarantine your sore at the first sign of an outbreak. The herpes simplex virus is highly contagious, so avoid kissing or other mouth-to-body activities at any time during an outbreak. Also avoid sharing utensils, cups, or straws with other people, and wash dishes and utensils thoroughly with disinfectant soap. Wash your hands frequently, and try to avoid touching the sore. If you touch the cold sore, you can then spread it to other people or to other places on your own body, such as the eyes and genitals. Gently washing the blisters with soap and water may also help to prevent the spread of the outbreak.
4. Change your toothbrush at the onset of an outbreak. Your toothbrush can keep reinfecting you, so throw it away when an outbreak starts. Use another toothbrush for the duration of an outbreak, and then throw that one away as well.
5. Take an antiviral medication. A few prescription antiviral medications, such as Penciclovir, Acyclovir, and Famciclovir, have been approved for treatment of herpes simplex outbreaks. These medications do not cure herpes simplex, and they have not been shown to be effective in preventing outbreaks, but they can speed up healing and reduce the severity of an outbreak. They are generally most effective if you start taking them as soon as you notice the first signs of an impending outbreak. If you have very frequent outbreaks, your doctor may prescribe these medications to be taken daily, even in the absence of symptoms, to suppress future outbreaks. Suppression therapy may be effective for some people, but clinical studies have not shown widespread success.
6. Treat the fever. As the name fever blisters suggests, cold sores are sometimes accompanied by a fever, particularly in younger children. If fever is present, use fever-reducing medications such as acetaminophen, and monitor the fever carefully. Antiviral medications may also reduce fever.
7. Ease the pain. Over-the-counter cold sore creams may help to ease the pain of cold sores, as may painkillers such as aspirin, acetaminophen, and ibuprofen. It's important to note, since cold sores often affect young children, that aspirin should generally not be given to young children because of the risk of Reye's syndrome, a rare, but potentially fatal disorder.
   
   
   • Icing the sore can be an effective temporary pain reliever. Use an ice pack, rather than touching ice directly to the sore, and keep moving the ice around. Do not ice for more than 10-15 minutes at a time. Applying heat to the sore may also provide relief.
   • A room-temperature compress of whole milk may ease the pain and speed healing. Be sure to wash the area after applying the compress.
8. Be patient. The outbreak should go away in 2 weeks or less, and until then, there's not much you can do. Avoid squeezing or picking at the sores, as this will only slow their healing.
9. Seek medical advice if you have a compromised immune system or if you experience a particularly severe outbreak, a fever that won't go down, an outbreak lasting more than 2 weeks, or irritation of the eyes. Some outbreaks can be serious. People with already-weakened immune systems are at particular risk of long-term complications or even death from a herpes outbreak. Herpes infections in the eyes are one of the leading causes of blindness in many countries, so be very careful not to spread the infection to your eyes, and if you have any irritation in the eyes, see your doctor at once.

Tips

• Herpes simplex outbreaks, and hence cold sore outbreaks, are believed to be triggered by certain things in certain people. It has been determined that wearing sunscreen on the lips and other vulnerable areas help prevent outbreaks in people whose outbreaks are triggered by sun exposure. It is also believed that stress may cause outbreaks in some people, and so practicing relaxation techniques to reduce stress levels may ward off outbreaks for these people. A weakened immune system probably allows outbreaks in general, so it's a good idea to try to stay as healthy as possible by eating right, exercising, and avoiding allergens, drugs, and excessive alcohol consumption.
• Some research has connected herpes outbreaks with the amino acid arginine, which is found in foods such as chocolate, cola, peas, cereals, peanuts, gelatin, cashews and beer. The evidence isn't conclusive at this point, but if you have frequent outbreaks, you may want to try limiting your consumption of these foods and eliminating consumption during outbreaks.
• It is possible that the amino acid lysine may help prevent outbreaks. If you experience frequent outbreaks you may want to try taking a lysine supplement daily. While the scientific tests are still inconclusive, it does seem to work for some people.
• An internet search for cold sores or fever blisters will turn up a multitude of home remedies, from vitamin supplements to poison ivy! As with any condition, naturopathic remedies may indeed be effective for some people, but they can also occasionally be dangerous. Use your common sense, and consult your doctor when in doubt.

Warnings

• This article is a general guide only and is not intended to substitute for professional medical advice. Herpes simplex can be a very serious condition, and it's important to consult with your doctor about treatment options.
• Herpes simplex type 1 causes most cases of cold sores, but herpes simplex type 2 (genital herpes) can also cause them on occasion.
• An outbreak may remain contagious even after all the sores are healed. Occasionally, cases of herpes are transmitted without any signs of an outbreak being present.