People's Pharmacy: What to do about cold sores

By Joe Graedon, M.S., and Teresa Graedon, Ph.D. King Features Syndicate - Published: December 10, 2013 | 12:00 pm 0

When the sniffle season arrives, cold sores might accompany it. Cold sores, fever blisters or the more technical herpes labialis - regardless of the terminology, these red, painful spots are unpleasant. The lesions usually appear on the outer edge of the lips. They hurt and they look bad.

A person with a cold sore has lots of company. An estimated 80 percent of adults carry the herpes simplex 1 virus in their body, and a majority probably acquired the infection in childhood through contact with an infected parent.

Once a person has the virus, he or she does not need to have a visible lesion to be shedding and therefore spreading it with a kiss. It does make sense to avoid direct contact with an active lesion. Don't share drinking glasses, spoons or toothbrushes with someone who has a cold sore.

Some people hardly ever have cold sores even though they carry the virus, while others suffer frequent outbreaks. The first sign is tingling or itching on the spot where the blister will appear. Medication and remedies work best if started during this initial ("prodrome") stage.

The popular names for this condition, "cold sores" and "fever blisters," suggest some of the common triggers of recurrence. Colds, fevers, excessive sun or wind exposure, menstrual periods, surgery and extensive dental work all have been known to bring on an outbreak.

What can be done to treat a cold sore? Your health care provider could prescribe a topical cream, such as acyclovir (Zovirax), penciclovir (Denavir) or Xerese, a combination of acyclovir and hydrocortisone. There also is an over-the-counter cream called docosanol (Abreva).

Prescription pills include acyclovir, famciclovir (Famvir) and valacyclovir (Valtrex). Even the generic versions are a bit pricey, though, ranging from $1.50 to about $4 per pill.

As a result, some prefer to use home remedies to treat cold sores when they appear. Ice might ease the discomfort: "As soon as I get that familiar tingling, I apply cold. Ice wrapped in a cloth or a package of frozen veggies pressed to the spot for about an hour or so takes the problem away."

Another favorite remedy is kiwi fruit: "This has been a total magic bullet for me. At first tingling, I eat two kiwis; then one a day until it disappears."

Probably the most popular cold-sore remedy is l-lysine. Some readers report that taking 500 mg daily of this amino acid can prevent outbreaks, especially if they also avoid nuts and chocolate. L-lysine is being considered to prevent fever blisters in burn patients (Journal of Burn Care and Research, November-December 2013).

Other approaches nclude lemon-balm ointment (Melissa officinalis) or the bee product propolis (Phytomedicine, February 2010).

Zinc-oxide cream also might offer quicker healing of fever blisters (Alternative Therapies in Health and Medicine, May-June 2001).

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Joe Graedon is a pharmacologist. Teresa Graedon holds a doctorate in medical anthropology and is a nutrition expert.

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