Medical Q&As

Cold sores - keep recurring?

I have recurrent cold sores every month; most times in different spots. I have tried everything. Is there anything to prevent them or is this something I have to accept?

I assume that the cold sores you are referring to are occurring around your mouth and nose. This is a very common form of infection that can affect up to 25% of the population and for many people it is a most annoying recurring problem. The infection is caused by the Herpes Simplex Virus type 2 (HSV 2). The virus is acquired by contact with fluids from an infected person. For example, kissing, sharing drink from the same glass and touching the infected area can all result in transmission of the virus. Once a person becomes infected the virus remains dormant in nerve tissue under the skin and can erupt again weeks or months later. Some people may only experience one attack without further recurrences whereas others can experience relapses at regular intervals. Relapses of infection can be triggered by other infection, trauma, menstruation or even by stress. Some people experience relapses when the skin is exposed to strong sunlight. Avoiding triggers, such as physical or emotional stress, can minimize recurrent cold sore outbreaks. Very often the eruption of the cold sores is preceded by numbness or tingling around the area where the spots eventually appear. Topical OTC (over the counter) creams such as acyclovir (Zovirax) ointment can shorten the duration of the acute eruption and reduce the level of soreness associated with cold sores. There are several prescription treatments available that can be taken orally for more severe episodes of infection. Cold sores usually clear up completely without leaving a residual blemish on the skin. However, if they are scratched or picked they can become secondarily infected which could lead to minor scarring. There is no definitive cure that will rid you of cold sores for good because the virus remains dormant in your system once it has been acquired in the initial bout of infection.