If you’ve had cold sores before, that tingling feeling in your lip usually only means one thing: a new bunch of blisters is set to erupt.
Cold sores are usually caused by herpes simplex virus type 1, a strain closely related to the type 2 bug responsible for causing genital blisters spread by sexual contact. Cold sores on the lips are mostly spread through casual skin-to-skin contact, but oral sex can spread genital herpes to the mouth.
Cold sores are uncomfortable and can also be unsightly. The good thing is that they’ll usually clear up on their own in two to four weeks. The not-so-swell part? You’ll be sporting some red, oozing, and then crusting blisters on your mouth until then.
Once you pick up the cold sore virus, it sits dormant in your nerve cells until a trigger —say, stress, an illness, or hormone changes — prompts it to rear its ugly head again. So the best way to avoid an outbreak is to reduce your exposure to certain triggers. If you already have a cold sore, don’t worry—we’ve got you covered. Follow these tips below to send your cold sore packing.
1) Catch it early.
Cold sores aren’t a wait-and-see condition: Early diagnosis is the best way to put the brakes on their arrival.
“You can actually keep them from breaking out, or perhaps keep them from breaking out as badly as they otherwise would,” says Bruce Robinson, M.D., a dermatologist in private practice in New York City and clinical instructor of dermatology at Lenox Hill Hospital.
Be on the lookout for what the docs call the “prodromal stage,” including symptoms like tingling, itching, inflammation, or soreness in areas where the sores will later break out. If you feel anything funny, call your doc to start treatment.
2) Try an antiviral.
Topical over-the-counter meds don’t work as well as prescription antivirals, says Robinson. Over-the-counter creams may provide relief from the tingling and burning, but they aren’t the best option if you want sores gone fast.
The best way to treat cold sores is to start treatment early in that prodromal stage, with a prescription oral antiviral medication like valacyclovir (which you probably know as Valtrex), says Lorraine Young, M.D., co-chief of dermatology clinical services at UCLA.
A common regimen is to take 2,000 milligrams in the morning and again later on in the day. This “decreases the virus from replicating, so then it will help it to heal faster,” says Young.
Preventing the virus from replicating prevents it from going through its normal course. The result? It can reduce the time it takes your blisters to heal—or even prevent them from appearing in the first place.
3) Add a steroid cream
If your doctor prescribes oral antiviral meds, you might benefit from including a topical steroid cream treatment too, says Young.
This can help reduce the inflammation associated with the sores, which can make the pain, redness, and irritation feel a little bit better.
Important note: Steroid creams are only an option if you’re on the antiviral drugs. That’s because steroids decrease your body’s ability to fight infections.
“If you just did the cream without viral therapy, you would be feeding the cold sore infection,” says Young. “But if you’re on the antiviral medicines, that could help decrease the symptoms.”
4) Make your own cold sore solution.
Robinson advises making a solution with Domeboro, a powder used to help with skin irritation. Available at the drugstore, dissolve the tablets or packet of the powder in about 12 to 16 ounces of water. You’ll notice some gunk at the bottom of the glass—that’s okay.
Then dunk a thin cloth, like a handkerchief or pillowcase, into the glass. Wring it out and lay it on the blistering area for about 15 to 30 minutes. Repeat two to three times a day until the sores dry out. Be sure to make a new batch of the solution each time.
“It sucks the moisture and water out of the blister,” says Robinson. “I can get someone who has an outbreak to scab within 3 days using that—which otherwise might take a week to 10 days.”
Once it’s dry, stop the soaks and keep the area moist with a topical antibiotic ointment like Neosporin. This helps prevent secondary bacterial infection and aids the healing process.
5) Use cold compresses.
Reduce swelling and irritation with a cool, wet towel. The American Academy of Dermatology recommends using a cold compress for 5 to 10 minutes several times a day while you’re waiting for blisters to heal. Avoiding particularly acidic foods like tomatoes and oranges helps keep irritation to a minimum, too.
6) Don’t touch them — ever.
Those red cold sore blisters are packed with fluid, making them prime for popping. Don’t do it.
“People pick at anything on their skin, so it can be tempting to do that,” says Young. “But anytime you do that, it can get secondarily infected.” And that’s bad news: Bacterial infections can make the sores stick around longer, and picking at a bad infection can lead to scarring.
7) Identify your triggers.
If you’re prone to cold sores, the virus that’s hibernating in your cells is more likely to emerge when you’re stressed out, sick, or if your skin is dry.
Sun is also a major factor that can set off an outbreak.
“Our immune system is compromised to some degree by ultraviolet light,” says Robinson. This means you’re less likely to fight off infections.
Your move? Slather on sunscreen with an SPF of at least 30 before going outside. And don’t forget to slap on some Chapstick as well.
8) Use aloe vera.
While it won’t zap cold sores overnight, aloe vera has been found to reduce the pain associated with cold sores. It also contains vitamins A, C, and E, which may help to expedite the healing process.
9) Avoid acidic or spicy foods.
While you’re recovering from a cold sore, it’s probably best to lay off the hot sauce for a while. Try to avoid hot and spicy foods, particularly if your sores are still open and haven’t scabbed over yet. The same goes for acidic foods, like pineapple, tomatoes, and citrus fruit.
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