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Herpes simplex (cold sores)

What is herpes simplex?

Herpes simple (cold sores) is a viral infection of the skin that causes two types of infection:

  • the classical cold sores on the lips and around the mouth
  • genital cold sores, which are spread by sexual contact

This pamphlet will consider cold sores on the face.

What are the symptoms?

This common infection is known also as 'fever blisters'. The first symptom is itchiness and tingling at the site of the developing infection, usually on the edge of the lips. Blisters soon appear and later burst to become crusted sores. The person usually feels unwell. The infection occurs only occasionally in some people but frequently in others.

How does herpes simplex develop?

It usually begins in childhood as a mouth infection. The virus then lives in the nerves supplying the skin or eyes, waiting for an opportunity to become active. It may erupt on any area of the body's skin or in the eyes. The following may precipitate eruptions:

  • overexposure to sunlight
  • overexposure to wind
  • colds, influenza and similar infections
  • heavy alcohol use
  • fever from any cause
  • the menstrual period
  • physical stress
  • emotional stress

Does it spread?

Herpes simplex is contagious. It is present in saliva of affected persons and can be spread in a family by the sharing of drinking and eating utensils and toothbrushes or by kissing.

It is most important not to kiss an infant if you have an active cold sore.

Is herpes simplex dangerous?

It usually presents no serious risk, but it can be very unpleasant for patients who have eczema. It also can infect the eyes, and can cause a serious ulcer on the cornea.

What is the treatment?

There is no special treatment; most sores heal and clear in a few days. They should be kept dry: dabbing them with plain alcohol will relieve itching and help keep them clean and dry.

When you feel them developing, the application of an antiviral ointment may help, but it must be applied early to be effective.

Notify your doctor if you have a persistent fever, pus in the sores or irritation of an eye.

How can it be prevented?

Those prone to cold sores should avoid overexposure to sun and wind. If you cannot, apply a sunscreen or zinc oxide ointment around the lips and other areas where cold sores have erupted previously.

Copyright 1995: John Murtagh, Professor of General Practice
Monash University, Melbourne, Australia

North East Valley Division General Practice, Victoria, Australia, Disclaimer 
Level 1, Pathology Building, Repatriation Campus, A&RMC, Heidelberg West VIC 3081. .. map
Phone: 03 9496 4333, Fax: 03 9496 4349,  Email: nevdgp@nevdgp.org.au
Please note: NEVDGP does not provide an on-line consultation

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