Cold Sores

Oral Herpes infection caused by the Herpes simplex virus is commonly known as ‘coldsores’. This is the most common form of the infection with the Herpes virus. Herpes virus alternate between active disease and remissions (state of absence of disease activity) and are uncomfortable for the sufferer as the active disease can last anywhere between 2 and 21 days. Given the obvious appearance and prominent location of the lesions, they make the infection of the sufferer obvious to other individuals who may come into contact with him/her. The virus is shed by the infected individual throughout the periods of active disease as well as during remission,that is, at all times once the infection has been acquired. Causes of the recurrence of the disease have yet to be determined accurately though a few potential triggers have been isolated.
It has also been noted that diseaseseverity and frequency also decrease over time. At present, there is no effectivecure for Herpes. However, medical therapy focuses on reducing the virulence of infectionand frequency of exacerbations.
How it spreads Herpes simplex virus can be transmitted by direct contact with an active lesionor the body fluids of an infected individual. Transmission can even occur through simple skin-to-skin contact even during periods of asymptomatic shedding.Certain barrier-protection measures have been found to be effective in preventing transmission,but are not absolutely effective.

Risk factors Some risk factors associated with the contraction and development of Herpes infectionincludes: poor hygiene, stress, overcrowding and lower economic status. Orofacial Herpes infection or cold sores This type of Herpes affects the face and mouth. Infection is caused by the virus coming in contact with the lining of the mouthor through abraded skin. Mostly, infections of the face and mouth are caused by the type 1 virus, thoughthe type 2 virus has also been known to cause these infections. This infection is usually without symptoms. However, when symptoms appear they tend to resolve within 2 weeks. The mainsymptom of this infection is an inflammation of the cheeks and gums. This first symptom usually presents within 5–10 days of infection. Othersymptoms also include painful ulcers, fever and sore throat. In addition, there can be difficulty in swallowing as well as swollen lymph nodesin the regions of the head, neck and axillae. This type of infection when causedby the type 1 virus is more prone to recurrence. Recurrence of infective symptoms is preceded by certain milder symptoms such astingling, itching and redness of skin around the affected area. The recurrent episode becomes full blown with the appearance of fluid-filled blisters,usually on the lip or at the lip–skin border. Why there is recurrence Following active Herpes infection, the viruses establish a presence inthe nerves. These viruses are then activated by certain triggers that may be causedby physical or psychological stressors. Even the changes that occur in the immunesystem due to the variation in Hormone levels can trigger an outbreak of the virallesions. Other infections in the body that cause fever can also cause a recurrence. It isbelieved that this association with other infections has led to these eruptionsbeing called the cold sore. Other causes for recurrence include local injury tothe facial tissues, exposure to wind or sunlight and even surgery. Managing recurrence It is advisable to start with antiviral treatment at the time when the warning symptoms of a recurrence set in. Even if one fails to prevent a recurrence, the lesions that develop will be fewer in number, less severe and painful and heal faster. In addition,subsequent outbreaks tend to decrease in frequency. This decrease in frequency has been attributed to the development of immunity to the virus.
Preventing infection Avoidance of excessive and potentially infective contact between an infected individualand an uninfected person is advisable. Even the use of barrier methods, such as condoms, is not completely effective atpreventing transmission of this virus. However, condoms when combined with antiviraltreatment of the uninfected partner have been found to have higher efficacy ratesat preventing transmission of the virus. Following sexual intercourse, the parts of the body that were not covered by thecondom and that may have come into contact with the skin and secretions of the infectedpartner will need to be cleansed well with water and soap. Women are more at risk of contracting this infection, and this is a fact that istrue for most sexually transmitted infections. The infection takes on a seriousdimension in pregnant women who become infected during pregnancy or in the thirdTrimester. For this reason, pregnant women who are Seronegative but have seropositivepartners are advised to avoid oral–genital contact with a partner postive for type1 virus and conventional sex with a partner infected with the type 2 virus. Mothers infected with Herpes virus and having active lesions at the time of laborwould be counselled to consider opting for an elective Cesarean section to reducethe risk of transmission to the infant. The necessity of a Cesarean section canbe avoided if the mother is put on antiviral medication from the 36th week of pregnancy.
Treatment Although there is no cure for this disorder currently, antiviral medicationscan be used to reduce the frequency, duration and severity of the outbreaks. Asthese antiviral agents also reduce the asymptomatic shedding of the virus, theyalso reduce the potential for infecting others. Antiviral medications that are availableas topical creams are ideal for reducing disease severity in individuals with recurrentoutbreaks on the lips. Dietary regulation Certain dietary supplements have beenfound to be effective in managing the course of cold sores. These include lysinesupplementation that can be used as a preventive measure as well as in treatmentof Herpes infection. Garlic has also been demonstrated as having as having an inhibitoryaction in Herpes simplex infections. Lactoferrin that is a component of whey proteinalso has a health-beneficial effect when combined with antiviral medications. VitaminsA, C and as well as zinc have had positive effects in the treatment of Herpes.