Please can we talk about how stressful cold sores are?
Fed up of the embarrassment of getting recurring cold sores? You are not alone. Here, a dermatologist gives us the facts on what causes cold sores, how we should treat them and the biggest misconception about them.
My friend recently returned from a date looking a little traumatised. Everything had gone very well until he saw she had a cold sore and freaked out. Furious at hearing this, but not completely shocked, my mind flashed back four years to the moment my then-boyfriend sent me away from his flat because I had a very obvious cold sore. “You could give me a lifelong disease!” he wailed, which in turn caused me to cry (you’ll be relieved to hear we broke up soon after).
Since then, I have been plagued by cold sore anxiety and admin. Last year, a slight tingle triggered me to cycle around all of Hackney’s pharmacists in the quest for cold sore cream so that it wouldn’t erupt on a date I had planned. And in those miserable, wintry days of the pandemic, I was thankful that I could hide my mouth behind a face mask.
I am not alone in feeling there is a stigma around cold sores, despite the fact that around one in five people in the UK have recurring cold sores.
“I’m always so embarrassed when I get them, even though my step-mum, housemate and best friend get them really badly,” Chloe tells me in our ‘Cursed by Cold Sores’ chat. “I guess I always wonder how seriously I should take them. My step-mum won’t drink from a glass without a straw when she has one in case she passes it on to any of us, and my housemate won’t kiss his girlfriend when he has one. Should I literally avoid contact with EVERYTHING?”
“I got my first cold sore about 10 years go,” Suzanne tells me. “The best remedy I actually found was Lysine tablets and cream from Holland & Barret – the enzyme that’s in milk. For me personally, it does really help. I didn’t have one for years but then, in lockdown last year, I got an almighty one – I think because of stress. It was so painful and big that, if we hadn’t been working from home, I don’t think I’d have gone into work. I get them when I’m run down and stressed, or if I have splits in my lips. I hate them. People are quite judgmental and say, ‘Urgh, you have a cold sore on your face.’ I cancel any social plans if I have one because you can’t cover them up and it does affect my self-esteem.”
Enough is enough. It’s time to break the stigma around cold sores, speak loudly about them, and get to the bottom of what causes them and how to treat them. In search of answers, I put all the big questions to dermatologist Dr. Hiba Injibar…
First things first: are cold sores different to genital herpes?
“A cold sore is a small blister that appears around one’s mouth. It’s caused by the virus herpes simplex which causes outbreaks of cold sores. Genital herpes is caused by a different strain of the virus and causes painful blisters and sores on and around the genitals.”
(It’s worth noting that, according to the World Health Organisation, herpes simplex is mainly transmitted by oral-to-oral contact to cause cold sores, but it can also cause genital herpes through oral-genital contact when you have a blister – so avoid.)
What really brings on a cold sore?
“They can be triggered by exposure to the wind or sun, by a cold or another illness, by a weak immune system, an increase in stress or a hormone change.”
Do cold sores really stick with you for life?
“Unfortunately, yes – cold stores are incurable although they can stay inactive for a long time.”
What’s the best treatment for when you feel a tingle?
“It’s important to start antiviral therapy medication (oral and/or topical) as soon as you feel a cold sore coming on, even if the blisters haven’t yet appeared.”
What is the biggest thing that people get wrong about cold sores?
“It’s natural to want to hide your cold sore with make-up but this might actually make it worse. Many cosmetics contain perfumes and other chemicals that can irritate damaged skin. People also frequently pick at blisters which may spread the virus, make the sore larger and mean that it takes longer to heal and can lead to a scar.”
Once a cold sore erupts, what can you do to make it feel and look better?
““Apply an over-the-counter antiviral cold sore medication at the first sign of a cold sore; take pain relief, such as Ibuprofen; apply ice or a cold, wet towel; and use moisturiser and sunscreen. Make sure you wash your hands every time you touch your face, try not to cover it with make-up and keep the area dry and clean.”
What can you do to avoid/minimise scarring?
“Use 1% otc hydrocortisone for a couple of weeks and if it’s still there, consult a dermatologist.”
Can you pass cold sores through shared glasses, knives and forks, towels etc?
“It’s unlikely but possible that the herpes virus will be shared by using the same glass, cutlery or straw so I’d recommend against sharing anything. If your sore is active, it’s particularly possible.”
The hard-to-swallow fact is: once you have the virus, you have it for life. Following Dr. Injibar’s advice above, there are ways to manage and minimise cold sores, which includes looking after your mental health (stress seems to be a big factor here).
Yes, they’re ugly and painful and very annoying. But they shouldn’t be something to be embarrassed about; it really is just a case of bad luck that affects and sticks with a lot of people. And if anyone says something to make you feel bad about having a cold sore, just tell them to grow up – they’re clearly not someone you want to kiss anytime soon anyway.
Check the NHS website for further information on cold sores.
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