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The disorder is characterised by groups of fluid-filled blisters which appear on red swollen areas of the skin or on the mucous membranes. The areas can be tender and painful. The blisters heal without scarring but have a tendency to recur.
What causes the virus?
The virus can only be transmitted by close personal contact such as kissing. Most people will have come into contact with the virus between the ages of three and five but will not show any symptoms until after puberty.
HSV invades the cells of the epidermis, the outer layer of the skin, causing fluid-filled blisters to appear. The virus travels from the epidermis along the nerve paths to the roots of the nerves where it becomes inactive.
A weakening of the body's defences, due to a severe cold for example, can lead to a reactivation of the virus and a return of the blisters.
What are the symptoms?
The primary infection can progress in different ways. Some people only have very mild symptoms or none at all. The first outbreak starts one to three weeks after the virus has been contracted. It subsides spontaneously within a few weeks. Later, if HSV is reactivated, the blisters will return.
The first symptom of an outbreak is an unpleasant tingling feeling in the skin. After a short while, a number of fluid-filled blisters appear.
The sores become covered by scabs that, typically, fall off after 8 to 10 days. The virus can spread until the sores are completely covered by scabs.
Around 20 per cent of the people with HSV antibodies have recurrent attacks of cold sores throughout their lives.
In children, the virus can infect the mouth and throat. The infection may be accompanied by a fever and general aches and pains.
What can be done to prevent cold sores?
How are cold sores diagnosed?
A combination of the patient's medical history and the appearance of the sores will usually be sufficient for a diagnosis. A scrape or a blood sample can be used to confirm it.
Possible complications
How are cold sores treated?
Treatment is aciclovir 5 per cent cream (eg Zovirax cold sore cream), applied to the cold sore five times a day for five days. This can be bought over-the-counter from a pharmacy or obtained on prescription.
The treatment should be started as soon as the first symptoms appear. It can often reduce the length of the outbreak and the infectious period.
Recurrent severe attacks can be treated by anti-HSV agents in pill form.
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