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New Treatments For Cold Sores

If you have a cold sore, you are not alone. Nearly 70% of Americans aged 12 and over have positive for HSV-1 (the cold labile-causing virus). Recurrent cold sores occur in at least 20% of HSV patients.

HSV-1 is transmitted through direct contact with infected skin or saliva. Primary infection usually occurs in childhood, causing gills that cause fever, gum pain, sore throat and neck swelling or tenderness. Afterwards, the virus remains dormant in the nerve roots near the infected skin. In some people, the virus rarely reactivates. But in others, relapse, known as secondary herpes, often produces cold sores. Although medical experts have not yet determined the exact cause of activation, a variety of stimuli, such as stress, dental instruments treatment, disease, lip trauma or sun exposure, can trigger an outbreak.

Dr. Joel Laudenbach, an assistant professor and senior director of dentistry at Columbia University School of Dental and Oral Surgery, said: "Although there is no cure for cold sores, there are drugs that can be used for both treatment and prevention.

The three oral antiviral agents that are sometimes prescribed are Zovirax, Famvir and Valtrex. Although neither of these drugs can eliminate a dormant HSV-1 infection that causes cold sores, they help the ulcer heal faster and relieve the associated pain and discomfort. They can also help suppress the onset of a cold.

These medications can also help prevent cold sore outbreaks during increased susceptibility, such as beach or ski vacations, which will involve a wide range of sun exposure. In addition, recent studies have shown that the use of valacyclovir before certain dental procedures can help reduce recurrent eruptions. Other treatments include topical antiviral creams and salves, such as Denavir creams. Some studies show that penciclovir seems to reduce the average size and duration of cold sores.

It is reported that penciclovir should be used as soon as possible after symptoms (pain, stinging, itching, burning or blistering). Although the recommended dose varies from one individual to another, the average adult dose requires cream to be applied to the affected area every two hours while sober for four days.

Topical acyclovir ointment can also be used for the symptoms of HSV infection on the skin, mucous membranes and genitalia.

Dr. Laudenbach said cold sores and aphthous ulcers are not the same. Oral ulcers occur only in the mouth, not caused by the virus, nor contagious. Cold sores usually occur outside the mouth and are caused by the virus (herpes simplex virus [HSV-1]) and are contagious, he said. Since aphthous sores are not caused by viruses, antivirals and dental equipment do not effectively treat them.

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