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Sunday, December 21, 2014

Dr. Pegs Prescription

Oral herpes painful and a pain but manageable

Does this sound familiar? A round, raw-looking sore on the edge of the lip, right where the lip meets the face. You have probably seen this on someone, perhaps even on yourself. Commonly called a cold sore, or a fever blister, it is actually neither. This is not caused by cold weather, a cold, or a fever. It is actually caused by a virus: herpes simplex, to be precise.

The medical term for “cold sore” is “oral herpes.” Like any virus, Herpes simplex is contagious. Oral herpes is usually passed by direct contact such as kissing or oral sex, but it can also be passed by sharing items like razors or towels.

It is pretty easy to diagnose just by looking at it. Oral herpes is extremely common. You might think you have never had a cold sore, but you could be mistaken.

The American Social Health Association asserts that “50-80% of the adult population in the United States has oral herpes, with as many as 90% having the virus by age 50.” Most of us get it as children, when some well-meaning but infected relative gives us a smooch and a squeeze.

Now, to cut Aunt Blanche some slack, she probably didn’t have a nasty, oozing sore when she kissed you. The problem is she could have passed it along to you even without an active sore, or outbreak.

Once it gets under your skin, herpes takes up residence deep in the root of a nerve. It can stay there forever without ever coming out, or it can venture up to the surface and wreak havoc. Unfortunately, before the havoc arises — that is, you get an actual sore — you can still shed viruses and be contagious.

Some people can tell they’re about to have an outbreak because they feel tingling or pain at the site. Triggers for the virus to make a surface foray include sunburn, stress, illness, lack of sleep … yes, basically the college lifestyle. Students may have more outbreaks than other, less stressed adults, even if the infection rate is the same.

How can you keep from getting oral herpes? Stay away from Aunt Blanche! Just kidding, mostly, but you shouldn’t be kissing anyone with a sore on their lip, or letting them kiss you. Anywhere.

Herpes simplex comes in two subspecies — type I and type II. Type I generally prefers lips, and type II usually prefers genitals, but they are adaptable. Either type can live in either place. And either type can be passed from one place to the other.

The good news about oral herpes is that it causes a sore and that’s all. Yes, it takes up residence in your body for life, but it doesn’t damage your internal organs, cause cancer, or kill you.

Ever since HIV has come on the scene, herpes seems a lot less of a big deal.

The other good news is that many people “grow out of” cold sores. They may have outbreaks for several years after the Aunt Blanche episode, but stop having them by the time they’re adults. Adults who catch the virus may notice that their outbreaks diminish over time and eventually stop.

If you develop a cold sore, know that it will clear up in about a week. In the meantime, try to keep your hands off the sore, avoid kissing and performing oral sex, don’t share eating utensils or cups, and wash your hands often. Take a pain reliever if needed, and apply ice or warm compresses, whichever feels better.

You can ask your pharmacist for topical creams or ointments to soothe your discomfort, or you can come to Student Health and Counseling (SHAC) for a prescription for antiviral medication.

These medications can decrease the severity of the symptoms and shorten the duration of the outbreak. Call 277-3136 for an appointment.

Dr. Peggy Spencer is a physician at Student Health and Counseling. She is also co-author of the book “50 Ways to Leave Your 40s.” Email your questions directly to her at pspencer@unm.edu. All questions will be considered, and all questioners will remain anonymous.