Dear Dr Peg,
What is the fastest way to get rid of a cold sore when it is already on your lip? Please help. My social life is suffering and my boyfriend threatened to cheat.
Dear Sufferer,
If your boyfriend is threatening to cheat because he has to stay away from your mouth for a few days, he needs a chill pill at the very least.
For you, an antiviral pill or a special ointment. If you come in to Student Health and Counseling (SHAC), we can give you a prescription for Acyclovir or Valcyclovir pills to take at the first sign of an outbreak. They will decrease the duration and severity of your cold sore outbreak. There are also prescription antiviral ointments, and several over-the-counter products as well. I will get into specifics below but first a little background.
Your cold sore is caused by the herpes simplex virus, most likely Type I. About three quarters of the people in the world have this virus. You get it from having direct contact with someone else who has it. Many of us catch it when we’re kids, from other kids or affectionate adults. Likely whoever gave it to you did not even know they had it when they kissed you or rubbed their face on you. If someone has the herpes virus, they can pass it along even if they don’t have an active sore at the time. Once you have caught this virus, it hangs out in the nerve roots in your spine. You might get a sore, you might not. You might get only one in your life, or you might get them frequently.
Especially during times of stress, illness, or injury, the herpes virus gets agitated and comes to the surface, creating the red-and-yellow crusty monster you have now. Sometimes you get a hint that it is about to erupt, like a tingly sensation or numbness in the area. The cold sores tend to come back in the same place time after time.
If you can catch it in that prodrome stage, when you’re feeling the tingles but don’t yet have the monster, start taking your favorite antiviral medication and continue for five days. Or choose a topical product. Docosanol is an over-the-counter cream approved for cold sores, and there are several other topical products available that dry and numb a cold sore. Come to the SHAC pharmacy and ask.
If you prefer more natural medicines, you might try a lemon balm ointment, a sage and rhubarb cream or lysine. Lysine can be taken orally for prevention, or applied topically for treatment. Find these products where herbal medicines are sold, like The Herb Store or La Montanita Coop, both in Nob Hill.
Even if you do absolutely nothing, a cold sore will clear on its own in about a week. If that is too long for your boyfriend to tolerate, I recommend he contact the psych department and register for Patience 101.
Peggy Spencer is a board-certified family physician. She has been a UNM Student Health physician for 17 years. Drop your questions into her box in the lobby of Student Health and Counseling or e-mail her directly at pspencer@unm.edu
All questions will be considered, and all questioners will remain anonymous. This column has general health information only and cannot replace a visit to a health provider.
