Oral Herpes/Cold Sores Essential Facts

Cold sores are small blisters or sores on the face, usually on the lips or nose.

They vary in severity: sometimes they are painful and unsightly; at other times they may be so mild that you can't even be sure that you have them.

Outbreaks of cold sores usually last several days.

They can be brought on by illness, tiredness, dry or sunburnt skin, excessive pressure or rubbing - but often there is no obvious trigger. Many people experience warning symptoms such as numbness or tingling just before an outbreak. It's common for outbreaks of cold sores to become less frequent, and much milder, over time. In many cases they seem to "go away" altogether.

The underlying cause of cold sores is a virus.

Cold sores are usually due to the herpes simplex virus 1 (HSV 1). When you contract this virus it remains in your body for life. Most of the time it will be inactive and not cause any problems, but sometimes it re-activates to cause cold sores.

Cold sores are passed on by direct skin-to-skin contact.

The main way of passing on cold sores is by kissing, but they can be passed on if the affected area rubs against another person's skin in other areas. This means that someone with oral sores can pass on the virus to a partner through oral sex. If this happens, the partner may develop genital herpes - which is the same condition as cold sores, but on a different part of the body.

People with cold sores are most infectious when there are sores or blisters present, or in the days just before an outbreak.

But sometimes they can pass on the virus even when there are no symptoms. This is called asymptomatic shedding of the virus and is a very common way of passing on the herpes simplex viruses.

Most Australians carry the herpes simplex 1 virus.

Over 70% of Australians carry the herpes simplex 1 virus and approximately 13% carry the herpes simplex 2 virus (HSV 2) which can cause genital herpes.

Most people come into contact with HSV-1 in childhood.

Because the herpes simplex viruses are very common, and because kissing is a very common activity, it's common for children to contract the virus. This would usually happen after a kiss from a relative or friend. The first time someone comes into contact with the herpes simplex virus, they can become generally unwell with a fever. There may be sores covering a larger area of the face and the mouth itself may be involved. Fortunately these are usually first-time symptoms only.

Many people don't know they are carrying the herpes simplex viruses.

You can carry HSV 1 and/or HSV 2 with very mild symptoms, or sometimes no symptoms at all. But even if you don't know you have HSV 1 or HSV 2, it can be possible to pass it on. This is one of the reasons why the HSV viruses are so common.

The cold sore virus can cause sores on other parts of the body.

If someone with cold sores (or shedding the virus) touches the affected area they can spread the virus especially the fingers or the eyes. To prevent this, people with cold sores should be careful not to touch the sores during outbreaks.

Effective treatment is available.

While it is not possible to eradicate the herpes simplex viruses from the body, outbreaks of cold sores can be treated. Aciclovir ointment can speed up the healing process and reduce the discomfort.

In Australia, a single-dose oral treatment (famciclovir) has recently become available. It can reduce the healing time of cold sores by two days.