Cold sores affect millions


Caused by herpes simplex virus type 1, cold sores, also known as fever blisters, are highly contagious and are present throughout the U.S. population in epidemic proportions. Because the stress of the new school year weakens the body's defenses and triggers cold-sore episodes, September may be called the start of the cold sore "season."

Key Points

In ancient Rome, an epidemic of cold sores (also known as fever blisters) prompted Emperor Tiberius to ban kissing in public ceremonies. Today, cold sores continue to present in epidemic proportions, with approximately 100 million recurrent episodes arising each year in the United States.

Caused by herpes simplex virus type 1 (HSV-1), fever blisters infect most people before they are 10 years old. The virus, highly contagious when fever blisters are present, is indeed frequently spread by kissing. Children often become infected by contact with parents, siblings, or other close relatives who have active cold sores.

The herpes virus can reside in the body for years, appearing as a sore around the mouth only when provoked by factors that weaken the body's defenses, such as illness, fever, hormonal changes (such as menstruation), sun exposure, and emotional stress.

Recently, the Food and Drug Administration approved Medivir's Lipsovir to shorten the duration of cold sores or prevent them altogether. Lipsovir combines the antiviral acyclovir with the anti-inflammatory agent hydrocortisone. Intended for use in patients aged 12 years or older, it's indicated for the early treatment of recurrent herpes labialis to reduce the likelihood of ulcerative cold sores and to shorten healing time. The product is not yet available in the United States.

The aboriginal people of Australia have long used tea tree oil, which has antiviral, antibacterial, and antifungal properties, as an antiseptic. Burt's Bees uses tea tree oil as the featured ingredient in its Herbal Blemish Stick, which a company representative says is helpful in treating cold sores as well as acne and other skin problems. The .26-ounce stick retails for $8.50.

Orajel has a new Overnight Cold Sore Patch it is promoting as "the only cold sore treatment that works while you sleep to help speed healing." It's indicated for the temporary relief of pain and itching associated with cold sores. A box contains eight unit-dose patches.

Scientists at the National Institute of Dental and Craniofacial Research have confirmed that sunscreen on the lips, applied before going outside and reapplied frequently during sun exposure, can prevent sun-induced recurrences of herpes. (The researchers used a sunblock with a protection factor of 15 in their studies.) Two companies told Drug Topics that they have recently introduced new lip products for preventing or alleviating cold sore occurrences.

Carma Laboratories has added to its Carmex lip balm product line the new Carmex Moisture Plus Ultra-Hydrating Lip Balm. The new product's ingredients include vitamin E, aloe, shea butter, and avocado butter, and it has a rating of SPF 15. It is packaged with a "sleek applicator" and carries a suggested retail price of $2.99. According to a company representative, "This is the first time in more than 70 years that Carma has introduced a new product line unique to the core Carmex brand."

Quantum Health has extended its Super Lysine+ line with Little Lips Super Lysine+ Ointment, a berry-flavored product created for young people between the ages of 5 and 18. The ointment contains lysine plus 14 healing herbs and vitamins; the .25-ounce package list price is $6.99.

Dana K. Cassell, a frequent contributor to Drug Topics, lives in North Stratford, New Hampshire.

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