Phil Kieran: How can my teen stop her cold sores from coming back?
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Cold sores can be painful and frequently cause anxiety and social discomfort. These familiar lesions are caused by the herpes simplex virus. Roughly 70%-80% of adults have had the virus.
It’s possible to spread it even without getting cold sores yourself. A significant portion of people who have ‘never had a cold sore’ will shed the virus occasionally without knowing it.
All this means is that your daughter is part of the majority, though I don’t expect this will be much comfort to her. With treatment options for cold sores, we consider giving a prescription for a supply of anti-viral tablets, which can be effective if started early on. Treatment with anti-viral creams is often not particularly effective, and studies have shown uncertain results.
Oral anti-virals can work well for some people who have pronounced cold sores. However, they are most effective if taken at the start of symptoms. This means that episodic medication can be less effective if you, like many cold-sore sufferers, don’t get that warning ‘tingle’.
We sometimes start suppressive treatment for people with very frequent cold sores. This involves taking antiviral medication regularly for about six months.
For some, this will lead to long-term suppression of the virus — for others, it is less useful.
The first time someone gets infected with this virus, it can cause severe symptoms, with ulcers spreading over the lips, tongue, and throat.
This can be so severe that the lips can stick together or the child becomes dehydrated, due to an inability to eat and drink.
The most crucial step is to provide enough pain relief for children in this situation. Also, a barrier like Vaseline can prevent the lips from sticking together.
If you get cold sores regularly, you could address a few things in your lifestyle to keep them at bay. Protecting your lips will reduce the frequency of flare-ups. Cold sores often appear on injured or irritated lips, so wearing lip cover with sun protection is a good idea.
Smoking and vaping can contribute to frequent flare-ups, as nicotine irritates mucous membranes, which can cause skin irritation, increasing the risk for recurrence.
Lastly, if you notice your daughter has a habit of chewing on her lip or biting her nails when stressed, this may be causing micro-trauma, which makes the cold sore more likely.
If you have a question for Dr Phil Kieran, please send it to parenting@examiner.ie.