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Cold sores - why they occur

If you've ever had a cold sore outbreak, you probably don't need us to tell you how irritating they can be.

There is unfortunately much stigma around the cold sores, which information and education can help eliminate. So, whether you're someone who suffers from cold sores or you know somebody who does, we're here to offer you more information on this common condition, enabling you to understand how cold sores (or fever blisters, as they are sometimes known) may be more effectively treated.

Cold sores and the herpes simplex virus

In a nutshell, cold sores are caused by the herpes simplex virus (HSV-1) for which there is currently no cure.

Cold sores are incredibly common. The World Health Organisation estimates that 67% of the population under 50 is infected with HSV-1, the strain of the Herpes Simplex Virus that causes cold sores.

While this may sound like a lot, many people who carry the virus will never display symptoms. It is thought that the virus lies dormant in approximately 70-80% of the population and does not cause any visible signs. This means most people who carry the virus remain completely unaware they have it. However, for those who do suffer the symptoms – painful blisters on their lips and the surrounding area – the virus is likely to be a recurring nuisance throughout their whole life.

How does the herpes virus infect people?

Highly contagious, HSV-1 is usually transmitted through oral-to-oral contact. Most people will be exposed to the virus during childhood after coming into close contact (such as a kiss) with an adult carrying the virus.

Often the initial infection has hardly any symptoms, but in some cases it can cause herpetic gingivostomatitis. This affects the gums and mucosa (the lining inside of the mouth) and the infected person will present flu-like symptoms. In any case, this first infection is self-limited and subsides in a few days.

During this stage, the herpes virus travels along the infected zone's sensory nerves, reaching the structures where the corresponding nerve cell bodies (ganglia) are present. Most of the time, this structure is the trigeminal ganglion, which has sensory nerves that cover a large part of the face, including the lower part where the mouth is.

Inside the ganglia, the herpes virus goes into a static state and could remain dormant like this for weeks, months, years, or maybe for the rest of the individual's life. In case of the latter, the carrier may remain unaware they have the virus and therefore are in danger of passing it on, as the virus can be transmitted between people even when there are no visible symptoms.

Throughout this period – called the latency stage – no new virus is produced and it is very difficult, if not impossible, to reach the hidden virus with medical treatments. This is why, at present, there is no cure that can totally eliminate the herpes virus from an infected person, only treatments which can help to reduce the symptoms.

In members of the population who do experience recurring outbreaks, the virus will come out of its dormant state and travel back along the sensory nerve fibres to the skin cells, where it will begin to replicate itself using enzymes present inside the cells. Once this has happened, the virus will leave the cell – which will now die as a result of the infection – and continue moving from one to the next.

Precautions to take when you have a cold sore

Cold sores are contagious because the virus can be present in the blisters and fluid – which can be spread – as well as in the saliva before the cold sore even appears. It is therefore crucial that those infected take precautions to avoid others becoming infected and special care should be taken around babies or very young children whose immune systems are not fully matured.

The virus is unlikely to cause much harm for adults who aren't immunocompromised, but in young and vulnerable people, such as adults with severe immunodeficiency either caused by a disease or due to treatments such as chemotherapy, an HSV infection can lead to severe, potentially life-threatening complications.

What triggers a cold sore outbreak?

For carriers who do suffer from recurrent outbreaks, there are certain triggers that may affect the immune system and reactivate the virus. These triggers include stress, overexposure to UV light, some foods or drugs, and fever (febrile illness) – all of which cause the immune system to weaken. Furthermore, intense dental work and laser skin treatments can induce a cold sore and, in women, menstruation can also be a trigger. Eating foods that are high in arginine (including grains, nuts and seeds, and chocolate), can also trigger an outbreak, as the amino acid arginine encourages the replication of the virus. The amino acid lysine, found in dairy, meat products, and many fruits, balances out arginine and has the opposite effect.

In most people who experience cold sores – 20-30% of the population – HSV-1 will only cause the typical appearance of localised blisters and ulcers that are commonly associated with the virus. Only in cases of severe immunodeficiency might a cold sore episode cause more serious health issues.

Some of the more serious complications of cold sores include herpetic whitlow, which can occur if the fever blister comes into contact with an open cut on the fingertip and causes swelling and lesions on the finger; Herpetic keratoconjunctivitis, which affects the eyes; and eczema herpeticum, which is a rare but serious complication occurring when a cold sore blister comes into contact with an outbreak of eczema and causes a cluster of blisters.

Again, these complications are rare and in most cases the virus will only cause the appearance of a blister that will likely heal within 10 days.

Still, the irritating symptoms suffered by those who have frequent cold sore outbreaks can be an issue. Consequently, a treatment such as Herstat, which offers accelerated healing and can alleviate pain and itching, is usually required.

Herstat

Herstat is a product that, unlike most other cold sore treatments, can be applied to your cold sore at any stage of the infection – from the first tingle to the final ulcer.

The benefit of Herstat treatment is, if you apply it when the first sensations of an outbreak present themselves, it will help to keep your cold sore at bay. Nevertheless, if it's used after the cold sore has appeared, it will help to reduce swelling, itching, and pain – and speed up the healing time of the cold sore. Herstat's effectiveness has been proven in clinical trials, where participant found the ointment to treat their fever blisters much better than a placebo.

For further information about Herstat cold sore treatment, please visit our Product information or Frequently asked questions pages.

If you'd like to try Herstat and experience the beneficial effects for yourself, please visit the Buy Products page to make a purchase.