Cold sores are caused by a common viral infection (herpes simplex virus-1) that is easy to get, but impossible to cure. Initial infection with the virus is often asymptomatic or results in very mild symptoms. Future episodes occur periodically in 30-40% of people. These often start with a mild burning or tingling near the lip border that progresses to a group of red bumps, and then finally to honey-crusted lesion. Treatment is best initiated as early as possible, such as when tingling begins and before the reddened area develops. Product selection should be individualized and is based in large part on the frequency and severity of outbreaks.
This issue provides a brief review of the cold sore virus and the infection it causes, and an update on treatment options including oral and topical prescription antiviral agents, a non-prescription viral entry inhibitor, and a variety of over-the-counter products that are intended to reduce symptoms rather than affect the virus. The potential benefits of each are discussed. A detailed patient education page summarizes all aspects of the condition including treatments and common myths associated with cold sores.