Cold Sores Flashcards
What are the symptoms of cold sores?
Localised itching or tingling 1 to 2 days before the appearance of a blister, followed by collections of small blisters which can be accompanied by pain, tenderness, and a sensation of heat and burning
Do cold sores require a counselling room?
Yes
What are 9 red flags for referral with cold sores?
- Painful mouth ulceration with poor oral intake.
- Signs of bacterial skin infection.
- Systemic symptoms present.
- Lesions on other parts of the body.
- Outbreaks that occur more than
- 3 times a year.
- Aged < 18 years.
- Lesions present for > 7 days.
- Immunocompromised patients or if taking immunosuppressant medications.
Do cold sores have a PSA self-care card?
Yes (Cold Sores)
What is the preferred over-the-counter treatment option for cold sores?
Aciclovir 5% w/w cream (Zovirax)
What are the directions for aciclovir 5% w/w cream (Zovirax) in cold sores?
At the first sign of a tingle or blister, apply a small amount to the affected area 5 times day for 4 days.
What are 3 non-preferred over-the-counter options for cold sores and why?
- Oral famciclovir: systemic therapy with more risks (can’t be used in pregnancy, breastfeeding or children under 18)
- Idoxuridine + Lignocaine (Virasolve): does not contain an antiviral
- Compeed Cold Sore Patches: less effective and can be annoying/hard to apply
Is aciclovir 5% w/w cream (Zovirax) safe in pregnancy?
Yes
Is aciclovir 5% w/w cream (Zovirax) safe in breastfeeding?
Yes
What is the age range for aciclovir 5% w/w cream (Zovirax)?
Safe in infants over 3 months
What are 8 pieces of non-pharmacological advice for cold sores?
- Avoid picking the scab or breaking the blisters because this can cause a secondary infection and scarring
- Avoid known triggers if possible (for example, stress, sunlight, ill, changes in weather, hormonal changes)
- Wash hands after touching cold sore to reduce transmission to others and also to prevent infection of the eye (causing red and painful eye)
- Avoid sharing cutleries, drinks, or other personal items (for example, towels)
- Avoid close contact (for example, kissing) with people, especially newborns, people with atopic dermatitis, and the immunocompromised because there is a higher likelihood of them experiencing primary symptoms
- Exclude kids from school or childcare until blisters have stopped weeping
- Use sunscreen (sun can reactivate virus)
- Use moisturising lip balm to prevent drying out and cracking which can lead to secondary infection
How long do cold sores typically last?
Cold sores are self-limiting and tend to resolve within 14 days without treatment.
Describe the first onset of a HSV infection.
The primary (first) infection does not normally cause symptoms in adults but are common in children, such as fever, tiredness, blisters/ulcers inside and around the mouth, sore throat and swollen neck glands
Do cold sores usually recur in the same place?
Yes
How does the presentation of cold sores progress?
Blisters burst after a few days and develop a crust. The crust dries up and eventually falls off after ~10days
