Skin OTC - Cold Sores

Question 1

What are the causes of cold sores? (2)

Answer 1

Reactivation of Herpes Simplex virus.
Initial infection usually contracted in childhood.

Question 2

What are the symptoms of cold sores?

Answer 2

Painful small blisters usually around the mouth/nose area ( can be anywhere on face or body)

Question 3

What are the stages of cold sores?

Answer 3

Prodromal phase - tingling sensation
Eruption of vesicles within 24 hrs.
Vesicle rupture - painful, weeping erosions
Scab forms
Takes 10-14 days to heal.

Question 4

What are the possible causes of cold sore reactivation?

Answer 4

sunlight, trauma, emotional upset, menstruation and illness.

Question 5

What are the treatment options for cold sore?

Answer 5

Aciclovir 5% (Zovirax, Soothelip = GSL)
- Best used at the tingling stage for max effect.
- Can decrease length of time of attack.
- Apply to face only.
- Application = 5x daily.

Apply UV sunblock to lips to prevent reoccurrence.
Reduce infection spread as before (avoid kissing newborn and infants)

Penciclovir: Apply every 2 hrs for 4 days (Fenistil - GSL) 12yrs+

After vesicles have erupted use prep containing: local anaesthetics, antiseptics, iodine base.

Patch (Compeed cold sore patch) = physical shield

Question 6

What symptoms would warrant a referral for cold sores?

Answer 6

Affecting the eye
Frequent severe attacks
Pregnant
Genital lesions
Mouth lesions
Patients on immunosuppressive therapy.
Young infant
Possible impetigo? - age, Hx of cold sores, itch, a sense of tingling stage, colour of scabs.