how can I stop freaking out about cold sores?

September 17, 2008 2:17 PM

how can I stop freaking out about cold sores?

I am a male. Lets say I'm 30. I have been getting cold sores since I was a kid. For some reason, I've had an increase in frequency in the past few months, and I am not sure why. I know stress is often a primary factor, but I have not been under any more stress than in other periods of my life. I used to go long periods of time without incident.

So, how can I stop being completely embarrassed by them?

How do I deal with this while dating? Maybe that's the bigger issue.. I am coming out of a 10-year relationship (she knew and didn't care. but she's a health care professional, so her opinion on the matter was at least informed). But I feel like I'm now dealing with the stigma of an STD.

Are cold sores really that prevalent among the general population?

I use Valtrex, but not daily. I don't want to have to use it daily, either. I use one pill if I feel one beginning, and it usually kills it within a day. I'm now wondering if my body has built a tolerance to the drug, since it seems like the frequency of the cold sores has increased after the first time I used valtrex to suppress it (only within the past year or so). I've considered stopping the valtrex altogether and letting my immune system deal with them on it's own; i wondered if maybe if maybe the valtrex was interfering with my body's ability to suppress outbreaks on its own.

See what I mean? I am totally freaking out about it.

posted by anonymous to health (17 comments total)

How are you sleeping? Lack of sleep means more likelihood of cold sores.
posted by Greg Nog at 2:32 PM on September 17

Sun exposure can trigger them as well.

Most estimates I've read say it's likely that 90% of the adult US population has antibodies to HSV1 (ie have been exposed), but only a fraction of those exhibit the sores.
posted by mandymanwasregistered at 2:39 PM on September 17

and eating. and exercising. all of these things help.
posted by object-a at 2:40 PM on September 17

I think they are really prevalent. Every woman with whom I have had a long-term relationship has had them, as probably did some or most of the short-term ones (it was never a subject of conversation, so I don't know). I've gotten them ever since I was a small child; every single person that I know of in my extended family has had them since they were young. A lot of friends (male and female) get them, too, and many of them are in relationships, so it's not a dealbreaker for them, either.

So while I wouldn't want to kiss someone who had big, suppurating sores on their lips, that they got periodic outbreaks is no big deal to me. I do hope, though, that anyone I'm with is going to have the courtesy to not perform oral sex when they have active sores or can feel one coming on. But beyond that, it's not something I worry about.

I get outbreaks when I am tired, stressed, and not eating well; sometimes the outbreak is my clue that I am indeed more stressed than normal, even though I was thinking things were like usual. I don't take Valtrex, so can't comment on that — it seems more like a question for your doctor, rather than an occasion to unilaterally change your medication.
posted by Forktine at 2:55 PM on September 17

MandyMan's number surprised me, but it sure does look like all the studies report from a low of about sixty to a high of about ninety-eight (!) percent of people studied are carrying HSV1 anyway. It looks like the newer the studies and more modern (sensitive) the tests, the higher the result.

"The fact that HSV-1 DNA was discovered in such a high percentage [98%] of healthy people in the general population tells us that the virus is everywhere and it's unavoidable."

So the difference, I guess, is whether your own immune system suppresses or expresses, and that likely changes day to day, month to month, year to year, depending on your overall health. This, I know, is the origin of the term 'cold sore', since when your immune system is already beat down (by a cold, for example) they're more likely to appear.

Apologies if this is old news, but your question is about dealing with it, so I thought that might help you think about it differently.
posted by rokusan at 3:00 PM on September 17

Incase you are interested, I had a friend who swore by using Tea Tree essential oil on her cold sores to make them go away faster.
posted by All.star at 3:08 PM on September 17

how can I stop being completely embarrassed by them?

People take a lot of cues from each other. If you are embarrassed by your coldsore, you will be non-vocally telling the person "This thing I have is something to be ashamed of", and because you are the expert about you, they will believe your expert opinion over their own non-expert opinion, and at some level will consider you to be icky (which is embarrassing for you), even if they know better - because you instructed them too, and they obeyed you.

This doesn't help you stop being embarrassed, but flip it around: If you are non-vocally telling people that things are ok, they'll believe your expert opinion, and then you won't have any cause to be embarrassed any more.

Ok, so that leaves you with a chicken-or-egg problem - if you can get over the embarrassment, you break the cycle, but easier said than done.

Relentless reminding-yourself logic perhaps? At 80% of the population, everyone else has it, so it's like zits - forget about it. If someone freaks out, they're the oddball - they're probably not very informed, which is embarrassing to them, not you. Be aware that they're the ones committing the faux pas, not you, but be gracious about it, and don't draw attention to their error, they don't know any better, but whether it's your place to correct them depends on the situation. it will happen, and eventually it will happen to someone where it matters to you that they don't freak out, but chalk this up ahead of time as ones of the costs of life, so you don't develop a neurosis when it happens, because that would put back in the rut of telling everyone that there is something badly wrong with you, when there isn't.
posted by -harlequin- at 3:11 PM on September 17 [2 favorites]

I don't get 'em very often, but mine are triggered by lack of sleep, poor diet, stress, or sunburns on my face. Any three of those happen at the same time, and it's time to watch out. Just take a shitload of lysine when you get one (and ~1000mg per day to prevent 'em) and use some kind of moisturizing and anti-redness cream on the affected area, and they'll go away in about a week.

As far as dating goes... the way I look at it is, would you really want to date somebody who makes a big stink about something as transient as a cold sore (assuming you're considerate enough to not rub it all over them)? That's pretty shallow and kind of cold. And it's not like your HSV is going away or anything, so if someone can't deal with them it's better to find out sooner rather than later. If you're still too embarrassed (and believe me I've been here), just tell her you're not feeling well and ask if you can postpone the date until next weekend.
posted by xbonesgt at 3:27 PM on September 17

500mg of lysine a day for a few weeks until they go, and then resume if they come back--it's what worked for me anyway.
posted by idb at 3:51 PM on September 17

Are you biting your lip/mouth while eating or sleeping at all? Maybe these cold sores are actually wounds from scrapes in your mouth?

Perhaps I'm completely off base, but I thought I was getting cold sores, too. My dentist pointed out that my teeth are unusually sharp and have a tendency to scrape the inside of my mouth.
posted by yellowbkpk at 4:49 PM on September 17

If you're embarrassed by them, it may behoove you to know that my boyfriend uses concealer on his. And I had no idea until after we had sex.

For mine, I don't touch my face alot, wash 2x a day and spritz with witch hazel. Oh, and I carry Abreva around - I get a faint tingling sensation a day or so before the fuckers appear, so as soon as I feel that, I start using the Abreva. I haven't had one in over a year.

brb knocking on wood.
posted by damnjezebel at 5:07 PM on September 17 [1 favorite]

Germanium is what I've heard recommended, worked for a friend it seems. Mentioned here and that site may have more tips.

As for not freaking out about it, find the next thing that you are ready to devote time and interest to ... then do it! Your focus on a new task will hopefully be constructive and detract from your current focus.
posted by unclezeb at 5:45 PM on September 17

Abreva is the shit I use to kick those fuckers to the curb (as soon as I feel the little tinglyness). It's just one of those things that I think a LARGE portion of the population has to deal with.
posted by sperose at 6:24 PM on September 17

I have not been under any more stress than in other periods of my life....
...I am coming out of a 10-year relationship
How do I deal with this while dating?

You broke up fairly recently? Dude, you are under stress and your body knows it even if your head doesn't.* Just cut yourself some slack.

* Coming out of a long-term relationship, one I ended, I had to check the door lock three times before I fell asleep for like a YEAR AND A HALF. I'm the kind of person who used to sometimes just leaves the door unlocked on purpose because "who's really going to just try to walk in?" And suddenly I'm all, "oh, but did I really turn the handle all the way when I checked it? I better get out of bed again and check." Your body just knows these things.
posted by salvia at 8:35 PM on September 17 [1 favorite]

I used to get cold sores. On the recommendation of the lovely girl I got them from, I started eating high-potency B-complex vitamins at the first sign of an outbreak. I also tried assorted commercial antivirals and lysine. The B-complex worked better, for me.

I haven't had the actual blisters for about five years, now. Closest I get is an occasional warning tingle in the nose corners if I've let myself get too much sun - then it's straight back on the B vitamins.

For me, cold sores are like the red lights on my car dashboard - they're a warning that I need to pay attention to the health of the system, rather than a thing-in-themselves to get rid of.
posted by flabdablet at 8:44 PM on September 17

Most of my partners had the virus. IME most people know that it's no big deal and that they're very very common.

You may find it useful to experiment with diet. Eat lysine rich foods (all dairy products, meat, and fish, many fruits, certain veggies/beans), and especially, avoid arginine rich foods (nuts and seeds, onions and garlic, many grains, certain other veggies/beans). (Or pig out on peanut butter to see if the sores get worse.) The virus needs arginine to replicate. Lysine resembles arginine enough that when there's enough of it, it'll fill the virus's arginine receptors.

I googled the above info a few years ago during a time when I was under severe stress, had severe breakouts daily for weeks, and the lysine supplementation I had previously used for years to keep it under control wasn't working very well any more. I found several charts online at the time listing the lysine-arginine ratio of specific foods, eg turnips, lettuce, spelt have more lysine than arginine; rutabagas, swiss chard, corn have more arginine than lysine. The only thing that got it under control was restricting my diet to only lysine-rich foods. I didn't know about Abreva at the time. It's hard to avoid nuts/seeds, onions/garlic especially when eating out, but most servers are accommodating.
posted by cybercoitus interruptus at 9:14 PM on September 17

I find them very embarrassing as well, to the point where I simply won't leave the house. I may not be the best person to take advice from, but sometimes I get my courage up enough that I just go out anyway and if anyone looks at me funny, they can fuck off. When I get my courage up, it works surprisingly well just to confront it. When. Getting the courage isn't that easy.

Abreva and tea tree oil, by the way, work very well for me.
posted by Nattie at 4:32 AM on September 18