What is up with coldsores?

August 18, 2009 4:32 AM

I've gotten coldsores since I was a kid, generally once every 18-36 months. I got one 2-3 months ago, but then I got another one today. My whole life I got them on my top lip, but 2-3 months ago I got it for the first time on my bottom lip. This time, it has appeared on my bottom lip again, but now I think a SECOND one is also appearing on my top lip. Why has it moved? Why has it become more frequent? Why am I now getting 2-for-1? Should I be freaking out?

Note: I am freaking out. One is bad enough, but TWO? I'm a leper.

posted by mjao to Health & Fitness (27 answers total)

hey mjao,

you have herpes simplex A

Common Herpes. Don't worry... you can get it in the womb.

http://en.wikipedia.org/wiki/Herpes_simplex_virus
posted by evil_esto at 5:08 AM on August 18, 2009

Whoa! I've had the same story all my life too, minus the expansion part. I'd be freaking out as well.

Someone else can tell you if this to be expected or not, but my advice is to see a doctor about getting a prescription for Valaciclovir (brand name: Valtrex). I keep a supply on hand and at the first hint of a sore I down the prescribed amount (two doses of six over a 24 hr period I think, don't trust me on that though) and 90% of the time it nips it in the bud.

P.S. I am not a doctor!
posted by furtive at 5:10 AM on August 18, 2009

for what its worth i get coldsores when all of the following are true

i've been out in the sun without uv lipbalm
i haven't drunk enough water
i am stressed or haven't been eating properly

maybe there is a similar pattern for when you get them

I understand how you feel though, even though they are small, they make you feel terrible

IAMNYD, but I find having zovirax (or generic) and lipbalm at the ready and using them at the slightest twitch, it seems to help get rid of them faster.

I also find cooling my lip with an ice cube held in a piece of cloth can help right at the very start.

my understanding is that the virus lives in your nerves and can travel a little bit. creepy...
posted by compound eye at 5:16 AM on August 18, 2009

zovirax is the main brand of topical aciclovir in australia, its an over the counter medication in australia, ultimately the same medication as furtive is suggesting. I've never tried Valaciclovir furtive, how to you find it different to the lotion?
posted by compound eye at 5:20 AM on August 18, 2009

yeah, valtrex is the way to go, here.

also, prevention: arginine encourages the virus, lysine discourages it. i've found taking lysine supplements when i'm particularly vulnerable (stressed, eating lots of peanuts (high in arginine!), sick) seems to help.
posted by rmd1023 at 5:21 AM on August 18, 2009

(but Valaciclovir, which futive is suggestion is the oral form)
posted by compound eye at 5:21 AM on August 18, 2009

Story of my life. Seconding Zovirax. I've also found that taking L-Lysine supplements seems to help prevent an outbreak when I'm going through something that triggers them - stress, sun over-exposure, chapped lips - basically anything that compromises my immune system is capable of bringing them on. I had five at once one time when I was massively stressed. (shudder) Never. Again.
posted by EvaDestruction at 5:28 AM on August 18, 2009

Anecdotal. I have had coldsores since I was a kid, get breakouts every 2-3 years now. I have noticed that the outbreaks are less severe as I get older, but tend to migrate. I get them on my chin now which is gross, (but at least its not my nostrils, seen that on a family friend).

The outbreak on my chin seemed to come after I stupidly tried to squeeze a very stubborn blackhead, so maybe tissue trauma might trigger an outbreak and a new location for a sore. I also get them almost exclusively when I am very run down.

They are a pain but don't freak out. Zovirax is good, and take care of yourself.
posted by arha at 5:33 AM on August 18, 2009

Happens. If you dont want to or can't get Valtrex (which I do not personally bother with, but then again, since I've been eating far less shittily, I get these far less often), go for Abreva. For me, Abreva+Carmex (I know, awful, but it's the only thing that works for me during These Trying Times) -- and use Q-Tips to apply the stuff.

As above, Lysine bombing is really helpful to me too, if I catch it in time. Drink lots of water, take lysine supplements, use OTC stuff to feel better/heal faster, maybe get medicated.
posted by Medieval Maven at 5:52 AM on August 18, 2009

You're absolutely not a leper. Probably the stress of worrying about this isn't helping--you might see a doc for a prescription, but more importantly, for a little peace of mind. Please don't stress out about this, even though I know it can feel awful.
posted by corey flood at 6:59 AM on August 18, 2009

Some people report that eating a nice juicy kiwi at the first signs of outbreak can noticeably minimize outbreak times.
posted by Aquaman at 7:10 AM on August 18, 2009

Kiwi fruit. Not the bird. Don't eat the bird.
posted by Aquaman at 7:10 AM on August 18, 2009 [8 favorites]

i had them for years. herpes simplex A. same causes as mentioned above: too much sun (and wind), stress, not enough sleep. sometimes on one part of the mouth, sometimes the whole perimeter. tried everything. then discovered abreva (and put on sunscreen and slept more). it's expensive, about $20, and you don't get much, but for five years now, at the first little burning sensation, i slather it on. for me, it's worked perfect. give it a try.
posted by holdenjordahl at 8:08 AM on August 18, 2009

I take l-lysine and now hardly ever get them. (I eat gobs of almonds, which are l-argenine filled). Also, when I DO get them, I wash them with regular bar soap very frequently. They go away a lot quicker.
posted by small_ruminant at 10:27 AM on August 18, 2009 [1 favorite]

If you're anyplace but the US they have some pretty nifty acyclovir patches you can wear over them. They're small and round and medicated and keep them from getting contaminated (or contaminating, I suppose, though I wouldn't put it to the test.)
posted by small_ruminant at 10:29 AM on August 18, 2009

fwiw, Valtrex didn't do a better job than l-lysine for me. YMMV.
posted by small_ruminant at 10:32 AM on August 18, 2009

I've gotten these since I was a little kid, too.

First: Abreva is a good topical ointment. If I use it when I first think I'm getting one, sometimes I don't get it at all. If I still get one, it heals much faster. (Usually takes two weeks, about a week or less with the Abreva.)

Second: It's pretty commonplace to get them anywhere near your mouth, even if you haven't had one on your other lip before.
posted by Nattie at 10:59 AM on August 18, 2009

Denavir...also good. I find Denavir + Abreva (I'm a psycho like that) can sometimes prevent them from even fully forming if I nail one right when I first feel it coming on.
posted by jnnla at 1:05 PM on August 18, 2009

Anybody know what dose of lysine is recommended (and can back that up with a cite) ? I've often seen it recommended, but nobody seems to know how much is appropriate to take.
posted by canine epigram at 1:13 PM on August 18, 2009

L-lysine has always worked wonders for me, and I've had HORRIBLE cold sore problems my whole life. As soon as I feel that first tingle, I start taking the max. dose of lysine, and it always nips in the bud. Also, I have found that Carmex works better than almost anything at helping those buggers go away once they have reared their ugly heads. A pharmacist recommended that to me when I was considering Abreva, and it's probably some of the best advice I've gotten. Good luck!
posted by I_love_the_rain at 1:17 PM on August 18, 2009

I just got over a HUGE coldsore, so I feel your pain! I usually get them when Im about to get sick, when Im about to get my period, or any other time when my immune system is feeling crappy. My most recent one was after sitting in the sun too long, and getting horribly burnt. Like you, I always get it in the same spot, and it is usually manageable with ABREVA, and you cant even see it. This one, my entire lip swelled up, and it went all the way up to my nose. Horrible! I feel you.. Douse it in abreva, or if you can get the prescription, valtrex. It will be gone soon. I also put neosporin LT (Lip treatment) on it after the initial cold sore was gone to soften the scab, and speed up healing time.
Hang in there... I know its nasty, but it's not as noticeable as you think! :)
posted by shannie-bananie at 4:58 PM on August 18, 2009

Response by poster: Thank you everyone, this whole thread is very oddly calming!

So, EvaDestruction: you've only had multiple coldsores once? Is that right? I'm just hoping this never happens again! I prefer the small singular ones I used to get- they seem like a picnic compared to this.

Like canine epigram, I'd also like to know - how much should I take? A lot?

I'm going to eat so many damn kiwi fruits tonight....

I'll also see a doctor and discuss a scrip... by the way, in case anyone cares, one of the treatments I am using is Herpotherm, this ridiculously expensive little gadget that heatshocks the sores - it did clear it up in 1 week as opposed to 2, last time.

It's just the idea of it spreading and being bigger that is killing me right now! It's like a nightmare. What if it gets worse next time?
posted by mjao at 7:49 PM on August 18, 2009

Response by poster: oops, how much "lysine" should i take?
posted by mjao at 7:50 PM on August 18, 2009

I have no idea what the recommended doses are, but I take two a day (500mg) as a maintenence thing, (one in the morning and one at night) and if I'm stressed out I take 2 of them 3 times a day for a week or so. I usually get cold sores 3 days after I'm really stressed out or exhausted or otherwise debilitated. If I actually HAVE a cold sore I do the same.

The 2-per-day is what the bottle recommends. The other one I just made up.
posted by small_ruminant at 10:10 PM on August 18, 2009

I've had cold sores since I was a baby, but very infrequently since a bad stress-induced breakout a few years ago, when I first learned (here on askme, natch) about lysine. That first time I took lysine for the whole length of the cold sore, at the recommended dose (the ones I get are 500mg capsules you take two at a time, three times per day).

Now I keep a bottle of lysine around and if I ever feel the tingle of a cold sore I take the recommended dose for a day or two. Works like a charm. Read up on lysine vs. arganine and from there you can learn to keep an eye out on how your diet plays a role. If there's too much arganine in your system it's basically a "bring out some cold sores" cue.

Try l-lysine supplement before prescriptions, honestly. It works and is cheaper. My (20 dollar!) tube of abreva from three years ago sits unused in a drawer. I don't plan to ever need it again.
posted by SassHat at 10:19 PM on August 18, 2009

I take l-lysine supplements for my coldsores too, and it helps keep the break-outs from happening. I take 500mg twice a day, one in the morning and one at night.

If I do get a breakout, I use Vicks vapor rub on it, and up the l-lysine by 500mg. Works for me. Three days, it's gone. YMMV
posted by patheral at 10:55 PM on August 18, 2009

mjao, I have had a (mercifully very few) other occasions where I had two. The epic monster breakout of particular awfulness only happened once. (Sidenote, the single worst breakout I ever saw was a friend who had one the size of a quarter on his forehead.)

Taking about 1500 mgs of lysine when I suspect I might've put myself at risk of a breakout (and following up with 500-1000 per day for a couple days after), having Abreva/Carmex/other OTC topical treatment on hand (at home, at work, in my travel kit), and not working for Satan seem to have kept the absolute worst at bay for many years now. I haven't had a multiple outbreak in ages.
posted by EvaDestruction at 1:04 PM on August 22, 2009