Free Clinic in Boston Area?
December 28, 2005 9:58 AM   Subscribe

My wife has cold sores (for the first time). They have been there for about 10 days. She is uninsured and has tried Abreva and is taking L-Lysine with little success. We are new to living in the Boston area. She is getting pretty distressed about them. Can anybody recommend a Free Clinic in the Boston/Cambridge/Brookline area or somewhere where we can get cheap treatment?
posted by Hillman Cobs to Health & Fitness (27 answers total)
Are you sure you need treatment for cold sores? They're caused by a virus, and treating them clinically isn't necessarily going to help. The best way to treat them that my girlfriend and I have found (both of us being regular sufferers) is to slather them with neosporin several times per day.
posted by SpecialK at 10:09 AM on December 28, 2005

This is not a direct answer to your question, but it may help her to know that cold sores begin to clear up after 7-10 days on their own.

MedlinePlus page on cold sores.
posted by moira at 10:24 AM on December 28, 2005

Try alcohol wipes. I usually take a couple with me, and use them about three or four times a day, once I notice one of those little suckers appearing. This should dry them out, and allow them to scab. Remember do not pick the scab. Other than that, ensure that this is not impetigo. But regardless, the wipes should still work.
If your wife is daring, she may pierce the blisters with a pin; just clean the pin with alcohol prior to piecing. Then wipe the affected area with the alcohol wipes. Vodka and Kleenex may work as a substitute to the alcohol wipes. Good luck.
posted by strangelove at 10:48 AM on December 28, 2005

take 500 milli's of vitamin C every hour.
rinse with listerine every morning and evening.
keep taking the l-lysine
get more sleep.

she'll be fine. cold sores are a pain in the ass, but they are an excellent early warning system about fatigue and lack of optimal nutrition.

had them forever. above treatment results in them gone in 72 hours.
posted by ewkpates at 10:55 AM on December 28, 2005

There is not much you can do with cold sores once they erupt, just wait it out. Tips: (1) Now you have had them, you will get them again but I find there is always a trigger that sets them off. For me it is peanuts. I couldnt resist them at the staff party and now all my 2005 Christmas pics have me with a bloody growth on my lip. (2) Use the red-eye removal tool on photo-retouching software to get rid of cole sores on pics.
posted by priorpark17 at 10:59 AM on December 28, 2005

Is it possible her Lysine dosage is too small? They come in 500 and 1000 mg pills. This dentistry site and this homeopathic site recommends 3000mg/day.
posted by Dr. Zira at 11:14 AM on December 28, 2005

As most others have said, cold sores (if that's what they are) are caused by a virus, and there's seldom anything you can do to get them to go away faster. I'd steer clear of the alcohol wipe idea, though -- they can be as irritating to the healing process as anything else (hence us not all swabbing all of our cuts and scrapes a few times a day with alcohol swabs).

Oh, and ewkpates, 500 mg of vitamin C an hour?!? So if you're awake for 15 hours, you're taking 7.5 grams of vitamin C a day? Wow... just, wow. If anyone is thinking of following suit, talk to your doctor first -- there are certainly things that should give you pause about this strategy...
posted by delfuego at 11:17 AM on December 28, 2005

Vitamin C in huge doses is relatively benign. Some researchers actually recommend 1-2g/day, every day, and I too believe the RDA of 60mg is laughable. Generally the largest problems would be glow-in-the-dark pee and any buffers like calcium in with the C that you wouldn't want too much of.
posted by kcm at 11:33 AM on December 28, 2005

I thought garlic (or was it lemon) applied to the cold sore would destroy it. But maybe I'm thinking of warts.
posted by five fresh fish at 11:35 AM on December 28, 2005

Except that you can't absorb more than about 50mg of C at one go, so any extra is just peed out.
posted by OmieWise at 11:37 AM on December 28, 2005

OmieWise: "Except that you can't absorb more than about 50mg of C at one go, so any extra is just peed out."

Not so sure about that.
posted by kcm at 11:45 AM on December 28, 2005

Be careful with the Vitamin C - I've got what's referred to in my family as "high body acid" -- manifests as being allergic to cheap jewelry and being unable to tolerate massive amounts of Vitamin C and/or citrus. For me, the L-lysine always makes cold sores go away faster, but the vitamin C would be suicidal. People's experiences vary, of course, but it's something to keep in mind.
posted by Medieval Maven at 11:50 AM on December 28, 2005

C is only going to help the immune system if you take it in high doses every hour or three.

According to the research I like, and my own experience, absorption rates for C very with frequency of consumption.

One good way that anyone could discover the truth of this is to take 1 gram per hour until bowl tolerance is reached. Then back it off for 1 week by only taking 1 gram in the am and one gram in the pm with food.

After a week, repeat bowl tolerance test... I bet you learn something new!

There is, really and truly, no point to low dose C. The key is high blood concentrations maintained over a period of time. This is, oddly enough, true of all vitamins, and part of the credo of optimal nutrition.
posted by ewkpates at 11:50 AM on December 28, 2005

I'm not going to get into a vitamin C debate, especially in an AskMe thread about finding a doctor to help with cold sores. Again, I'd just repeat the recommendation that individuals should find their own physicians and ask them about the difference between what's known about vitamin C and what's been pseudoscientifically declared about vitamin C. (This is, oddly enough, true for all statements about vitamins.)
posted by delfuego at 12:08 PM on December 28, 2005

I highly recommend the OTC ointment called "Abreva". Put it on every hour or so when she first feels the tingle and it's usually gone within 24-72 hours. No big whoop.
She also might want to start taking L-Lysene on a daily basis. 500mg to 1 gram.
posted by willmize at 12:13 PM on December 28, 2005

kcm-I think your link argues that extra absorption over a day of taking C occurs, but doesn't address my statement which was about absorbtion of one dose. I have no medical opinion about taking megadoses of vitamin C because I'm not a doctor, but food scientists and nutrionists are taught that only about 50 mg can be absorbed at once, so if you want to take megadoses you should space your individual doses out.
posted by OmieWise at 12:13 PM on December 28, 2005

If you decide to take more than a gram of vitamin C per day, beware that it may burn when you pee, for a little while.
posted by rxrfrx at 12:19 PM on December 28, 2005

In response to your original question you might try this:
East Cambridge Health Center
163 Gore Street
Cambridge, MA 02141
posted by Xurando at 12:25 PM on December 28, 2005

Isn't the Vitamin-C-capacity of the human body debate getting a little derail-y...?

Hillman Cobbs, assure your wife that they'll be but a bad memory soon, and there's not much point to clinical treatment, as SpecialK said. Stress, however, will prolong the healing time.

A good night' sleep, a good meal, a backrub, a multivitamin, and maybe a nice big glass of OJ (with a straw) should fix her right up. If you're from a warmer climate than Boston, you'll have to take more care to avoid chapped lips, which is a cold sore trigger for some people.
posted by desuetude at 12:27 PM on December 28, 2005

desuetude writes "Isn't the Vitamin-C-capacity of the human body debate getting a little derail-y...?"

Only if you've already concluded that the advice to take Vitamin C is bad advice, in which case your own advice could be similarly judged. If, as often happens, AskMe is partly working by offering unrecognized alternatives to a distressing problem, then the Vit C debate seems entirely germane.
posted by OmieWise at 12:30 PM on December 28, 2005

Response by poster: Thanks for all your help!
posted by Hillman Cobs at 12:31 PM on December 28, 2005

In case you check back, I would disagree vehemently with the "wait it out" crowd. There's therapy that's cheap and effective, acyclovir, that if taken promptly will virtually always abort the worst days of the sore. I give patients a refillable Rx and tell them to always keep it on hand and start it as soon as symptoms show up. Topical regimens usually are far less effective. You absolutely, definitely, can shorten these episodes with antiviral therapy. It's very safe as well. Ask your clinician when you see them.
posted by docpops at 1:00 PM on December 28, 2005

As a manager of a dental office we see cold sores all the time. There are medications that you can take even after the outbreak has started. The newest thing in our office is the non-thermal laser that causes the pain to stop within 4 hours and accelerates the healing process by somehow exciting the tissue. If you have a dentist in Boston, call him/her up and see if they have this laser (it's still considered pretty new, but it's worth checking) and maybe they can fit you in. If they don't have a laser they could at least look, diagnose, and prescribe. cheaper than a doc anyday, just don't call it an emergency exam.

feel free to email me with any questions. the company that makes this laser is called Waterlase, affiliated with Biolase.
posted by bilabial at 2:04 PM on December 28, 2005

Lysine. It's all you need. 1000mg, 3 times a day. I used to have outbreaks regularly, but since I found Lysine (and stopped screwing nymphomaniacs) they completely went away. I found that taking some a minute I could feel the "tingle" starting would usually stop the sore from developing at all. I haven't had an outbreak in several years now.

I would worry about cross infection though. You two could be reinfecting each other.
posted by y6y6y6 at 2:30 PM on December 28, 2005

There's a health clinic in Davis Sq, Somerville (in the courtyard where Starbucks and the shoe repair shop is) that has a free healthcare morning one day a week. I can't think of the name of the place--it may be Davis Sq. Healthcare. The free day may be Wednesdays.
posted by jdl at 3:51 PM on December 28, 2005

I do believe that the first outbreak is usually the worst, if that's any consulation, (I seem to remember hearing this).

Feel free to correct me if I am wrong . . .
posted by 6:1 at 7:19 PM on December 28, 2005

I strongly argue against using Abreva.

My personal experience is that it made my cold sores worse. Because of using Abreva (according to directions) I'm pretty damn sure I have two new sites for cold sores to erupt. They used to only come in at one, small site, now that site is larger and I have two new sites, one on the same lip and one on the other lip.

Being hyperaware of my own body, my opinion is that Abreva either "pissed off" my virus/cold sore infection, or somehow possibly caused it to mutate. My cold sore is decidedly not the same as it was before briefly trying Abreva.

I wouldn't be surprised if there was a class action lawsuit occuring or occuring over Abreva in the near future, or other related herpes simplex medications.

Beside, the crap is expensive, and you're better off just eating right and managing stress and all that in the first place.

I combat my cold sores by staying hydrated, eating well and managing stress.

AFAIK L-Lysine is readily available in dairy products. I drink a lot of (hormone free) milk and eat a lot of yogurt when I feel an outbreak coming on. Along with the above management tools, it seems to work well. I also have noted that when I elimate diary/L-Lysine from my diet I get cold sores more often.
posted by loquacious at 11:51 PM on December 28, 2005

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