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Cold Sores
17 Hints to Heal Herpes Simplex
That tingling you feel just above your upper lip is unmistakable. Oh,
cripes. You know what that is—the start of another cold sore or fever
blister.

You've gone through this routine before. First it gets red. Then that
itchy, tingly area puffs out. The more water the blister draws to
itself, the bigger it gets, and the more embarrassed you feel.

For some reason you can't stop checking yourself out in the mirror.
(Maybe you're hoping against hope each time you look that the cold
sore has disappeared, that it only existed in your imagination. But no
such luck.) Why, you wonder, does it have to happen to me?

Cold sores are caused by the herpes simplex virus. In all likelihood,
some relative of yours infected you when you were a child by kissing
you at a time when his herpes simplex was infectious.

The virus scooted right into your mouth and sought a hospitable host
cell, probably a nerve cell that would let the virus move right in.
The virus then "ordered" the DNA in its host cell to make lots more
viruses exactly like it.

For the most part, those viruses are homebodies. They stay put. But
from time to time, the virus family likes to take a little vacation.
So it cruises down the nerve highways until it reaches the skin
surface. And when that happens, you start to feel that awful tingling
sensation that signals the start of another you-know-what.

What can you do about it?

Keep the cold sore clean and dry. "If the cold sore isn't really
bothersome, just leave it alone," says James F. Rooney, M.D., a
clinical virologist at the Laboratory of Oral Medicine at the National
Institutes of Health. "Make sure to keep the sore clean and dry. If it
becomes pussy—and this rarely happens—seek medical attention to make
sure the bacterial infection is properly treated."

Replace your toothbrush. Your trusty toothbrush can harbor the herpes
virus for days, reinfecting you after the present cold sore heals.

Researchers at the University of Oklahoma exposed a sterile toothbrush
to the virus for 10 minutes. Seven days later, half of the
disease-producing viruses remained, says Richard T. Glass, D.D.S.,
Ph.D., chairman of the Department of Oral Pathology at the University
of Oklahoma College of Medicine and College of Dentistry.

How do you counter the infectious toothbrush? Get rid of it. Dr. Glass
recommends that you throw your toothbrush away when you notice you're
just beginning to get the virus. If you still develop the cold sore,
throw your toothbrush away after the blister develops. That can
prevent you from developing multiple sores. And once the sore has
healed completely, replace your toothbrush again. Dr. Glass said that
patients of his who tried this found that it cut way down on the
number of cold sores they typically experienced in a year.

Don't keep your toothbrush in the bathroom. A nice wet toothbrush in a
moist environment like your bathroom is as cozy an environment as the
herpes simplex virus could hope for. That moisture helps prolong the
life of the herpes virus on your toothbrush. That's why Dr. Glass
recommends that you store your toothbrush someplace dry.

Use small tubes of toothpaste. Toothpaste can transmit disease, too,
says Glass. Think how often you put the brush that's been in your
mouth right up to the opening of the tube. If you use small tubes of
toothpaste, you'll be sure to replace it regularly.

Protect with petroleum jelly. You can protect your cold sore by
covering it with petroleum jelly, says Dr. Glass. Be sure not to dip
back into the jelly with the same finger you used to touch your sore.
Better yet, use a fresh cotton swab.

Zap it with zinc. Several studies show that a water-based zinc
solution, applied the minute you feel that tingling, helps speed
healing time.

In a Boston study of 200 patients who were followed over a six-year
period, a 0.025 percent solution of zinc sulfate in camphorated water
was found very effective. Sores healed in an average of 5.3 days. The
solution was applied every 30 to 60 minutes during the onset of the
cold sore.

Researchers in Israel also found a 2 percent water-based zinc
solution, applied several times a day, to be very helpful, says Milos
Chvapil, M.D., Ph.D., professor of surgery and head of the Surgical
Biology Section at the University of Arizona College of Medicine.

How does zinc help? Dr. Chvapil says that zinc ions crosslink with the
DNA molecule of the herpes virus and prevent the double helix from
splitting. That means the virus can't get the DNA to help it
replicate.

Dr. Chvapil says that zinc gluconate is kinder to the skin than zinc
sulfate. The mineral is available at health food stores.

Lick it with lysine. Dermatologist Mark A McCune, M.D., chief of
dermatology at Humana Hospital in Overland Park, Kansas, advises
patients who have more than three cold sores a year to supplement
their daily diets with 2,000 to 3,000 milligrams of the amino acid
lysine. He also recommends that they double up on the dosage when they
feel the itching and tingling that signals the development of another
cold sore. (Of course, don't use this or any supplement without the
advice and consent of your doctor. This is especially true for
pregnant women and nursing mothers. Some animal studies have shown
that excess lysine can interfere with normal growth.)

Not all studies have found lysine helpful for cold sore sufferers. But
in one study of 41 patients, Dr. McCune and his colleagues found a
daily dose of 1,248 milligrams of lysine helped subjects reduce the
number of cold sores they have in a year.

Good food sources of lysine include dairy products, potatoes, and
brewer's yeast.

Identify the pattern. What was going on in your life just before you
got your last cold sore? What about the cold sore prior to that? If
you do some sleuthing, you just might figure out what triggers a cold
sore for you. If you can find a trigger, take additional lysine when
you're most prone to cold sores, says Dr. McCune.

Freeze-dry it. Some of Dr. Rooney's patients reach for ice when they
first feel the tingling. "I'm not sure that it works, but if I were to
speculate, I'd say that ice does decrease inflammation. And if
inflammatory substances aid the reactivation process, this could
help."

Dab on witch hazel. "Some patients claim that breaking a sore and
using witch hazel or alcohol to dry it really helps," says Dr. Rooney.

Soften it with an OTC. There are numerous products that claim to heal
cold sores. In general, they contain some emollient to reduce cracking
and soften scabs, and a numbing agent like phenol or camphor.

Phenol may have some antiviral properties, says Dr. Rooney. "It does
denature proteins. Theoretically, it is possible that phenol is
capable of killing the virus."

Block that sun (or wind). Protecting your lips from trauma like
sunburn or wind exposure was cited by all our experts as a key to
preventing cold sores.

Avoid arginine-rich foods. The herpes virus needs arginine as an
essential amino acid for it metabolism. So cut out arginine-rich foods
such as chocolate, cola, peas, grain cereals, peanuts, gelatin,
cashews, and beer.

Perfect your coping skills. Studies have shown that stress can trigger
recurrences of the herpes simplex virus. High levels of stress are not
necessarily the culprit, says Cal Vanderplate, Ph.D., an Atlanta
psychologist specializing in stress-related disorders. "How you cope
with the stress—how you perceive it—is what's important. Stress is not
a tangible thing; it's a concept."

His number one stress deflator is "maintaining a loving social support
system. This is the number one thing you can do to protect yourself
from high stress," he says. "A sense of control is also very
important. If you take a positive attitude toward your health, you'll
be more able to influence your symptoms."

Relax. "By the time symptoms appear, it's too late to intervene in
stress reduction," says Dr. Vanderplate. "But you may be able to
reduce the severity by doing some relaxation exercise." He favors deep
muscle relaxation techniques, biofeedback, visualization, and
meditation.

Exercise. "There is some evidence that exercise actually helps bolster
the immune system," says Dr. Vanderplate. The stronger your immune
system, the better able it is to defend you against viruses. Exercise
is also a super way to relax, he says.

Correct your perception. No one likes getting a cold sore. But if
you've got one, focusing on it and worrying about how you look can
make it worse. "Minimize any negative perceptions you have about it,"
says Dr. Vanderplate. "Tell yourself that 'this is just like a pimple
and it won't interfere in my life in any way.' "