What Is This Thing On My Lip?
If you have a cold sore on your lip then what’s happened is that the herpes virus that was dormant in the nerve cells around your face has, for some reason (something probably caused your immune system defenses to drop for a short period, thereby allowing the virus to go active) decided it was going to come out and play–fun for it, no fun for you, right? Oral herpes (aka HSV, or herpes simplex virus) is the most common form of herpes and is medically known as “herpes labialis”, which is the infection that occurs when the virus comes into contact with oral mucosa or abraded skin.
Other disorders such as herpetic whitlow, herpes gladiatorum, ocular herpes (keratitis), cerebral herpes infection encephalitis, Mollaret’s meningitis, neonatal herpes, and possibly Bell’s palsy are all caused by herpes simplex viruses.
The cold sore on your lip, as you probably know, will not be there forever, but while it is there it’s painful, annoying, itchy, and worst of all: embarrassing! For many people, cold sores are so unsightly and embarrassing that they won’t even leave the house until they’re completely cleared up! Regrettably, no cure or vaccine is currently available, although vaccines of varying effectiveness are currently in phase III clinical trials with the NIH (National Institute of Health–search Google for “herpevac” and “zostavax”).
Mind you, no matter what treatment you take, there is currently no “cure” for cold sores, and once you’ve got it, then it’s with you for life. Herpes cycles through dormant and active cycles, being dormant the great majority of the time, and only causes active outbreaks a few times a year that will typically last from between 2 and 21 days, often right around a week for most people.
Prescription anti-viral medications for herpes work by interfering with viral replication, thereby slowing the replication rate of the virus and giving the immune system more of a chance to shut the virus down before it can cause problems. Acyclovir was the original anti-viral prescribed for HSV, and is currently the recommended drug for suppression of HSV during the last months of pregnancy to help prevent neonatal herpes. The other two prescription anti-virals typically prescribed for cold sores are Famcyclovir and Valacyclovir. All three of these medications will essentially result in the same thing for the average cold sore sufferer: they will reduce the pain and irritation experienced by the individual, and they will shorten the duration of the outbreak by 1 to 2 days, that’s it.
I personally recommend that anti-virals, if you have a prescription for them, are combined with OTC (over-the-counter) and some simple home treatments that, when used together, can significantly shorten the duration of the outbreak down to as little as 24-48 hours in total length.
Cold Sore First Aid
Ok, here’s what to do:
1. As soon as you feel the tingling of an oncoming cold sore, immediately start taking your anti-viral medication if you have a prescription.
2. Keep the area clean by washing it once every 2 hours with a damp wash cloth and soap–use a new wash cloth each time so as not to spread the virus to any other areas of your body (you don’t want it in your eyes–herpes keratitis is a leading cause of blindness in the United States).
3. Ice the area with an ice cube for approximately 10 minutes at a time every 2 hours.
4. Apply benzyl alcohol with a q-tip to the area after you ice it. Let it absorb and completely evaporate. Isopropyl alcohol (plain rubbing alcohol) can be substituted if you can’t get any benzyl alcohol.
5. Apply some 10% benzyl peroxide acne medicine (like Clearasil) to the area–this will soak up any and all excreted fluid between now and the next time you wash it in 2 more hours.
This procedure will drastically reduce the length of your outbreak and significantly reduce the severity of the cold sore as well. If you do this early enough before the cold sore has even emerged when you’re feeling prodromal symptoms (symptoms that occur prior to an outbreak, the most common of which is tingling), then oftentimes the cold sore will be prevented and never emerge in the first place.
If you start this procedure once you’ve already got a cold sore I would advise you to ensure that you drain every last drop of fluid from it before washing it in step 2–treat it like you would a pimple, just pierce it with a sterilized (use alcohol to do this) pin and then squeeze and drain the liquid onto a kleenex that you can blot it with.