Dr Bryan Betty: What are Cold Sores?

One topic that is very common and can be quite distressing for patients is ‘cold sores’ sometimes referred to as ‘fever blisters’. A very common presentation to the doctor! 

 

What are cold sores? 

- Small fluid filled blisters appear on the skin, often in patches. 

- Usually on the lips, chin or cheeks, or nostrils. 

- Sometimes can occur in the roof of the mouth or gums. 

- Often start with tingling or itching. Over 48 hours blisters develop, then burst and ‘crust over’, and dry out. 

- Can take 2-3 weeks to heal completely. 

- Occasionally you also get a temperature, sore throat, and headache. 

  

What causes them? 

- They are caused by a virus – herpes simplex virus 1. 

- They can be spread through close contact – kissing, shared utensils, towels. 

- More likely to spread when the blisters burst. 

- The virus can hide in nerve cells and be triggered by: 

- Stress, fatigue, fever, trauma, sun, or wind. 

  

How do you treat them? 

- They get better over 2-3 weeks. 

- Use sunblock lip balm outside. 

- Paracetamol can help the pain. 

- Avoid salty food. Also, ice or warm flannels. 

- You can be prescribed or buy antiviral cream from a chemist to speed up the healing. 

  

Is there anything else I should think about? 

- It’s important to avoid close contact such as kissing, touching, or sharing towels when you have cold sores. 

- They can recur and be triggered, so avoid trigger factors if possible – sun, stress. 

- There is a natural remedy: kanuka honey-based cream shown to be effective. 

- See your GP if it’s not healed within 14 days, occurs near the eye, very large, or you have other issues such having chemotherapy. 

 

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Episode Transcript

Speaker 1 (00:07):
You're listening to the Saturday Morning with Jack team podcast
from News Talks.

Speaker 2 (00:11):
A'd be quarter to eleven on News Talks. D be
viewed a list all of the common things that gps
and doctors are presented with. Colds would be near the
top of the list. But also, and to surprise me,
cold sores. Our doctor, doctor Brian Betty, is here with
us this morning. What in it, Brian, I'm er Jack
not to be here? Yeah I was. I was a

(00:32):
little bit surprised by this. But but take us back
to first principles. What are cold saws?

Speaker 3 (00:37):
Yeah, look incredibly common. They can be very mild or
quite severe. And the small fluid filled blisters that are
tear on the skin and they often appear in little patches.
Now commonly what people say is among the lips, the chin,
the cheeks, and sometimes in the nostrils and more severe
cases they can actually happen on the roof of the
mouth or the guns and they tend to be particularly painful.

(01:00):
So what what patients will notice is is it starts
with a sort of ingling, riching over thatarticularly area of
the skin, and over forty eight hours, these little clusters
and blisters actually develop. Then given about a week later,
a few days later, they actually burst and they start
to crust over and dry out, sort of like if
you've got kids have had chicken pox, a similar sort
of thing tends to happen. They just dry out, take

(01:23):
about two to three weeks to hel up completely, and
sometimes we do see things like a slight temperature, a
slight sore throat, and the headache associated with them. But
incredibly incredibly.

Speaker 2 (01:33):
Common, and they're caused by a virus.

Speaker 3 (01:35):
That yeah, so they're caused by something called the Herpee
simplex type one virus. Now, Herpee simplex type two is
a thing that causes chenital herpes. It's actually a virus.
It's related, but it's a separate virus, and it causes
these things called cold slaws cold saws. Now, they are
spread through close contact, So if you've got a cold saw,

(01:57):
things like kissine, sharing utensils or sharing toils will actually
spread the virus, so you need to be particularly careful
of that. And they are more likely bread when the
blisters burst because there's a bit of fluid there which
is very easy to transmit. Now, the other really interesting
thing about them is the virus once you've got it.
The virus once it goes away, it hides in the

(02:18):
nerve cells of the face. Okay, so the virus never
ever goes away, It just suits it and it can
actually be triggered by things like stress, fatigue, trauma, fever,
sun wind. So some people get these recurrent episodes of
it triggered by what we call these trigger factors, and
the virus pops out again and you get another cold sauce.
So you never actually get rid of the virus. It's

(02:40):
quite interesting.

Speaker 2 (02:40):
So how do you treat them?

Speaker 3 (02:43):
Look, they get better over two to three weeks, so
regardless of what you do, they clear up and get better.
So that's the first thing to say about them. But
often we advise simple things like, you know, if you're
going outside, wear some sun block or lip balm because
that just helps protect the area that's affected. Paracetamol or
broof and can help with the pain. Look, avoid salty

(03:03):
foods around them. Anyone who's eating sort of chips with
the sore throat will know what I'm talking about. That
can cause a lot of pain. Things like ice and
warm flannels can help. And actually you can go to
the chemists, go to see a chemist, and there is
anti viral cream. You can get something called a cycle
of via or fam cyclavia cream and that can speed
up the healing of them.

Speaker 2 (03:22):
And is there anything else we should be thinking about
if we experience cultures obviously trying not to you know,
share drinks and that kind of thing.

Speaker 3 (03:32):
Yeah, so that's really important. You don't want to spread them,
so kissing you know, as we said, towels and things
don't do that. Look, they do recur, as I said,
with these trigger factors. So if you know that the
wind or the sun suddenly triggers them or something triggers them,
try and avoid that if you can. There's actually a
natural remedy. Kanooka honey based cream has been shown to
be quite quite beneficial with them. So there is a

(03:55):
proven natural remedy around which is quite quite interesting. But
I would say look at the particularly large they don't
clear up over about two weeks or they're near the eye,
and particular the eyes we get worried about. Please please
go and see your doctor or GP and get them
checked out. Please.

Speaker 2 (04:12):
Okay, Oh that's really that's really good advice. Thank you. Hey,
are you into the Olympics. Brian is that are you in.

Speaker 3 (04:17):
A well, I will be watching them. Yeah, but I
didn't manage to watch the ceremony this morning.

Speaker 2 (04:24):
It was only five hours long, don't worry about that.
It was pretty good. They had, you know, they had
Celindi on and Lady Gaga, rough, arm A Dull and yeah,
Serena Williams. Yeah it was. It was spectacular. But is
there an event that stands out to you that you're
that you're sort of most keen forum.

Speaker 3 (04:43):
So look, look, I think the canoeing, Actually I'm interesting
the kayaking. It's kayaking, isn't it. You know, at least
Carrington that I think that's going to be really really
interesting this year in terms of what happened.

Speaker 2 (04:55):
Such competition in New Zealand, right, yeah, the reason to
think that we could be one too in the in
the Woman's came, well, that's exactly right.

Speaker 3 (05:02):
So I think that's why it's well well worth watching.
But I'll be interested in Dylan Schmid as well. Trumpet leaders.
I think that'll be really interesting as well, so I've
been watching him closely. So look, I think it'd be
exciting two weeks. So it always is once it starts.

Speaker 2 (05:15):
Yeah, I know, once it kicks off and you know
it's past the opening cerem and he gets into competition
in earnest and the middles.

Speaker 3 (05:20):
Of being out very exciting.

Speaker 2 (05:22):
Yeah, hey, thank you so much. You take care and
we will catch your own doctor Brian Beatty.

Speaker 1 (05:26):
For more from Saturday Morning with Jack Tame, Listen live
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