Repeated Cold Sores

I need your advice on cold sores. I get them but only once or twice a year and my wife does not have them at all. My son who is in his final year of High School and is studying very hard, is having multiple attacks. Do you think they may be stress related? Is there any protection we can practice? Given that we never kiss him on the lips, where are they coming from (he does not have a girlfriend)?

Cold sores are an herpes infection. We all have an initial herpes infection in our first few years of life. Then it causes mouth ulcers. After the infection is over the herpes virus remains in the nerves that supply our lips. Most of the time we suffer no harm from this carrier state. Unfortunately, for about 40% of the population, when they are stressed, the virus becomes active and the ulcers appear on and near the lips again.

The most common cause of that stress is the common cold, hence the name cold sores. However, the stress may be emotional and it seems likely that is the case for your son.

There is an anti-viral cream that is effective in herpes but as each attack is self-limiting, it should only be used in the most severe cases for fear of the virus becoming resistant to it. Babies or the very elderly can get the herpes virus in their blood stream when it is frequently fatal without this anti-viral agent. In my opinion, we should reserve this agent for these cases or particularly severe skin herpes.

Anyone with active cold sores should not go near a newborn baby (under 1 month of age). If avoidance is impossible, a mask can be worn. However, the mask must be changed and hands washed every 20 minutes if the contact with the baby is to be prolonged. I must say it is rare in my experience for the mother with cold sores to give the virus to their baby.

I am one of the 60%. Who do not have repeated cold sores, but I feel very sorry for those who do.