Ugh!…I woke up with a nasty cold sore, and I have a date tomorrow! What do I do??

Always perfect timing isn’t, it? – That unsightly sore never fails to appear when you have a big day coming up: a wedding, presentation, a date etc. If you look hard enough, you can even see it transforming into a mutant monster (OK, I’m exaggerating, but I bet that how it feels sometimes).

While it is certainly embarrassing to have a sore on your lip right where everyone can see it (and in this case, when you were expecting to get a kiss at the end of your date night), cold sores are actually more common than you think. Apparently, the social stigma surrounding cold sores was created by a pharmaceutical company years ago as a marketing ploy to sell their drug.

In fact, most people in the United States are infected by age 20. So before you start feeling ashamed about your cold sore, I would like you to first realize that cold sores can be contracted in several other ways that do not involve sex or kissing. Such as:

•             Touching something that is infected with the herpes virus, such as infected razors, towels, cups, spoons, dishes, and other shared items.

•             When you were a child,  parents/guests or friends may have spread the virus to you during regular daily activities or playful kisses and pecks.

What is a cold sore?

A cold sore (aka fever blister) is a small, painful blister cause by an infection of the lips, mouth, or gums due to the herpes simplex virus (HSV-1) .It is not the same as Herpes virus type 2 (HSV-2) which is the cause of genital herpes. However, sometimes HSV-2 can be spread to the mouth during oral sex, causing oral herpes.

What are the symptoms and triggers?

After the first infection, the virus goes to sleep (becomes dormant) in the nerve tissues in the face. Certain triggers such as stress, fatigue, sun exposure, a weakened immune system, flu etc. cause the virus to “wake up” (reactivate), causing cold sores.  However not everyone has symptoms; some people have the virus but never develop cold sores.

The first symptom of cold sores is usually a tingling and itching sensation around the mouth/lips and sometimes a fever and sore throat, before the blister appears. After a few days, the blisters break open, leak a clear fluid, crust over and then disappear after several days to 2 weeks.

How do I treat my cold sore?

Cold sores will usually start to heal on their own within a few days, but if they are really painful or make you feel embarrassed, they can be treated. I usually recommend topical creams such as Lysine and Docosanol, but warn patients that they are not miracle creams that would make the sore disappear – in fact they may only get rid of the cold sores 1 to 2 days faster. However, one big advantage of the topical is that they help ease the pain of the blisters and other uncomfortable symptoms.

Oral antivirals such as acyclovir, famcyclovir and valacyclovir can also be used, but these medicines work best if you take them when you have warning signs (tingling/itching stage), before any blisters develop. If you get mouth sores frequently, you may need to take these medicines all the time. You can also apply ice or anything cool to the area, and take an over-the-counter pain reliever, such as acetaminophen or ibuprofen.

Here are some other helpful tips

1. Know your triggers, and either avoid or counter them. If stress is your trigger, doing some yoga can help reduce your stress, or suck on zinc lozenges to improve your immune system if that is your trigger.
2. Don’t touch your cold sore and if you do, be careful not to touch your eyes or genitals. Also wash your hands frequently so you don’t spread it.
3. Don’t cover with make-up or lipstick, the chemicals can irritate the sore and make it worse. Just use regular petroleum Jelly.
4. Change your toothbrush after each breakout
5. Do not perform oral sex or kiss if your cold sore is still active (sorry! I know you may have wanted that goodnight kiss)

Cold sore is no respecter of person and in fact here is an interesting Pinterest page that features numerous celebrities with cold sores. Seems like your cold sore may have been triggered by your anxiety about this date, but having a cold sore should not stop you from having a fabulous time. I’m sure your date would be blown away by your great personality and the sore would not even be a factor. And if you are THAT self-conscious, perhaps you can do a dinner date and go to a “low-lit” date venue so that it is not too visible. Having a cold-sore certainly does not mean you’re promiscuous, and in case your date doesn’t know much about them, please feel free to direct him to this blog for more education.

Hope this helps and good luck on your date! 🙂