Treating cold sores

Cold sores usually clear up without treatment within 7 to 10 days. Antiviral tablets orcream can be used to ease your symptoms and speed up the healing time.

If you develop a cold sore, some general advice to follow includes:

• drink plenty of fluids to avoid dehydration
• avoid acidic or salty foods and eat cool, soft foods
• if brushing your teeth is painful, use an antiseptic mouthwash
• dab creams on to sores rather than rubbingthem in
• wash your hands using soap and water before and after applying cold sore creams
• avoid touching your cold sores, other than to apply cream, and don't share your cold sore cream with others

Antiviral creams and tablets

Antiviralcreams such asaciclovir or penciclovir (also known as Fenistil) may speed up the healing time of a recurrent cold sore infectionif used correctly.

Cold sorecreams are widely available over the counter from pharmacies without a prescription.

They're only effective if you apply them as soon as the first signs of a cold sore appear, when the herpes simplex virus is spreading and replicating. Using an antiviralcream after this initial period is unlikely to have much effect.

If you have frequently recurring bouts of cold sores,use antiviral medicationas soon as you feel the tingling sensation thatindicates a cold sore is about to develop. You'll need to apply the cream up to five times a day for four to five days.

Antiviral creams can only help toheal a current outbreak of cold sores. They don't get rid of the herpes simplex virus or prevent future outbreaks of cold sores occurring.

Antiviral tablets are generally more effective than creams at treating cold sores, but are usually only prescribed for more severe cases.

Cold sore patches

Cold sore patches that contain a special gel called hydrocolloid are also available. They're an effective treatment for skin wounds and are placed over the cold sore to hide the sore area while it heals.

Non-antiviral treatments

Several non-antiviral creams are also available over the counterfrom pharmacieswithout the need for a prescription.

These creams aren't specifically designed to treat cold sores and won't help them heal faster, but theymay help ease any pain orirritation. Ask your pharmacist to recommend a suitable treatment for you.

Pain can also be treated with painkillers such as ibuprofen or paracetamol both are available in liquid form for young children.

However, don't take ibuprofen if you have asthma or stomach ulcers , or you've had them in the past.

Children under the age of 16 shouldn't be given aspirin.

Speak to your GP if you have cold sores and you're pregnant.

Treating complications

If your cold sores are particularly severe or your immune system is damaged for example, if you have HIV or you're having chemotherapy treatment you may be at risk of developing serious complications.

For example, your risk of developing encephalitis or the infection spreading to other parts of your body, such as your eyes, is increased.

Visit your GP if you're at risk. Theymay prescribe antiviral tablets and refer you for specialist treatment.

The type of treatment recommended will depend on the severity of your cold sore symptoms and the complication that's causing problems.

For example, if you develop herpetic keratoconjunctivitis a secondary eye infectionyou may need to see an ophthalmologist, a specialist eye doctor.

Gingivostomatitis

Visit your GP if you or your child developsswollen, painful gums (gingivostomatitis) as a result ofthe primary herpes simplex infection. They'll be able to suggest treatments to help ease your symptoms.

If the infection is painful, your GP may suggest using a preparation that contains benzydamine, which is available as anoral rinse or oral spray, to help relieve any pain in your mouth or throat.

Brushing your teeth may also be painful because of the swelling of your gums. Your GP may suggest using an antiseptic mouthwash. This helps prevent secondary infections and will also control a build-up of plaque if you can't brush your teeth effectively.

As with the treatment of cold sores, any pain or fever can be treated using ibuprofen or paracetamol.

In rare cases of gingivostomatitis, it's possible for your lips to become stuck together in places. Using a lip barrier cream available from your local pharmacist will help prevent this.

Dehydration

If you or your child has gingivostomatitis, it's important to drink plenty of fluids to avoid becoming dehydrated. Young children are particularly at riskas they may refuse to eat or drink because ofthe pain in their mouth.

It's important to watch out for signs of dehydration , such as:

• headaches
• tiredness
• irritability
• lightheadedness
• low urine output

Most cases of gingivostomatitis get better in 7 to 14 days, although it may take up to three weeks for the sores to heal completely.

Specialist treatment

If you or your child still has symptoms of gingivostomatitis after two weeks or the infection is severe, go back to your GP, who may refer you for specialist treatment.

Specialist referral may also be needed for gingivostomatitis if you're pregnant or have a weakened immune system.

Visit your GP if you have a newborn baby who develops gingivostomatitis, as they may also need to be referred for specialist treatment.