Cold Sores (Herpes Labialis)
Cold sores are recurrent blistering outbreaks on or around the lips caused by HSV-1. After initial infection, the virus remains dormant and can reactivate periodically.
Symptoms
Tingling prodrome followed by grouped vesicles at the lip border that rupture, ulcerate, and crust over in seven to ten days. Triggered by stress, UV, and illness.
Causes and risk
HSV-1 spreads through direct contact. Most people acquire it in childhood. Immunosuppression and UV exposure trigger reactivation.
How it is evaluated
Usually clinical. Viral PCR confirms uncertain cases. We assess outbreak frequency to determine whether suppressive therapy is appropriate.
Treatment
Oral valacyclovir started within 24 hours of prodrome shortens duration. Daily suppressive therapy reduces frequency in patients with six-plus episodes per year. Our Chicago team provides early-treatment prescriptions.