Two views: Cold sores

TRADITIONAL: MYRA ALLEN, pharmacist at Shoppers Drug Mart in Calgary

A cold sore is a common, painful infection that usually appears on the lips or around the mouth. It’s caused by the herpes simplex virus, which we can become exposed to by, for example, sharing a contaminated glass or kissing someone who has the virus.

After the first cold sore, the virus remains latent, or dormant, in the nerve cells of the skin. Recurrences may be triggered by extreme cold or heat, sun exposure, fatigue, stress or the onset of the menstrual cycle. Typically, you’ll feel a tingling on your lips, which is called the prodrome. Then bubbles, called vesicles, appear, burst and scab over, healing without a scar in most cases. Cold sores usually last from seven to 10 days.

To prevent an outbreak, use sunscreen, eat and sleep well, exercise and keep your stress in check. Once the cold sore has formed, keep the area clean and moist with lip balm or Vaseline until it scabs over. (The infection is contagious until the scab forms.) Taking pain-relief medication, such as Tylenol and Advil, can help.

Topical creams, such as Abreva, can keep the infected area moist and may shorten the duration of the outbreak by one or two days. Prescription medications, such as Zovirax and Valtrex, may prevent repeated infections, but they’ll never get rid of the virus completely.

Alternative treatments are fine, if they’re supported by scientific data. But always check with your doctor about whether those treatments might react adversely with medications you’re taking for other conditions.

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ALTERNATIVE: SANDRA MURPHY, naturopath at the Nurture Therapeutics clinic in Halifax

In addition to stress, sunlight, menstrual periods and some foods or drugs, an amino acid called arginine can trigger cold sores. If you feel that familiar tingling, I recommend a diet low in arginine, which is found in chocolate, peanuts and gelatin. I also recommend foods that are high in lysine, an amino acid found in fruits and vegetables.

Lysine tablets can also be taken orally, and black licorice syrup can be used topically to soothe outbreaks. Both products should be used only under the supervision of a health practitioner, such as a naturopath.

For recurring problems, I assess your immune system. If you get lots of colds, for example, I might recommend astragalus, a Chinese herb that boosts your immune system, or reishi-mushroom extract, which will build up your system and fight recurrences.

If your immune system seems fine, I examine your digestive system. Seventy-five percent of our white blood cells line our digestive systems, so if you’re not digesting properly, these cells will be tied up with that process. They won’t be available to fight off cold sores.

If the cold sores seem to be connected to your menstrual cycle, I conduct a full hormonal assessment and make recommendations to relieve premenstrual symptoms.

When pharmaceuticals work, that’s great. I’m part of a patient’s health-care team, which includes a family doctor. But alongside treatment, we should be asking, Why is your body not fighting off this virus naturally?