New research has identified the cause of outbreaks of cold sores, often known as fever blisters.

Cold sores, a common viral infection, manifest in the form of small, fluid-filled blisters on and around the lips. Often appearing in patches, the blisters eventually break, after which a scab forms. The scab typically heals within two or three weeks. Cold sores can spread through close contact, such as kissing. The usual cause is the herpes simplex virus type 1, and occasionally by the herpes simplex virus type 2. Both viruses can affect the mouth or genitals and can be transmitted by oral sex. Even if the sores aren’t visible, cold sores are contagious.

After becoming infected with the herpes simplex virus (HSV), the virus never disappears. Rather, it remains inside the body’s neurons, awaiting reactivation. New research from the University of Virginia School of Medicine explains how stress, illness and even sunburn can cause an outbreak. This new information could possibly lead to new prevention measures as well as preventing recurrent herpes-related eye disease.

“Herpes simplex recurrence has long been associated with stress, fever and sunburn,” said researcher Anna R. Cliffe, PhD of UVA’s Department of Microbiology, Immunology and Cancer Biology. “This study sheds light on how all these triggers can lead to herpes simplex-associated disease,” she said. Cliffe and her research colleagues discovered that when neurons that harbor the virus were affected by stimuli that induce neuronal hyperexcitation, the virus recognizes the change and embraces the opportunity to reactivate.

Manifestation of cold sores typically involves several stages, including tingling and itching, appearance of blisters, and oozing and crusting. Although there’s no cure for cold sores, treatment can help manage outbreaks. Prescription antiviral pills or creams can help to hasten the healing process. Additionally, they may reduce the frequency and severity of future outbreaks.

The researchers noted that more research is necessary to understand the potential factors that can play a role in herpes simplex outbreaks. It’s possible that depending on the virus strain or the type of neuron that’s infected, such factors may vary. However the new research can help to improve the understanding of what is occurring in neurons and the immune system, possibly leading to new prevention measures. “A better understanding of what causes HSV to reactivate in response to a stimulus is needed to develop novel therapeutics,” Cliffe said. The researchers hope to target the latent virus itself and make it unresponsive to stimuli.

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