cold sore questions

[poco1023]

Hi Doctor R, I'm hoping you can help me answer some questions.  I've had cold sores for 16 years, I'm female 45.  normally I get an OB once or twice a year depending on my stress level, which is what seems to trigger my ob's.  I've been cold sore free for over a year until saturday nov 18th.  This one was pretty severe for me.  The swelling was so bad on sunday i tried ice to ease it, but i dont think it worked. by day 5 wednesday i was still getting new blisters so i decided to go see my dermo.  She put me on valtrex 2 pills a day twice a day, morn/night. within hours of the first set of pills both eye lids and underneath got swollen and i developed a face rash. i went to see her next morning and she gave me a shot for the reaction and told me to stop the valtrex since it seems i was allergic.  She didnt put me on any oral meds only an ointment called Locoid.  It's now day 10 and the sore has gotten smaller but it's still there.  normally my ob's would last 8-10 days start to finish. Here are my questions:

1. did the ice make this ob much more severe?
2. do new blisters still appear at day 5 or did the ice make it spread?
3. since my last ob was over a year ago could that be why this one was alot worse then the others?
4.  What does the locoid do besides make the scab moist and cause the sore to be shiney and embarrasing? according to a site on the internet it states this med is not good for cold sores.
5. Is there another oral med i can take besides valtrex?
6. Should I stop the locoid and use abreva to help dry it up?

I'm at a loss with this ob. Usually i just deal with them and in less then 10 days it's gone. Also, I'm still having the tingling and itch around the sore and I'm also achey (achy). Is this because it hasn't cleared up yet?

It would be very helpful if you could answer my questions.  Also, would you have taken a different action in this case.

Thanks for you help.

[Alan Rockoff, MD]

1. did the ice make this ob much more severe?
No.
2. do new blisters still appear at day 5 or did the ice make it spread?
Ice didn't do anything but make them cold for a while.
3. since my last ob was over a year ago could that be why this one was alot worse then the others?
Don't know.  Outbreaks vary for no special reason.
4. What does the locoid do besides make the scab moist and cause the sore to be shiney and embarrasing? according to a site on the internet it states this med is not good for cold sores.
It's not likely to do anything, one way or another.
5. Is there another oral med i can take besides valtrex?
Famvir.  But to tell you the truth, I have never seen an allergic reaction to Valtrex.  I have no idea what that swelling was about.  But in any case, starting a pill like Valtrex once you have an outbreak makes almost no difference in shortening the outbreak--maybe by a day from what it would have been without it, so you're not missing much by not taking anything at this point.
6. Should I stop the locoid and use abreva to help dry it up?
I'd do nothing.  It will heal by itself.

Sometimes, cold sore outbreaks take longer than others.  No need to read more into it than what's there, which isn't much...

No, I wouldn't have done anything differently.

Take care.

Dr. Rockoff

[yesnomaybe]

I am in my 20s and have had cold sores my entire life.. The things I have found to set off cold sores for me are stress, hot sauce (and some really spicy food; could be jalopenos), and orange juice.  Why? I dont know.  But to defeat a cold sore, go to the pharmacy and get a bottle of " L Lycine" amino acid.  I don't know if that is the correct spelling.  The second I feel my lip tingle with that sensation of an oncoming cold sore, I take 4 pills (weather they are 500mg or 1000mg).  It may make you feel a little indigestive but not for long.  Then take 2 more every 6 hours for about 2 days, or until the cold sore goes away. Then take 1 pill every 12 hours for the next two days.  I find that by hitting it with a heavy dose up front it stops the cold sore in its place, especially if it has yet to actually form, and the rest forces it to subside. I havent had a bad cold sore for over a year either, and will never touch orange juice or really hot sause ever again if that is what it takes. Hope this helps, and maybe the doctor can tell me how unhealthy it is to take that much L lycine.  Because I hate gettting cold sores more than pretty much anything else.

[poco1023]

Thanks Doctor R for answering my questions.  Do you feel there's any facts or truth regarding "yesnomaybe's" comment about L-lysine?  I know what may work for one may not work for others, but I wanted to get your view on this since I have read about this before. I've also heard that taking this product long term can cause other problems.  Just would like your thoughts on this.  This will be my final question.

Thanks yesnomaybe for your advice.  I know with me my OB's do revolve around stress.  This one came on after some major dental work I had done. I knew it was going to happen just didn't know when and unfortunately for me my "signs" arent that pronounced so I didn't know it was coming until it was too late. I'm always looking to try something knew when it comes to these unsightly cold sores especially after having to deal with this one for a family wedding and turkey day. thanks again!

[BoogleBear]

I know, I'm not supposed to disclose personal information about my father (patients). It was a really intereseting situation though. Before he was going to meet his beautiful Girlfriend in Russia... he developed cold sores much like you explained.

My father has never had such severe cold sores all his life. This was a really good incident though, right before he was traveling. He really wanted to impress his sweetheart. I remember going with him to a make shift clinic.

I asked him, "are you sure this is okay?" he said, "It's fine, It's fine." They gave him some cream to use on his cold sore. (He is in medical field, but all man know everything, right?)

It got worse and worse for him. Seemed he had an alergic (allergic) re-action to it. My dad is not allergic to medicine.

I'm not a Doctor. Just twenty five years old and his son. I'm positive that he had accumilated too much stress because he was going to meet his new girlfriend. He has never met her in person. The rare occasion he got the cold sore, stress could have made it worse.

My dad has been divorced since I was 8 years old. So I have been the only person living with him sraight for ten years. I know him better than anybody in this world. I believe that I have noticed the same condition with him that you described.

Most of all I'm just trying to make sure you were not over stressed. I do hope you will not worry. Take it step by step. We are all here!

-BoogleBear

[poco1023]

Thanks so much for the story.  I can understand how meeting a new person that you've never met before be a stressful time especially when you want to impress that person.  I know definitely my ob was due to a high amount of stress from all my dental work that I had done. For the first two appts my dentist prescribed valium for me which I think really helped calm down my nerves. On the last appt back to the dentist I decided I was strong enough that I can handle this last appt with no meds.  Low and behold a week later after the dentist visit here came the cold sore.  Oddly enough I can usually predict when their going to happen depending on when the stress/nervous event took place which is almost a week to the day. I breezed through the first 2 weeks of appts with no problems, but I have to believe the valium kept my nerves at bay and that last appt just did me in. I let my nerves get the best of me.

[BoogleBear]

And stretching and pulling and picking and pricking and whatever else ... the dentist will never help when it comes to the lips. I'm sure the open mouth syndrome of the wonderful DENTIST didn't help ...  Just take it slowly. That is the most important thing that we can do for ourselves.

Best Best !!

-BoogleBear

[mae246]

A related discussion, cold sores was started.