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Cold Sores (cont.)

Cold Sore Prognosis

There is no cure for cold sores. The herpes simplex virus hides deep in nerve roots and cannot be wiped out by medicines that are currently on the market. The U.S. Food and Drug Administration warns that there are products that falsely advertise that they are getting rid of herpes for good, but these claims are fraudulent. The virus will continue to live in the nerve root despite treatment, and most people will continue to get cold sores off and on throughout their life.

Herpes can be spread from a cold sore to another area of the body, which is called "autoinoculation." For example, touching a cold sore on the lip can cause herpes of the finger (herpetic whitlow). Autoinoculation occurs most commonly at the time of primary infection when viral shedding is high and the immune system is still gearing up to contain it. The antibodies that are made after primary infection are usually -- but not always -- successful in preventing autoinoculation during recurrent attack. To prevent spreading the virus to other parts of the body, it is important to wash hands after touching the sore. One question that is sometimes asked is Do cold sores cause genital herpes or are they contagious to genital areas? Although it is possible to autoinoculate the genital area, most cases of genital herpes are acquired through sexual transmission.

A more serious complication is ocular herpes, which causes sores and severe pain around the eye. Ocular herpes is also caused by autoinoculation. If untreated, ocular herpes can lead to serious eye damage or even blindness.

Medically reviewed by Martin E Zipser, MD; American board of Surgery

Previous contributing authors and editors:

Author: Thomas H Scott, DO, Staff Physician, Department of Emergency Medicine, Newark Beth Israel Medical Center.

Coauthor(s): Tara Shapiro, DO, Assistant Director of Emergency Medicine Residency Program, Clinical Assistant Professor of Emergency Medicine, Department of Emergency Medicine, Newark Beth Israel Medical Center.

Editors: Scott H Plantz, MD, FAAEM, Research Director, Assistant Professor, Department of Emergency Medicine, Mount Sinai School of Medicine; Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine; Steven L Bernstein, MD, Vice-Chair, Academic Affairs, Department of Emergency Medicine, Newark Beth Israel Medical Center; Assistant Professor, Department of Emergency Medicine, Mt Sinai School of Medicine.

REFERENCE:

Cernik, C., K. Gallina, and R.T. Brodell. "The Treatment of Herpes Simplex Infections: An Evidence-Based Review." Arch Intern Med 168.11 June 9, 2008: 1137-1144.


Medically Reviewed by a Doctor on 5/7/2014
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The eMedicineHealth doctors ask about Cold Sores:

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Read What Your Physician is Reading on Medscape

Herpes Simplex »

Herpes simplex viruses (HSVs) are DNA viruses that cause acute skin infections and present as grouped vesicles on an erythematous base.

Read More on Medscape Reference »


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