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Cold Sore Outbreak Warnings

COLD SORE OUTBREAK WARNINGS

Is there a way to know when a cold sore outbreak is coming?  Is there anything that can be done to ward off cold sore outbreaks and herpes outbreaks in advance, before they start?

Tens of millions of Americans experience painful and socially embarrassing recurring cold sore outbreaks which can happen with varying degrees of frequency, ranging from a few times a year to monthly, or more!  The symptoms of cold sore outbreaks, which are caused by the rapid reproduction of the HSV-1 virus, can include blisters or lesions of cold sores on the mouth, cold sore blisters on the lips, cold sores on the tongue, and even cold sore outbreaks on the chin or nose, and around the nasal opening.  The symptoms can be mild or more severe, and can vary greatly from person to person, or even from one cold sore outbreak to the next.

Advance Warning Signs of Cold Sore Outbreaks

Almost every who experiences recurring cold sores or herpes outbreaks experiences a set of ‘early warning’ signs in the week or two before a cold sore outbreak erupts and becomes visible.

This warning sign period is called the ‘Prodrome’ period, or simply ‘prodrome’.  Sometimes it’s hard to miss, but once one understands what to look for, and knows what the prodrome warning signs are, it may be easier to prepare before the outbreak actually erupts.  It’s also a time when the HSV virus is very infective, and one can spread or transmit the herpes virus to another person even when there is no visible or active cold sore outbreak.

This is because as the virus reproduction levels are increasing, on the way to erupting in a cold sore outbreak, there is more virus present in the body, and virus particles in skin cells (which are constantly being shed every day) can very easily be passed from one person to the next by simple direct contact.

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HSV-1 Cold Sore Prodrome

During prodrome (a period of several days to several weeks prior to a cold sore outbreak actually erupting), those with the HSV-1 virus may experience such warning signs of an impending outbreak as:

  • Itching of the lips or skin near the mouth or nose
  • A burning sensation near the lips or around the mouth or nose
  • Tingling near the lips or near the mouth or nasal areas
  • Mild symptoms of a sore throat
  • A mild fever
  • Swollen glands
  • Painful swallowing
  • Muscle aches
  • A slight malaise (just not feeling well)

Over time, most people who experience recurring cold sore or herpes outbreaks learn to sense or feel one of more of these prodrome effects, and this can help them become aware of the need to more carefully avoid trigger foods or events that can further stimulate the virus to reproduce in greater numbers.

When one feels any of the prodrome effects, it’s a good idea to take a moment to think about any possible foods or activities that might be a trigger for virus reproduction and a next cold sore outbreak, so let’s review some of these here:

Often, the rate of viral replication leading to an outbreak level, (sometimes referred to as a ‘high viral load’) can be triggered by a wide range of events, including, but not limited to:

  • Exposure to the sun, extreme heat or overexposure to UV rays, such as from tanning
  • Fever from another cause
  • Stress and fatigue – one of the most common causes of outbreaks
  • Menstruation or changes in hormone levels
  • A weakened immune system, or an immune system occupied with fighting some other infection or disease
  • Friction, rubbing or trauma to the infected area
  • Vigorous sexual activity
  • Exposure to cold or wind which could irritate an infected area of the skin
  • Diets rich in specific trigger ingredients
  • Excessive consumption of alcohol, which can weaken the immune system

Prodrome Early Warnings of Genital Herpes Outbreaks

The symptoms of an HSV-2 outbreak are similar in most ways to those of HSV-1, and can vary from lesions or blisters in and around the vagina, penis or anal areas to a wider outbreak affecting the thighs, lower back and buttocks.

Symptoms may also be mild or severe, and this too will vary from person to person.  Typically, people will experience warning signs during a short period before an actual outbreak – called the ‘Prodrome’ period, or ‘prodrome’.

HSV-2 Prodrome

During prodrome, HSV-2 patients may experience such warning signs as:

  • Decreased appetite
  • Itching of the skin in or around the genitals
  • Generally not feeling ‘well’ – referred to as ‘malaise’
  • Muscle aches in the lower back, thighs, knees or buttocks
  • A burning sensation in the genital region
  •  Tingling in the area of the genitals
  • A mild fever
  • Swollen lymph nodes in the groin (more common during an actual outbreak)
  • Pain in and around the groin area

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HSV-2 Outbreaks and Symptoms

When an outbreak occurs, HSV-2 blisters may appear on or around the female labia, inside or on the exterior of the vagina, on the cervix, around the anus or on the thighs or buttocks; in men, HSV-2 blisters may appear on the penis or scrotum, around the anus, on the buttocks or on the thighs.

The blisters will typically appear similar to those of an HSV-1 outbreak, as a group of small ‘pustules’ (small swollen capsules of liquid) and may form into red or dark blisters that can break open and leak infective fluid, which will typically be yellowish in color. Smaller blisters may merge forming larger blisters as they fill with fluid.

These blisters can last for a few days to as long as several weeks. When the blisters break open, they may leave small shallow ulcers that can be extremely painful. Eventually, if left alone these will heal; first they will turn yellowish and get crusty, then they will begin to scab over and shed off like dried skin, eventually revealing normal but lighter colored skin beneath, which will darken over time to look like normal skin.

Provided the blisters or affected areas are not further damaged by scratching or peeling the blisters, scarring should be a rare occurrence. During an HSV-2 outbreak, patients may experience painful urination or a vaginal discharge.

It is important to note that during an outbreak of HSV-1 and HSV-2 blisters, the affected person is highly contagious, and should exercise extreme care in ensuring they do not transmit the virus by direct contact to others, as well as preventing cross-contamination from their genitals to their faces or mouths, and vice-versa.

Outbreaks of HSV-2 will likely occur when the virus has reproduced so much that the host cells they have infected can no longer contain the volume of newly formed viruses. The membrane of the host cells will then break open, releasing the newly formed virus particles into the surrounding area, where they will seek new host cells to attach to, insert their DNA or RNA into and begin replicating.

Often the virus will go dormant for a period of time, from weeks to months or more, before a subsequent outbreak may occur if triggered by an excessive viral load or the action of a specific trigger. HSV-2 symptoms are more common in women than in men.

Potential Triggers of HSV-2 Virus Impending Outbreaks

The rate of viral replication leading to an outbreak of HSV-2, (sometime referred to as a ‘high viral load’) can be triggered by a wide range of events, including, but not limited to:

  • Fevers from other causes or diseases
  • Physical or emotional stress and fatigue – one of the most common causes of outbreaks
  • Menstruation or changes in hormone levels
  • A weakened immune system
  • General irritation of the affected area from vigorous sexual activity or an injury
  • Diet – especially high levels of L-arginine (frequently found in flour, gelatins, nuts, chocolate and pastas), as well as caffeine and related stimulants
  • Excessive consumption of alcohol, which can weaken the immune system

Outbreaks or manifestations of Herpes virus infections may appear in different places on the body and may often be mistaken for other types of infections or rashes. Remember that cold sore outbreaks and HSV infection outbreaks can vary in intensity and symptoms from mild to more severe.

There is no substitute for the advice or diagnosis of a medical professional – do NOT try to self-diagnose, as this may lead to a wrong conclusion, and thus one may be tempted to try various therapeutic approaches which may not work or may exacerbate the condition. SEE YOUR DOCTOR OR DERMATOLOGIST FOR A PROPER DIAGNOSIS AND PROFESSIONAL TREATMENT AND RECOMMENDATIONS.

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