Enhanced Verifiable CPD from the
University of Birmingham

Dentaljuce Shorts: 500 words, 10 MCQs, on general medicine and surgery.

Cold Sore (Herpes Labialis)

Cold sores, also known as fever blisters, oral herpes, or herpes labialis, are a common infectious disease of the lip caused by the herpes simplex virus (HSV). The condition is characterised by small blisters or sores that typically heal within ten days. The virus, usually HSV type 1 (HSV-1), remains dormant in the trigeminal ganglion and can periodically reactivate.

Signs and Symptoms

A cold sore on the lower lip. Note the blisters in a group marked by an arrow.
A cold sore on the lower lip. Note the blisters in a group marked by an arrow.

Herpes labialis usually presents with burning pain followed by the development of small blisters or sores. Initial infection may also include symptoms such as fever, sore throat, and enlarged lymph nodes. Recurrent infections follow a series of stages:

  1. Latent: Virus resides in sensory nerve ganglia without symptoms.
  2. Prodromal: Tingling and redness precede blister formation.
  3. Inflammation: Swelling and redness as the virus reproduces.
  4. Pre-sore: Formation of tiny, inflamed papules and vesicles.
  5. Open lesion: Vesicles break open, creating a weeping ulcer.
  6. Crusting: Formation of a honey/golden crust as healing begins.
  7. Healing: New skin forms under the scab.
  8. Post-scab: Red area remains as the cells regenerate.
Herpes labialis spread over the entire circumference of the lips.
Herpes labialis spread over the entire circumference of the lips.

Causes

Herpes labialis is primarily caused by HSV-1 and occasionally by HSV-2. The infection spreads through direct contact with infected individuals, often via non-sexual means. Triggers for reactivation include sunlight, fever, psychological stress, and menstruation. The virus resides in the central nervous system and can reactivate to cause cold sores.

Diagnosis

Diagnosis is usually based on clinical symptoms but can be confirmed with specific testing. Differential diagnoses include herpangina, aphthous stomatitis, impetigo, and mononucleosis.

Prevention

Primary prevention involves avoiding direct contact with infected areas and frequent hand washing. During active infections, it is advised to avoid kissing and sharing personal items. For recurrent infections, sun protection and antiviral medications such as acyclovir and valacyclovir may help reduce frequency and severity.

Treatment

Treatment options vary based on symptom severity and include:

  • Topical Creams: Zinc oxide, anaesthetic (lidocaine, prilocaine), and antiviral (acyclovir, penciclovir) creams.
  • Oral Antivirals: Acyclovir, valacyclovir, and famciclovir, effective in reducing symptom duration and viral shedding.
  • Mouth Rinse: Combinations of ethanol and essential oils have shown therapeutic potential.

There is no cure for HSV, but the body's immune system typically manages the virus. Chronic suppressive therapy may be necessary for severe or frequent recurrences.

Epidemiology

Herpes labialis is widespread globally. Studies indicate varying lifetime prevalence rates, such as 20-45% in the USA, 32-42% in France, and 32% in Germany. Recurrence rates are common, with around 33% of individuals experiencing subsequent episodes.

Research

Ongoing research aims to develop vaccines and new therapeutic drugs for both prevention and treatment of herpes infections.


Self-assessment MCQs (single best answer)

What is the primary cause of cold sores?



Which stage of herpes labialis involves the formation of tiny, inflamed papules and vesicles?



What symptom is typically experienced during the prodromal stage of herpes labialis?



Which of the following is NOT a common trigger for the reactivation of herpes labialis?



What is the recommended primary prevention method for herpes labialis?



During which stage of herpes labialis does the formation of a honey/golden crust occur?



What are the common symptoms of the initial herpes labialis infection?



Which diagnostic method is commonly used to confirm herpes labialis?



Which of the following treatments is NOT used for herpes labialis?



What is the estimated lifetime prevalence of herpes labialis in the USA?



Dentaljuce

Dentaljuce provides Enhanced Continuing Professional Development (CPD) with GDC-approved Certificates for dental professionals worldwide.

Founded in 2009 by the award-winning Masters team from the School of Dentistry at the University of Birmingham, Dentaljuce has established itself as the leading platform for online CPD.

With over 100 high-quality online courses available for a single annual membership fee, Dentaljuce offers comprehensive e-learning designed for busy dental professionals.

The courses cover a complete range of topics, from clinical skills to patient communication, and are suitable for dentists, nurses, hygienists, therapists, students, and practice managers.

Dentaljuce features Dr. Aiden, a dentally trained AI-powered personal tutor available 24/7 to assist with queries and provide guidance through complex topics, enhancing the learning experience.

Check out our range of courses, or sign up now!

Membership Options

Dentaljuce offers a range of membership options…

Regular Membership

With enhanced CPD Certificates. Dentaljuce is brought to you by the award winning Masters team from the School of Dentistry, University of Birmingham, UK. All have won awards for web based learning and teaching and are recognised as leaders and innovators in this field, as well as being highly experienced clinical teachers. Full access to over 100 courses, no extras to pay.

Buy Now

£89.00 per year

Student Membership

No Certificates. With universities cutting down on traditional lectures, many students are currently having to rely more on online resources. If you don't need CPD Certificates, we are offering an amazing discount on your Dentaljuce personal membership fee. Special student price just £29 for 12 months individual membership.

Buy Now

£29.00 per year

Really good, very user friendly and practical.
JW

© Dentaljuce 2024 | Terms & Conditions | Privacy Policy

Recording CPD time: recorded.