By Cheryl Solimini

I was 16 when I got my first cold score, an unintentional Christmas gift from a relative who passed it on through the traditional holiday smooch. I thought it was just another of my teenage blemishes, until it took on cauliflower-like proportions and began aching and itching like crazy.

From then on, it became an uninvited guest at least once a month, usually arriving and staying at the same time as my other "uninvited guest." I spent about 25% of my high school years with one hand covering my lower lip. Not a plus for my social life.

I hope I would outgrow it. But 25 years later, painful cluster of blisters still emerge when I least expect them and want to look my best. Morning doses of the supplement lysine, an amino acid, keeps them in check, but stress seems to be a major trigger. Mixing wine with chocolate or the onset of a cold also seems to make me susceptible. Would I ever rid myself of this unsightly scourge?

"Sorry, no," says Brenda Moneymaker, RDH, MS, Assistant professor of Dental Hygiene at Eastern Washington University in Spokane. "Herpes simplex type 1 (HSV-1), the virus that causes cold sores, will never die," she explains. It lies dormant on nerve cells, called ganglions, until reawakened by stress, either emotional (such as getting fired or a death in the family) or physical (prolonged exposure to sunlight, allergy, menstruation, a fever, cold, flu, or other illness, even dental work or cosmetic surgery).

I am not alone in my suffering. "Up to 90% of the US population has the virus," says moneymaker, though only 20% to 40% may develop the tingling, burning, itching, or tenderness that herald a full-blown blister cluster. A fortunate few will go as long as three years between episodes; for other, it can be a monthly, even biweekly curse.

The first outbreak can be shocking, with a multiple lesions appearing on the lips as well as inside the mouth and on the tongue and throat lining; this may be accompanied by fever, swollen, lymph nodes, and headache. Later occurrences are less severe, usually limited to a small patch of blisters that almost always appears in the same location: the edges of lips, the gums, the hard plate (the bony part of the roof of the mouth), and the corners of the nose. "These blisters eventually erupt, leaking as sticky fluid that quickly hardens into a crusty coating," says Linda Golden, DDS, of the Golden Dental Wellness Center in Manhasset, NY.

At this stage, HSV-1 is also so highly contagious that a single kiss, handshake, or sharing of eating utensils with a carrier can infect another. Though related to sexually transmitted herpes simplex virus type 2, HSV-1 rarely affects the genitals, though it can be transferred there and also to the eyes by hand or even towel contact.

"While HVS-1 has no cure, some medications can lessen the severity," says Moneymaker.

You doctor can prescribe antivirals, such as acyclovir (brand name: Zovirax), famciclovir (Famvir), foscarnet (Foscavir), penciclovir (Denavir), and valacyclovir (Valtrex), either as a cream or tablets. "Both forms will alleviated symptoms, but onlay the pills and penciclovir ointment will shorten the life of the sore-an average f a day or two," says Moneymaker.

"Several over-the-counter (OTC) treatments such as Orabase, Orajel, and Zilactin can reduce the discomfort," says Moneymaker, "however, they won’t necessarily speed healing."

A Second Scourge

Do your blisters appear inside your cheek, the floor of your mouth, the underside of your tongue, or your soft plate (behind the hard plate)? Then your problem probably isn’t cold sores-it’s recurrent aphthous ulcers (RAUs), also known as canker sores.

"Luckily, RAUs are not contagious, but they will recur, not always in the same area of the mouth. Anyone is susceptible-about 20% of us are afflicted at any time," says Dr. Golden.

"No one knows yet what causes them," admits Moneymaker. It is thought to be a glitch in the body’s autoimmune system: the mouth area is irritated (perhaps by too vigorous toothbrushing, an acidic food, or biting the tongue or cheek), and the brain sends cells to repair the damage. But instead, they attack the tissue itself, and a white or grayish circular lesion form.

The same OTC oral-care ointments used for fever blisters, as well as kank-a by Blistex and symptoms. Amlexanox (Aphtasol), a prescription oral-paste antiulcer drug recently approved by the food and Drug administration, seems to speed healing time and lessen pain. "Truly severe or continually recurring canker sores may also require a prescription steroid medication such as fluocinonide (Lidex), which should never be used on cold sores, or they can worsen," says Dr. Golden.

Our experts offer these preoutbreak hints that may put the brakes on your sore spots:

• "Supplements that boost your immune system may help," says Dr. Golden. She suggests taking as much vitamin C as you can tolerate, up to 5 grams (large doses can cause diarrhea), and between 400 and 800 Ius of vitamin E per day, as well as a multivitamin. Vitamin E oil can also be applied directly to sores to protect tissue and prevent scarring.

• Watch your intake of chocolate and nuts (including peanut butter). They contain arginine, an essential amino acid that seems to stimulate HSV-1. Also avoid alcohol and caffeine, which act on the central nervous system. A food allergy may be behind cankers, so keep track of which edibles might set off an attack, and avoid them.
• The amino acid lysine seems to counteract excessive arginine. Dr. Golden suggests taking 500 mg twice a day and doubling the dose during an episode.
• An aspirin a day may keep a cold sore at bay. A small study reported in the Annals of Internal Medicine suggest that a daily 125-mg dose taken by adults at the first sign of a sore and continued throughout the outbreak can shorten its visit, as well as lessen the pain and inflammation.
• Shield lips and surrounding skin from the sun by using sunblock; apply a lip balm or lipstick with as SPF of at least 30.
• Avoid tartar- control toothpastes and mouthwashes that contain alcohol. Always brush teeth and gums gently.
  
• Always use a clean cotton swab to transfer makeup, sunscreen, or lip balm ointment from the tube to the affected site to prevent contamination or reinfection.
• Wash your hands after touching or treating a sore- otherwise, you might spread the virus to other people, other body parts, or reinfect the same area.
  
• Even without treatment, both cold and canker sores will clear up within 7 to 14 days. "But if they linger longer or recur more frequently, the lesion may be a sign of more serious autoimmune illness," says Moneymaker. High fever, spreading infections are other signals that you should consult your doctor.