Tips for healthy lips

By Dr. Richard Thomas

It’s prime time for cold sores

Although we tend to associate cold sores with the winter season of colds and flus, they actually crop up more often during the summer months. Sun exposure weakens the immune system, which allows the herpes virus responsible for cold sore outbreaks to multiply. Too much sun and heat can also lead to dry lips, which are more prone to injury and susceptible to infection, like any broken skin. 

Cold sores are caused by the herpes simplex virus-1, which is carried by about 80 per cent of the population. The virus is usually inactive, lying dormant in your body until something reactivates it. Triggers include stress, fatigue, sun exposure, fever, hormonal changes (e.g., menstrual cycle or pregnancy) and trauma, such as injury or dental work.

While many people have the virus and never develop cold sores, others get them frequently – usually on the lips or near the mouth, although they can develop elsewhere or spread to other parts of the body.

Cold sores are as common as they are annoying. Those who suffer from them would gladly try anything to get rid of them or at least make them go away faster. Over two million Canadians buy cold sore products each year, spending $30.5 million to treat the painful blisters.

While you can’t get rid of cold sores for good, there are many treatment options that can help reduce the uncomfortable symptoms and even speed up the healing process. Over-the-counter products
generally relieve pain and itching rather than treating the virus. Active ingredients in these products include docosanol,
zinc, heparin and lysine (also available in oral supplements).

Prescription products alleviate symptoms and treat the virus itself. A new prescription topical product, for example, combines an antiviral (to reduce viral reproduction) with hydrocortisone (to reduce swelling and pain). Your dermatologist can also prescribe oral antiviral treatments, such as acyclovir, valacyclovir and famciclovir, which may help shorten the outbreak’s duration and severity. These drugs target the virus, and work by slowing down viral reproduction.

If you’re prone to getting cold sores, follow these tips to reduce your chances of another outbreak:

  • Protect your lips. Wearing lip balm can keep lips moist and prevent chapping and cracking.
  • Minimize sun exposure. Avoid long periods in the sun, and choose a lip balm with an SPF of 30.
  • Stress less. Stress weakens the immune system, which provides a welcome mat for cold sores. Try stress-reducing strategies such as walking, meditating, getting enough sleep and eating healthily.
  • Don’t share. Cold sores are highly contagious. Reduce the chance of spreading them by washing your hands often, avoiding kissing and by not sharing towels, pillows, cups or food when you have a cold sore.
  • Leave them alone. Picking or squeezing a cold sore doesn’t speed up healing and may worsen the symptoms.
  • Treat symptoms quickly. The best way to minimize cold sores is to start treating them as early as possible. The first signs are usually tingling and/or itching. 

Dr. Richard Thomas is a dermatologist based in Vancouver, BC at the Face & Skin Clinic. Along with running his clinic, he is also involved in clinical trials and is the co-medical director of, a network of skincare-related websites written by dermatologists for patients.


Recognize these five stages

Cold sores last approximately 10 days, moving through these common stages:

  • Tingling (1-2 days) Before you even see a cold sore, you may feel a prickling or burning sensation on your skin.
  • Blistering (2 days) A cluster of tiny blisters develops.
  • Weeping (1 day) Blisters break open and start to weep.
  • Crusting (2-3 days) A yellowish scab forms over the area that had blistered. It can sometimes crack and bleed.
  • Healing (2 days) During this final stage, a series of increasingly smaller scabs will form and flake off.

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