Klarinet Archive - Posting 000928.txt from 1999/02

From: "Steven J Goldman, MD" <gpsc@-----.com>
Subj: RE: [kl] Cold Sores
Date: Wed, 24 Feb 1999 23:25:09 -0500

Just got home from another long day of treating the flu to read all this
stuff on "cold sores". Most of it is, to put it nicely, well intended
claptrap.

Just to make sure everyone's on the same page, there are two oral problems
that people call cold sores. The first are those unsightly painful lesions
on the lip. These are a result of herpes simplex virus infection (there is
one type of herpes that likes the mouth, another that prefers down under,
but both can be found in either place). The other lesion is also called a
canker sore, and these are found IN the mouth (cheek, tongue, gums, etc.).
The cause of these is unknown. It occurs whenever your immune system is run
down, but may not be caused by an infectious agent.

I'll assume we all are talking about the herpes virus lesion here.

Sorry guys and gals, all the home remedies are very interesting and give you
something to do, but are useless. There is no vaccine or cure for herpes
yet. The people who noticed that they seem to occur when you are "run down"
are correct. The herpes virus lives way up in the nerve that supplies your
lips when it is inactive. When it somehow senses that your immune system is
not working full force, it migrates down the nerve to your lip and bingo,
there goes your concert, date, or whatever. Some reoccurrence are severe,
others mild, hence the many home remedies (if you use something during a
mild case, you think the stuff worked miracles - sorry)

Zovrax (acyclovir) is an antiviral medication that works against herpes
virus. It's nothing to be frightened of. We give small children it to reduce
the symptoms of chickenpox. Side effects are generally no better or worse
than a strong antibiotic. The bad news is that topical Zovrax does not
reduce the severity of symptoms or the length of time they last. It does
reduce shedding time which means the amount of time you are contagious to
others. Depending one the dose of oral Zovrax, you may reduce the duration
of symptoms, but not by very much. Some newer drugs do a bit better, but
still are not anything to write home about. But there is one use of these
anti-herpetic drugs that may be useful. Remember the old line herpes is
forever. Well studies have shown that if you take the above drugs daily for
one year, it greatly reduces, and in some cases eliminates reoccurrence. Now
taking these drugs for a year increases the chance of side effects, and you
need to talk to a doctor who has experience with this treatment. It is
usually reserved for those who get many, many painful reoccurrence.

Lysine was hoped to be useful. Sadly, controlled studies showed no
difference between it and placebo.

The best non-pharmicologic way to prevent recurrences is to do things that
keep your immune system in top shape. Eat right, get a good nights sleep,
and avoid stress (sounds just like what mom use to tell me).

Finaly, as I stated before, don't give or listen to medical advice given
over the Internet (even mine!). It is as likely to do harm as good. Find a
good doctor who knows about whatever your complaint is. If your doctor does
not understand why a problem is very important to you, it's probably time to
find a new doctor.

Steve Goldman
Glenview, IL

sjgoldman@-----.com

-----Original Message-----
From: Kevin Fay (LCA) [mailto:kevinfay@-----.com]
Subject: [kl] Cold Sores

I have the flu (bad) and with it, yet another #@-----. I have been
plagued with them for my entire life, it seems. (Fortunately for me, only at
the top end!)....

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