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Sunday, Oct 22, 2017
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‘Cold sores,’ ‘fever blisters’ common this time of year

When the sniffle season arrives, cold sores may accompany it. Cold sores, fever blisters or the more technical herpes labialis — regardless of the terminology, these red, painful spots are unpleasant. The lesions usually crop up on the outer edge of the lips. They hurt and they look bad, often undermining the sufferer’s confidence for the week or two they take to clear up. A person with a cold sore has lots of company. An estimated 80 percent of adults carry the herpes simplex 1 virus in their body, and a majority probably acquired the infection in childhood through contact with an infected parent.

Once a person has the virus, he or she does not need to have a visible lesion to be shedding and therefore spreading it with a kiss. It does make sense to avoid direct contact with an active lesion. Don’t share drinking glasses, spoons or toothbrushes with someone who has a cold sore.

Some people hardly ever have cold sores even though they carry the virus, while others suffer frequent outbreaks. The first sign is tingling or itching on the spot where the blister will appear. Medication and remedies work best if started during this initial (“prodrome”) stage.

The popular names for this condition, “cold sores” and “fever blisters,” suggest some of the common triggers of recurrence. Colds, fevers, excessive sun or wind exposure, menstrual periods, surgery and extensive dental work all have been known to bring on an outbreak.

What can be done to treat a cold sore? Your health-care provider could prescribe a topical cream, such as acyclovir (Zovirax), penciclovir (Denavir) or Xerese, a combination of acyclovir and hydrocortisone. There also is an over-the-counter cream called docosanol (Abreva).

Prescription pills include acyclovir, famciclovir (Famvir) and valacyclovir (Valtrex). Even the generic versions are a bit pricey, though, ranging from $1.50 to about $4 per pill.

As a result, some people prefer to use home remedies to treat cold sores when they appear. Ice may ease the discomfort: “As soon as I get that familiar tingling, I apply cold. Ice wrapped in a cloth or a package of frozen veggies pressed to the spot for about an hour or so takes the problem away. I also use lip balm with sun protection to prevent outbreaks.”

Another favorite remedy is kiwi fruit: “This has been a total magic bullet for me. At first tingling, I eat two kiwis; then one a day until it disappears. If I eat a kiwi fruit once a week, I do not get cold sores.”

We heard from a man whose pharmacist told him to drink buttermilk to avoid cold sores on the lips. He reported that it worked very well, and others also seem to find it helpful.

Probably the most popular cold-sore remedy is l-lysine. Some readers report that taking 500 milligrams daily of this amino acid can prevent outbreaks, especially if they also avoid nuts and chocolate. L-lysine is being considered to prevent fever blisters in burn patients (Journal of Burn Care and Research, November-December 2013).

Other approaches may include lemon-balm ointment (Melissa officinalis) or the bee product propolis (Phytomedicine, February 2010). Zinc-oxide cream also may offer quicker healing of fever blisters (Alternative Therapies in Health and Medicine, May-June 2001).

Q. I picked up a couch of my Grandma’s from my uncle. He’d kept it in the garage with a ton of mothballs. It fits in my living room, but I notice I’ve been feeling weird lately. My eyes are bothering me, and I have a headache, breathing problems and feel nauseated and dizzy. The aroma of mothballs is still very noticeable.

My wife also is feeling bad, and I am worried about the kids. Could that old sofa be making us sick?

Answer: It is possible. Most mothballs contain paradichlorobenzene (p-DCB), a pesticide that goes from the solid mothball form to a gas that is toxic to moth larvae.

Exposure to the vapor can trigger irritation of the eyes and nose. High concentrations may lead to fatigue, headache, nausea and vomiting. P-DCB fumes can even affect the nervous system, causing weakness and lack of coordination. This compound has some estrogenic activity and is considered an endocrine disruptor.

If children or pets swallow mothballs, they could be poisoned. It sounds like the free couch from your grandmother was no bargain.

Q. I had hard-to-treat asthma for years and was referred to an allergist who prescribed the antibiotic azithromycin. After I finished the first course, with some improvement, he prescribed another round. When I finished the second course, my asthma disappeared as suddenly as it had come on. I no longer have to use an inhaler.

Answer: Some cases of hard-to-treat asthma may result from a persistent lung infection (Current Allergy and Asthma Reports online, Oct. 3, 2013). Certain bacteria that are hard to diagnose or treat can cause wheezing, shortness of breath, coughing and other symptoms of asthma.

We have just published a book by David L. Hahn, M.D., M.S., about using azithromycin for asthma treatment. The book, “A Cure for Asthma? What Your Doctor Isn’t Telling You — and Why,” is available at www.PeoplesPharmacy.com.

Another reader offered this report: “I heard about the extended use of antibiotics for asthma and convinced my doctor to try it. I improved my lung function dramatically and now 18 months later only need my corticosteroid inhaler if I hang out with smokers. My doctor was amazed at the results we achieved with the antibiotic.”

Q: I can’t stand the smell of most deodorants, so I tried a hand sanitizer. It works very well. I had no odor at all, even by the end of the day.

The main ingredient is ethyl alcohol. Do you know of any reason I should not use it?

Answer: Many other readers have found that alcohol in one form or another can control underarm odor. One person wrote: “I’ve tried rubbing alcohol under my arms. It kills bacteria and works well, but I was not sure using it daily would be good for my skin. I now am trying vodka! It also kills bacteria. The smell is milder than the rubbing alcohol and is gone by the time it has dried, which is very quickly.”

Our only concern about people using hand-sanitizing gels on their armpits is the other ingredients that might be included. Fragrances and benzophenones may have hormonal activity. Tocopherol (vitamin E) can sometimes be irritating to the skin.

Some readers also report that milk of magnesia makes a good, low-cost underarm deodorant without any aroma.

In their column, Joe and Teresa Graedon answer letters from readers. Email them via their website: www.PeoplesPharmacy.com.

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