Cupid’s Measles or The Carly – Yup! It’s the Nasty Cold Sore Edition

Practicing dermatology in the free world I was quiet accustomed to seeing the very frequent cases of kissing sores, as around 90% of the population in Europe & America’s is reported to suffer at the hands of the pesky herpes labialis virus. Practicing in Jeddah considering the conservative religious population I was not betting on seeing as much of the darned cold sores. But, the gnarly, massive cold sore; which once you exhibit gets passed on through awkward conversations, and the evil icy stares is an incidence; which is being brought to derma practices in the region quiet frequently. So read along as, its time to brush up & update medical info. Herpes labialis is the infection of the lips, mouth, or gums with the herpes simplex virus. It leads to the development of small, painful blisters commonly called cold sores or fever blisters.

The Cause & Course:

Herpes labialis is caused by infection of the mouth area with herpes simplex virus type 1. Most people in the United States and Europe are infected with this virus by age 20.

The initial infection may cause no symptoms or mouth ulcers. The virus then remains dormant (asleep) in the nerve tissue of the face. In some people, the virus reactivates and produces recurrent cold sores that are usually in the same area, but are not serious.

Herpes virus type 2, which usually causes genital herpes and can infect babies during birth to infected mothers, can also cause herpes labialis.

Herpes viruses are contagious. Spread may occur through intimate and personal contact, or through contact with infected razors, towels, dishes, and other shared articles (razors, toothbrush, makeup brushes and sponges etc.). Occasionally, oral-to-genital contact can also spread oral herpes to the genitals (and vice versa).


First symptoms usually appear within 1 to 3 weeks, after contact with the virus. Sore throat and fever that can last up to 5 days may occur before the blisters appear. There may also be swollen glands in the neck.
First episode may last 2 to 3 weeks. The lesions may be on the gums, in the mouth and throat, or on the face. It may hurt to swallow. Later episodes are usually milder.

An outbreak usually involves:
  • Skin lesions or rash around the lips, mouth, and gums
  • Small blisters (vesicles) filled with clear yellowish fluid
  • Blisters on a raised, red, painful skin area
  • Blisters that form, break, and ooze
  • Yellow crusts that slough to reveal pink, healing skin
  • Several smaller blisters that merge to form a larger blister

Episode Triggers: May be triggered by menstruation, sun exposure, fever, stress, or various other unknown causes.
Warning symptoms of itching, burning, increased sensitivity, or tingling sensation may occur about 2 days before lesions appear.

Exams and Tests
Diagnosis is made on the basis of the appearance or culture of the lesion. Examination may also show swollen lymph nodes in the neck or groin areas.
Viral culture, viral DNA test, or Tzanck test of the skin lesion may reveal the herpes simplex virus.

·      Untreated, the symptoms will generally go away in 1 to 2 weeks. Antiviral medications taken by mouth may help the symptoms go away sooner and decrease pain. Acyclovir, Famciclovir, and Valacyclovir are the three oral treatments currently available.

·      Herpes sores often come back again and again. The antiviral medicines work best if you take them when the virus is just starting to come back -- before you see any sores. If the virus returns frequently, your doctor may recommend that you take the medicines all the time.

·      Topical (rubbed onto the skin) antiviral cream (penciclovir andaacyclovir) and Xerese (acyclovir 5% and hydrocortisone 1%) may be used. Cream must be applied every 2 hours while you're awake. They are expensive and often only shorten the outbreak by a few hours to a day.

·      Washing blisters gently with soap and water to reduce the spread of the virus to other areas of skin. An antiseptic soap may also be used to avoid further bacterial contamination of the open sore. Applying ice or warmth to the area may reduce pain.

Tips To Prevent Future Outbreaks

·      Apply a sunblock or lip balm containing zinc oxide to the lips when you're outdoors.
·      A moisturizing balm to prevent the lips from becoming too dry may also help.

What Future Holds In Terms Of Treatments:

Existing treatments can minimize or even prevent an outbreak, but they do not kill the virus which lies dormant when it is not activated. Scientists believe they have finally found a permanent cure for cold sores. They say the treatment, a lotion, will be the first to kill the virus that causes the sores.

A new treatment (NB001) lotion has been developed that not only halts the attack, but also kills the virus. This treatment lotion has been developed as a by-product of biological warfare technology, which actually kills the virus by exploding it from the inside. It is made up of nano-particles of detergent and solvents in emulsion. These particles are so small that they penetrate the outer coating of the virus and destroy its effectiveness. The lotion will also work for genital herpes, a sexually transmitted disease, and it is being looked at as a potential treatment for a range of other viruses, including HIV, Ebola and smallpox. Currently studies are ongoing to assess the safety and efficacy of this new emulsion and we await results.

Researchers have also been working on a twice-a-day pill to prevent the cold sore from growing by attacking the DNA of the virus. The aim is to meet the virus head-on as it emerges into the lip or skin tissue and to stop it multiplying and forming bumps or blisters. The drug gets into the DNA of the virus and turns off its ability to replicate, stopping it from reproducing itself and expanding.

The bottom line

Your best bet is to treat cold sores at the first sign of symptoms with topical or oral anti-viral treatment, and to prevent an outbreak by getting enough sleep, eating a well-balanced diet and exercising (the same way you would avoid coming down with any other virus).

Keep lips moisturized through lip balms and by drinking plenty of water, and apply sunscreen regularly if spending time outside. While you’ll carry the virus forever, you needn’t suffer because of it: just keep your immune system boosted and treat cold sores immediately to reclaim control.


Effects of Gold on Skin

It is believed that Cleopatra wore pure gold for a radiant complexion. Romans used gold preparations for treatment of skin lesions and sores. Egyptians believed the healing powers of gold could cure all manner of physical, mental and spiritual ailments.  In ancient Chinese medicine, gold was the secret to youthful skin. Today gold leaf is used in the treatment and rejuvenation of skin conditions. The application of gold compounds to medicine, called chrysotherapy, reduces inflammation beneficial in the treatment of a variety of diseases, but this therapy often causes adverse gold-related skin reactions.

Rejuvenation of Skin

Many luxury spas use 24-carat gold leaf treatments to hydrate, firm and moisturize the skin claiming reduced fine lines and wrinkles resulting in smooth and radiant skin. A news feed from the World Gold Council site reported a gold leaf facial treatment created in Japan declaring gold leaf put on the face naturally rejuvenates skin and reduce wrinkles. According to the creators of the treatment, gold locks in moisture and keeps skin firm by maintaining collagen in the skin and inhibiting the breakdown of elastin. A study appearing in the "The Journal of the American Medical Association," reported the effect of gold leaf on low blood-flow skin ulcers. Findings showed a significant improvement in mouth legions and skin ulcers with no adverse reactions to gold leaf observed.

Contact Dermatitis

Allergic reactions to gold are extremely rare but can result from direct skin contact. According to a publication in the "Daily News Analysis," some people display allergic skin responses to gold jewelery or dental crowns, says Dr. Thomas Fuchs of Goettingen University Hospital in Germany. After a survey of various dermatological clinics and hospitals, he concluded pure, unalloyed gold can trigger allergic reactions. The degree of allergy varies from immediate dermatitis on hands and feet from contact with gold items to reactions only after many years of skin contact.

Skin Rashes from Chrysotherapy

Chrysotherapy is a successful treatment for rheumatoid arthritis, but dermatological reactions to gold limit therapeutic usage. A study done at Tel Aviv Medical Center reported in "Annals of Rheumatic Diseases" was discontinued when patients given gold salts reacted adversely with symptoms including gold-induced skin rashes. After the study was stopped, coincidentally the patients with skin rash experienced remission in their rheumatoid arthritis. The patients without skin rash did not.

Skin Disorder Treatment

Gold is thought to have anti-bacterial properties and help transport oxygen molecules into the skin for cell-renewal to treat ulcers and inflammatory disorders of the skin. Some skin healing benefits of gold were demonstrated by an in vitro chrysotherapy study, by the University of Miami School of Medicine, which found that concentrations of gold administered in skin inhibited prostaglandin synthesis. "The Journal of Investigative Dermatology" reported that the findings suggest gold is beneficial in treating autoimmune diseases, inflammation and inhibits skin enzymes involved in blister formation.


Kick Cankles To The Curb This Summer

As temperatures rise, so do hemlines –  which means you no longer have jeans and trousers to conceal your cankles. “Cankles” are the new muffin tops of lower legs; a clever nickname for thick lower legs that lack distinction between the calf and the ankle. Whether your cankles are an unlucky genetic gift, or caused by the few extra pounds you carry on your frame, here’re some fitness, camouflage and medical remedies to make your cankles look like slender ankles in no time.

Fitness Fix

Cankles are somewhat structural depending on genetics and the shape of your legs. 
Best advice I can give is to skip the salt, and maintain a healthy diet of leafy greens and plenty of whole grains and keep your body fat percentage in a healthy range by doing some form of exercise at least four days a week

Fake-it Fix

When you don’t have time to slim down, here’s a quick trick to make your ankles look slimmer.
If you need to be in shorts fast, self-tanner like
St. Tropez Perfect Legs is always a quick way to create the illusion that your legs are smaller than they are.

Full-on Fix

Laser liposuction as an outpatient procedure under I.V. sedation can easily reduce the bulge that some people have in their ankles. The skin typically retracts well and the incisions are easily hidden in the body’s natural contours in the sides of the ankles. Because a procedure on such bony body parts requires delicacy, I use several innovative forms of liposuction, including Da Vinci Lipo, in order to contour and re-sculpture the area while providing the most beautiful results with minimal scarring. Laser Lipo, used in combination with other forms of liposuction or alone, is a procedure that uses laser light to liquefy fat and tighten the surrounding skin. It involves less downtime and side-effects than traditional liposuction and is particularly good for small areas of fat deposits like the ankles. New technology that’s gentler and faster than ever before not only allows the removal of fat, but also re-sculpts the body.