Q: What happens to the Cold Sore Virus once it enters through the skin?

After getting a cold sore, a scab forms and the skin heals, usually with no residual scar. During primary infection, and in subsequent recurrent infections, the virus invades the body and infects skin cells. After first infecting a skin cell, the infection continues from cell to adjacent cell until the virus finds its way to the sensory nerve cells that supply that area of skin and surrounding area. The virus infects the nerve and goes to sleep. Later, triggers wake it up and the re-infection process begins. In this way the virus becomes a permanent resident of the body

Here is how the process works in detail. The HSV-1 virus consists of viral DNA that is encased in lipids (fat). During the primary infection, the virus infected many skin cells of the lip and eventually infected enough skin cells to find the end of sensory nerves known as a terminal neuron. This is the part of the nerve that feels. The herpes virus sheds its coat and enters the nerve by going through the terminal neuron. It then migrates up the shaft of the nerve and finally goes latent (goes to sleep) in the nerve cell body. Clusters of sensory nerves all terminate in what are known as ganglion. During the infection process, countless nerves are infected.

When the virus wakes up due to one or more stimulating triggers, it exactly reverses the path it took and reassembles a lipid coat as it exits the terminal neuron. The virus then infects a nearby cell in the lip, multiplies itself using cellular material stolen from the host cell, kills the host cell, and then these new viruses go on to infect more adjacent cells until the infection results in a lesion.

Sometimes the virus can wake up and not cause a lesion. In this case, the virus can still pass through the porous skin surface or into oral secretions with no symptoms at all. This is called asymptomatic shedding and is of course contagious. In reality, a person may have been exposed to the cold sore virus (HSV-1) without knowing it, be shedding the virus asymptomatically, and transmitting it unknowingly to others. The literature suggests that there is approximately a 5% chance of asymptomatic shedding at any given time. Your doctor has a blood test that can tell if you have been exposed to the herpes virus. Many tests are specific and can tell you if you have been exposed to HSV-1 or HSV-2 or both. There are also ways to test a lesion (before it scabs) to see what species of virus is present. Herpes is not an infection of the skin, but a viral nerve infection by way of the skin. It is not a skin infection, but a nerve infection.

In summary, the Herpes virus is a DNA virus that migrates up the nerve endings located in the skin to the nucleus (brain) of the nerve located in the cervical area of the spinal cord. It is here where the viral DNA get incorporated into the nerve DNA. This blended nerve milk shake now become a manufacturer of viral particles and is irreversibly permanently altered. An outbreak occurs when the viral particles migrate down the nerve to the skin causing blistering and ulceration. If there is not enough viral particles released for the skin to blister, the area may become reddish, itchy or even appear completely normal and asymptomatically shed the virus.

Q: What can be done to prevent Cold Sores from spreading?

The cold sore virus (HSV-1) is very sensitive to soap and warm water. If you have a lesion, the best way to help prevent spread of the virus is frequent hand washing with soap and warm water. To prevent infecting others, kissing and intimate contact should be avoided while any symptoms of an active cold sore lesion are present. Take care to avoid touching the sores and spreading the virus to new sites (auto-inoculation) or socially touching others. Another important way to help prevent the spread of cold sores is to treat the cold sore with a cold sore medicine in order to shorten the time that it is contagious. Some literature recommends when fever blisters erupt, each cluster of blisters should be popped, dried and be kept clean to prevent bacterial infections. A soft, bland diet is recommended to avoid irritation and allow the ulcers to heal.

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