BABY AND CHILDHOOD SKIN DISORDERS: COLD SORES (HERPES SIMPLEX)
These are small blistery sores that occur on and around the lips and are common in children and often keep recurring. They may also occur in the mouth and on the gums or tongue. They are very common in children under the age of five years.
The problem is caused by a germ called the herpes simplex virus-1, which is extremely infectious. A child may catch it from a parent or from another person. The blisters are preceded by a dry, irritating sensation which many sufferers come to recognize after a few bouts. Blisters develop quickly, and the glands under the jaw become swollen and very tender. Eating, drinking and swallowing may be painful.
Although these lesions have been given the name cold sores, they are not caused by a cold, although they are frequently associated with an upper respiratory tract infection. Often there is a high fever. Exposure to sunlight, especially early in the summer season, commonly triggers off attacks. Some youngsters have allergies which seem to predispose to their appearance. Emotional upsets also seem to play a part.
Usually the blisters settle down after a few days with or without treatment. But sometimes the infection may spread. This may be serious if the eyes are involved, and then requires immediate attention by the doctor.
On rare occasions the virus may suddenly spread to the brain and a serious viral encephalitis ensue. It may be difficult to detect symptoms of this complication, though the child may become vague in his actions, his memory is impaired, and coma may develop. This requires prompt medical attention also. A new drug called vidarabine is now curing children who previously may have died.
Occasionally the genital region may become infected, more likely in females. This is produced by a similar but slightly different germ called herpes simplex virus-2 (H.S.V.-2). It may cause very painful blisters which may break, leaving raw tender areas, and locally swollen lymph glands in the groin. The sores may take many weeks to heal.
Treatment
There is no specific cure at present, but simple measures will often bring relief. Recurrences are common, and an effort to avoid the precipitating causes is well worthwhile.
Local creams may help. Idoxuridine 0.5 per cent cold sore ointment (commercially known as Stoxil) may help if applied early enough, ideally when the skin is itchy and dry before the actual blister appears. A thin smear should be applied every hour. It is valueless after the blisters have appeared. Do not apply this cream to the eyes.
Many other applications have been tried, such as spirits of camphor, or 10 per cent camphor in alcohol, or bismuth-formic-iodide powder (B.F.I.). Some doctors paint on neutral red to the blisters after removing their covering. Simply painting the blisters frequently with methylated spirit often helps in drying up the lesions.
In recent times, reports in various medical journals have claimed the application of ice-blocks directly to the sores (ideally just as they are occurring, not after they are well developed) and held there for one to two hours will often result in their disappearance during the subsequent 24 hours (this is called cryotherapy—cold treatment). Other doctors say that painting the blisters with a borate solution is often helpful. Time will tell how successful these measures are; but when all else fails, and if the blisters keep recurring, they are worth a try.
Corticosteroid creams, often prescribed by doctors for skin inflammations should not be used for cold sores or any herpes infection. As many medicine chests have a half-tube sitting on the shelf, there may be a temptation to give it a go. But do not use them, for it may make the condition much worse.
If the eyes or the genital region are affected, see the doctor. Idoxuridine eye-drops may be prescribed for the eyes. But proper diagnosis and care is essential, for it can cause serious consequences if treated carelessly. New antibiotics are currently bubbling through the medical pipe-line.
Incidentally, if the infant has herpes infections, the mother should be checked also. Recently a link has been suggested between vaginal herpes infections and the possibility of cancer of the cervix of the womb. A cervical smear test and full pelvic examination could be advisable.
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General Health
- The expiry date is mentioned on each blister. It is different for different batches. The shelf life is 2 years from the date of manufacture and would differ from batch to batch depending on when they were manufactured.
- Read the product information leaflet provided with the product before using it.
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