Fever Blisters

What are Fever Blisters?

A fever blister is skin lesion near the mouth or on the face is due to the herpes simplex virus type 1. They occur as a cluster of tiny blisters around the edge of the lips, on the face or near the mouth including the lower portion of the nose. The virus stays inactive inside the nerves of the face and usually people are affected by the virus for the first time before they attain the age of 10 years.

Image Source: www.dermnetnz.org

However, when the individual suffers from a cold or fever, the virus becomes active again and manifests itself in the form of small painful bumps. The presence of the virus within the nerves of a face can cause fever blisters to reoccur.

Identification of Fever Blisters

Differentiation between Fever blisters and other types of mouth sores requires an evaluation of the blister by its location, its appearance through the stages of its formation and examination. The blister transforms and heals within a period of 8 – 12 days.

Following are the various stages involved in the development of the blister:

• Stage 1: Occurring within the first 1 to 2 days, individual experiences new sensations like itching, burning, soreness, swelling, tautness, stinging, etc. They are essentially indicators about the sore beginning to form. The area becomes reddish, slightly raised and corresponds to the area where the lesion appears in the future.
• Stage 2: Usually on the 2nd or 3rd day, fluid-filled blisters become visible. They may seem like a small cluster, or individual blisters may be joined together to form a larger blister. At this stage, the number of viri present in the system is the highest, and the size of the blister is related to the number of viri in the individual’s body. However, in almost 25% of the cases, the herpes virus is under control before the development of the blisters. Such cases are called ‘aborted’ or ‘failed’ lesions. Image Source: www.dermnetnz.org
• Stage 3: Also known as the weeping stage, the blister usually ruptures on the 4th day. It results in the release of herpes virions along with a clear fluid followed by sore changing into ulceration. The lesion is a shallow red ulcer that looks raw and wet soon after the rupture which gradually the surface turns gray. This stage is the most contagious and the most painful time.
• Stage 4: During the 5th to 8th day, the ulceration scabs over. It happens faster in cases where the location is away from the moisture. The scabbing has a dark red, yellowish or brownish crust that can crack or break resulting in bleeding. Scabbing occurs along with itching and burning sensation. Later, newly formed, pink tissues replace the scabs.
• Stage 5: The 9th to the 12th day is known as the healing stage for the sore. Scabbing repeatedly occurs in the area of the lesion and a new scab comes when the old one is flaked off. Usually, the successive scabs are smaller than the previous ones and over time, the lesion is repaired, sometimes even without a scar.

Causes of Fever Blisters

Two types of herpes viruses are known to cause fever blisters, they are:

• Herpes Simplex Virus type 1: It causes fever blisters in a majority of cases and affects the body tissues that are above the waistline.
• Herpes Simplex Virus type 2: Commonly, infection through this virus does not result in oral herpes lesion, but affects the tissues below the waistline and leads to genital herpes.

Transmission of Fever Blisters

• Direct Contact: The most common way of transferring the infection from one person to another is by direct contact. Skin to skin contact like hugging, kissing or even the blister touching the face of another can lead to clear transmission of the virus.
• Shared Objects: Objects that have come into contact with the blister or saliva of the infected person can infect others who use them. Sharing articles like soap, towels, napkins, lipsticks, contact lenses, toothbrush, razor, cup, glass or utensils can infect healthy people.
• Weak Immune System: People having a weak immune system such as human immunodeficiency and other similar illnesses are more prone to such infections. Babies have weak immune systems and thus their chances of developing these blisters are higher.
• Transmission to Other Body Parts: Sometimes one part of the body can transfer the virus to another. Its effects on other areas of the body include Whitlow, a painful infection of the finger and infection of the eye that causes corneal blindness. Image Source: en.wikipedia.org

Triggers for Fever Blisters

• Stress
• Fatigue
• Depression
• Hormone fluctuations
• Dental procedures
• Extensive exposure to the sun
• Injury to the affected area
• Changes in hormone levels
• Swollen lymph nodes
• Muscle aches
• Dehydration
• High fever

Symptoms of Fever Blisters

• Fever
• Irritability
• Headache
• Swollen neck glands
• Sore throat
• Inflamed gums
• Pain experienced while eating
• Nausea
• Vomiting
• Open sores in the mouth
• Tingling
• Burning
• Itching
• Swelling
• Redness

Prevention of Fever Blisters

• Avoid sharing items of personal care like towels and soaps to curb chances of transmission
• Wash hands well before eating and after coming in contact with others in case of greeting or shaking hands
• Always keep hands clean while dealing with a sore
• Do not prick on the blisters
• Instead of rubbing the medication on the lesion, it can be dabbed to avoid excess contact that could help in spreading the infection
• Reduce contact with people suffering from fever or cold to avoid activating dormant virus
• Avoid intimate physical contact that could cause infection in the partner’s genitals

Risks of Fever Blisters

Blisters usually accompany conditions of fever or cold. They can be signs of an immunity disorder or nutritional deficiencies. However, they can also appear in cases of serious medical conditions like HIV/AIDS, weak immune system, eczema, severe burns, etc.

Diagnosis of Fever Blisters

• Enquiry about the individual’s medical history
• Physical examination
• Tests to diagnose the sores

Treatment of Fever Blisters

• Ice: Wrapping an ice pack in a cloth or towel and placing it on the sore area can help to reduce the flow of blood in the area and thus reduce the inflammation. Although it is a temporary measure, ice can lower the pain for some time.
• Zinc therapy: Zinc is an enzyme that aids in the healing wounds. Topical zinc can treat fever blisters and duration of the blisters can be shortened if a zinc oxide and glycine cream are applied on it.
• Licorice extract: Licorice has antiherpetic effects. Dabbing licorice extracts on the blisters may help to heal them faster. The extracts can be put on the blisters using a cotton swab or the tip of the finger.
• L-lysine: Taking an amino acid called L-lysine can be used as a preventive measure against the development of fever blister. It hampers the production of the amino acid that boosts the formation of blisters.
• Lemon Balm: A cream or ointment containing lemon balm can be used to heal the blisters. These products can be applied twice or thrice a day to get better results.
• Tea tree Oil: Tea tree oil is known to have antiviral effects and can be used for effective healing of the sores or blisters.

When to visit a Doctor?

The following situations require immediate medical assistance:

• Prolonged fever
• Difficulty in swallowing or talking because of the sores
• Sores on the lips and mouth lasts for more than a week
• Recurrent outbreaks of blisters

Fever Blisters Pictures

Image Source: en.wikipedia.org

 

 

Image Source: www.dermnetnz.org

 

Image Source: en.wikipedia.org