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Suffering from cold sores. Looks like mouth ulcer. Not cured by medicine. What should I do?

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Practicing since : 1981
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hi, i occasionally suffer from what i think are coldsores but they arent 'normal' coldsores. i have a really bad one at the min. they are nearly more like a large mouth ulcer on the outside of my bottom lip, it takes a few days for it to fully develop and then it kind of scabs over but the scab is a soft white almost skin like material that if touched at all will come away from the surface of the lip. it is very painful and takes days to heal. during the night it tends to scab over but even if the scab is left untouched talking and eating etc seems to break it up and the scab comes off leaving it back to where it started. this process seems to continue for sometimes up to 2 weeks before it eventually starts to slowly dry up and evenually heal. i hace tried to use a couple of different coldsore treatments, aciclovir and penciclovir, but sometimes think they dont make much of a difference which makes me think it may be something else other than a normal coldsore. hope u can help! thanks H :-)
Posted Thu, 2 Aug 2012 in General Health
Answered by Dr. Anil Grover 1 hour later
Hi there,

Thanks for writing in.
I am a medical specialist with an additional degree in cardiology.
I read your mail with diligence and I tend to agree with you is these are not 'normal' cold sores. The description is more of blisters which is because of HSV 1 and HSV 2). They, as you have described can heal by themselves but pain and discomfort needs different strategy. Follow following steps.
1. Fist and foremost, think carefully, you are not having any other latent illness or
you are taking drugs antibiotics or otherwise for any illness. There is no extra
stress due to any reason. For these are antecedent causes.

2. Expected Duration, When you are first infected with HSV-1, symptoms can last
for 7 to 14 days. Cold sores usually crust within 4 days and heal completely
within 8 to 10 days (you said two weeks that is a shade longer). If they are
taking longer than that you need doctor to have look at these and send
samples if he/she considers necessary.
3. Prevention: To help to prevent a first herpes infection in children do not let
them be kissed by anyone who has cold sores, fever blisters or signs of a first
herpes infection. However, HSV-1 is very common. Most children will be infected
by the time they reach adulthood. Several different vaccines are being
developed against HSV (types 1 and 2), but these appear to protect only
people who have never been infected.

There is evidence that using sunscreen on your lips will prevent cold sores caused by sun exposure. Antiviral medicines may prevent cold sores from forming. In certain situations, your dentist or physician may prescribe these medicines. If you expect to encounter a known trigger, a medicine taken in advance can decrease the chance of a cold sore.

Treatment by prescription drugs (even prevention)
Some medicines can help cold sores heal faster. They also relieve pain and discomfort. The medicines are acyclovir (Zovirax), famciclovir (Famvir) and valacyclovir (Valtrex). These drugs cannot get rid of the virus. You need to take them each time you can feel a cold sore coming on. Once you have blisters on your lip, the medicines will not help much - perhaps you have tried these medicines later in the course of illness THAT IS WHY THESE DID NOT HELP a thought for you to consider.

If you have any more question, let me know I will respond asap.

With Best Wishes

Dr Anil Grover,
M.B.;B.S, M.D. (Internal Medicine) D.M.(Cardiology)
http://www/ WWW.WWWW.WW

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