Blister relief

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Healing help for canker sores and cold sores

Cold sores (a.k.a. fever blisters) and canker sores sure can be a pain in the mouth.

A canker sore is a small, round, white or yellowish ulcer, or sore, with a red "halo" surrounding it. It forms inside your mouth, usually on your tongue or the inside of your cheek or lip. It lasts only about one to two weeks. But it can make eating or talking uncomfortable and drinking orange juice a hair-raising experience.

A cold sore usually forms outside the mouth--on the lips, and sometimes on the nostrils, fingers or even eyes. (It occasionally can form inside your mouth, most likely on your gums and roof of your mouth.) It's actually a bunch of small ulcers that rupture to form one larger blister. It appears less circular and more red throughout than canker sores. That blister eventually breaks and oozes. A yellow crust forms and finally is shed when the blister heals within 7 to 10 days, without scarring. Unlike a canker sore, it has a direct known cause--the herpes simplex (almost always type 1) virus.

Now, don't let that "herpes" stuff scare you, says Brad Rodu, D.D.S., associate professor in the school of dentistry at the University of Alabama, Birmingham. "When people hear of herpes, they automatically think of genital herpes (type 2)," he says. "But this is a much different and separate phenomenon."

Though the two viruses are alike in structure, they turn up in different places. The cold-sore virus can be transmitted by shaking hands. The cold-sore virus is so contagious that 20 to 40 percent of Americans are afflicted with cold sores.

Here are some unexpected triggers of cold- and canker-sore attacks:

COLD SORES:
Your grandmother Or so the story goes. Most of us contracted the cold-sore virus in childhood.

A classic transmission runs as follows: An adult relative who already has the cold-sore virus kisses your baby face. You get the virus, along with a cold sore. Once you've got a cold sore, you can easily spread it. On first contact with the virus, you may get sick with a fever, fatigue and headache.

That all goes away within about two weeks. Then the virus lies dormant in a facial nerve until one of the instigating factors (which we explain below) weakens your body's defenses to it. The result is a cold sore a la Grandma.

Once you already have the virus, a cold sore is only really brought out by one of the other factors below. It's not a new virus you pick up from an infected certain someone.

The cold, cruel world Cold sores can be brought out by fever or illness, hence the names. But the outdoor temperature can play a role, too. Cold wind or hot sunlight can stir up the virus.

When you're going out in the sun, you should always wear sunscreen. But pay special attention to your lips if you're prone to fever blisters. Wear lip sunscreen and a broad-brimmed hat and sit in the shade of an umbrella.

And skiers, the rush of cold wind while skiing is famous for bringing out blisters. Wear a ski mask.

An oral trauma Your mouth is susceptible to harm from a number of seemingly innocent sources. Hot pizza can burn your mouth, leading to a blister. A rough-edged tooth or a cracked filling can rub the inside of your mouth, eventually causing a canker sore.

A dental visit Some patients' mouths just seem to have a tendency to develop fever blisters. For them, the trauma that may result from the dentist working in their mouth could weaken their immune system. That can lead to a cold sore. Since you need to go to the dentist, you can't do much to prevent it.

CANKER SORES:
Irritating foods Some people find that their canker sores are related to the foods they eat. Highest on the hit list are cherries, plums, pineapples, tomato products, nuts, chocolate and other sweets.

Try an elimination diet to decide whether your diet is wreaking havoc on your mouth, says Sol Silverman Jr., D.D.S., professor and chairman of the division of oral medicine at the University of California, San Francisco.

Start by cutting out all the salty, acidic or sweet foods listed above. Then reincorporate each at regular intervals. For instance, if your canker sores generally show up every four weeks, wait a month before adding the first item back into your diet. If that doesn't give you a problem, move on to the next item the following month. Notice when the sores develop. You might be able to locate a canker-causing ingredient in your diet.

Your nervous habit If you bite the inside of your cheek, you may be encouraging sores to form. Try chewing sugarless gum instead of your cheek.

Stress Canker sores may proliferate when you're under psychological stress. The standard example is for students around exam time to be more prone to developing canker sores.

Certain diseases People can get sores from a variety of diseases that affect the mouth, says Dr. Rodu. Two are Crohn's disease (a gastrointestinal disorder) and Behcet's syndrome, an autoimmune disease that affects the skin, mouth and eyes.

Keep an eye on sores in or around the mouth that can't be identified and don't heal quickly. There's always the chance that lingering blisters or ulcers are precancerous lesions. See a dentist or physician if a sore lasts more than a few weeks.

LIVING WITH CANKER AND COLD SORES
Experts say there's no real cure for either a cold or canker sore once it's in the works. But you can treat each attack to ease discomfort and even improve appearance.

If used early on, some over-the-counter medications can be effective in keeping the size of the cold sore small. And keeping a cold sore moist with petroleum jelly or ointment can help prevent cracking (which would make it look and feel worse) after the blister breaks. Avoid squeezing or picking it--it can become infected. (If a cold sore does get infected, see your dentist. It can be treated with a prescription antibiotic ointment.)

For canker sores, your dentist can prescribe a topical corticosteroid, which will reduce inflammation and soreness and induce healing. He can also give you a sealing medication to coat the canker sore and protect it for several hours from irritation. There are also some over-the-counter gels and rinses that ease pain.

Meanwhile, avoid spicy or acidic foods. Or take an antacid product, such as an antacid tablet (which can neutralize mouth acids that irritate the sores). And avoid antiseptic mouthwashes or antiseptic throat lozenges, because they could irritate the area.

Whatever you do, don't try to ease your pain by putting aspirin on a canker sore, says Dr. Rodu. Aspirin is extremely acidic and in the mouth can cause another, even bigger ulcer.

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By Stephanie Ebbert

With Maureen Sangiorgio

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