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Cold Sores are a nuisance to anyone who has ever suffered from them. Not only are they painful, but when they show up on the face they are also unsightly and can make people feel ashamed and embarrassed.

Cold sores are small fluid filled blisters which normally occur around the mouth and lips. They are caused by a viral infection of Herpes Simplex 1 (HSV-1). ​This strain is related to Herpes Simplex 2 which causes genital herpes – which means that a person who suffers from cold sores does not necessarily suffer from genital herpes.​ HSV-1 is spread by close contact such as kissing or oral sex.  The blister will form and then break releasing the fluid. After the fluid is released the sore will crust over and eventually heal in 10-28 days depending on how quickly the individual heals.

There is no known way to eliminate the HSV-1 virus once a person is infected. The virus will lie dormant in nerves under the skin. When a person’s immune system becomes compromised due to an infection or periods of high stress, the virus wakes up and becomes active. The first sign of a cold sore brewing is a tingling sensation at the affected area.

Below are my top recommendations for prevention and treatment of cold sores in addition to your MD’s recommendations:

Lysine and Arginine:

It has been observed that the amino acid lysine appears to suppress HSV-1 activity. Another amino acid, Arginine, competes with lysine. Thus if intake of arginine is significantly higher than lysine the circulating levels of lysine decrease.  Food sources of arginine include nuts, seeds, chocolate, meat and dairy.  (You can find a list of highest containing arginine foods here)  In my practice I have seen a trend in patients presenting to my office with cold sores.  The trend appears to be after periods of high sugar and chocolate intake, specifically during the month of November, February and March as well as a few weeks after Easter. I believe this is related to the high sugar and chocolate intake combined with the cold winter months here in Canada suppressing the immune system.  Thus I recommend my patients to take Lysine throughout these months as well as consume chocolate moderately.


Zinc oxide cream is an effective natural treatment to decrease actual wound healing time. Applying zinc cream to the affected site will provide increased levels locally, providing a direct effect on the wound itself. Oral zinc can also be taken which will have a broader more systemic influence. Talk to your ND regarding absorption of zinc as well as proper doses for supplementation of zinc. You should not take zinc for longer than 3 months without guidance from a medical professional.

Vitamin D:

Unfortunately for most Canadians, we are low in vitamin D. Our bodies have the ability to synthesize vitamin D, however, that can only occur when we are exposed to strong UV light. In Nova Scotia, this will only happen between May through to September. Therefore for half the year we are not producing sufficient levels of vitamin D. Vitamin D has been shown to activate the immune system, specifically T-cells which help to fight infections.  Supplementing with Vitamin D is a must in Canada and the dose you take should be determined by your blood level.

Selenium, CoQ10, Vitamin E & Methionine:

This combination of nutrients was shown to decrease incidence of cold sore relapse as well as speed up healing time in a study published in 2012 in the Journal of Nutrition.

IV Administration:

IV administration is a treatment option for patients who are looking for a fast and effective way to deliver lysine, zinc and selenium when acutely suffering from a cold sore.  This involves a quick visit to the clinic where an IV is administered via a peripheral vein, normally on the arm. The benefit of IV administration is that it increases circulating levels of the nutrients (zinc, selenium, vitamin C) immediately as well as bypasses the digestive system which means the patient receives 100% of the nutrients administered whereas if taken orally the absorption is dependent on the health of the digestive tract of the individual.

Though cold sores are annoying and can be embarrassing, they are not life threatening.  However, when I’m working with patients who feel as if they have been sick “forever” I always ask about cold sores, Epstein Barr Virus (EBV or Mono), Chicken Pox/Shingles and their history of other viral infections. The reason I ask is that these viruses never leave once they’re in us, and patients who have been sick for a long period of time can have reduced immune function which means they are more prone to these viruses becoming active.

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