Patient/caregiver was educated on pathophysiology of cold sores as follows:

1. Cold sores, also called fever blisters, are due to infection with herpes viruses and present as small fluid-filled blisters in patches.
2. Some strains of herpes viruses, typically HSV-1 & HSV-2, cause cold sores, with HSV-1 causing the sores around the mouth and HSV-2 causing the sores in the genital regions.
3. Cold sores and herpes virus infections are highly contagious and the fluid leaking out of the blisters is highly infectious, spreading the infection to contacts.
4. Spread of the infection can occur easily with direct skin contact during acts of personal intimacy, such as, kissing and oral sex. Oral sex can invite high risk for spread of herpes rash to genitals.
5. The spread of infection can also happen during contact with the saliva of a person during active infection from sharing food, drinks, spoons, forks, and toothbrushes. Sharing cosmetics, razors, and lipstick with a person during viral activation is also a popular mode of spread of infection.
6. In individuals with history of cold sores, the virus can live latent and inactive in the nervous tissues of skin involved for years.
7. Strong and intact immune system can help keeping the virus latent, thus preventing it’s reactivation.
8. The latent virus has the potential to get reactivated in future, especially under conditions of compromised immune system.
9. The herpes infection is mostly self-limited, with the burning pain and itching continuing for two to four weeks, until the open sores dry up, crust, and resolve.