All sores in and around the mouth are not alike. Two common types of sores are often confused with one another.
Before you can select the right treatment for oral sores, you need to know what you’re treating. Here’s what you need to know.
If you get unsightly, painful sores on your face around your lips, you know what a cold sore is. Cold sores are painful and unsightly lesions that are tough to get rid of. What’s worse, there’s no way to completely stop cold sores. That’s because they’re caused by a virus, the herpes simplex virus HSV-1. And you probably know it’s difficult to eradicate any virus (usually you can only keep it in remission).
But, there’s good news. There’s an easy way to reduce the painful, blistering effects of a cold sore. And this remedy can do so in just one or two days. Since it usually takes 7 to 10 days for cold sores to run their course, that’s a huge improvement.
HSV-1, which is related to Epstein-Barr and cytomegalovirus (CMV), is not a benign virus that just causes cold sores. It can also lead to serious eye infections. And while it’s different from genital herpes (HSV-2), these two viruses are so closely related that one can actually trigger the other. So if you are able to prevent cold sores, or even shorten their duration, you could be preventing more dangerous viral infections.
Most doctors will tell you Acyclovir (Zovirax) or a number of popular pharmaceutical topical anti-virals can treat herpes. They may reduce its pain and itching, and promote healing. However, they don’t necessarily prevent cold sores.
But the extract of Melissa officinalis, also known as the herb lemon balm, has the potential to shut down the cold sore trajectory. Researchers tested this herb in a 1999 study. They found it effectively reduced the duration of cold sores when applied topically four times a day as soon as they appeared. Use it at the first sign of a prodrome, that little tingling that precedes a blister. Most often you can avoid an outbreak.
You can buy a topical ointment containing Melissa extract, a plant that inactivates the virus. You should be able to find topical creams with Melissa extract in your local health food store. Patients report success using Cold Sore Relief, formerly called Herpalieve, made by PhytoPharmica. If you can’t find it, call 800-376-7889.
In addition, you can take steps to prevent cold sores. While they won’t completely prevent them, they will reduce the number you get and they will shorten their duration. The first thing you have to do is change the way you handle stress and support your immune system. Adaptogens are great for this. But you also may want to give yoga, breathing exercises, and other stress relieving solutions a try. Taking a good multivitamin, vitamin D, vitamin C, and other immune boosting nutrients will help.
Want even more protection? The amino acid l-lysine is anti-viral and often prevents cold sores. At the first sign of an outbreak (when you first feel any familiar sensation around your mouth), take 1,000 mg (1 gram) three times a day in between meals for a few days until your symptoms have resolved. All of these steps can really help get rid of cold sore.
Other Mouth Sores
The sores you can get inside your mouth are different than cold sores. And there are different steps to take to prevent and get rid of them.
These are not cold sores and they won’t respond to Melissa extract or immune support. They are painful oral ulcers known as Recurrent Aphthous Stomatitis (RAS). You probably know them as canker sores.
These ulcers affect from 10 to 25% of the population and need to be treated differently from cold sores. The problem is that until now there hasn’t been any optimal treatment for canker sores.
Now there is.
It was discovered by a group of doctors at Ben-Gurion University of the Negev in Israel. They conducted a study using 58 patients with RAS and gave them either 1,000 mcg of vitamin B12 before going to bed at night, or a placebo. They tested all of them once a month for six months.
During the first four months, all of the participants had fewer canker sores with a shorter duration. But by the fifth and sixth month, the group who took the B12 found it reduced the severity of pain, number of canker sores, and duration of outbreaks significantly. This was the only group to see these results.
Apparently, even a slight vitamin B12 deficiency can affect canker sores.
By the end of this study, nearly 75% of the people who took vitamin B12 had no outbreaks. What about the control group that did so well initially? When the study ended, their pain from canker sores actually increased.
The Dietary Connection
If you still keep getting painful canker sores, the cause and solution may be in your diet. An ingredient found in foods you eat every day could be causing these ulcers. The culprit is gluten.
Gluten is the protein in wheat, rye, and barley that causes celiac disease — an inflammation in the small intestines — in thousands of people. Both full-blown celiac disease and sensitivity to gluten (called gluten intolerance) contribute to canker sores in susceptible individuals.
Obviously, gluten doesn’t cause mouth ulcers in everyone who eats it. If it did, everyone would have canker sores all of the time. But several studies show a link between gluten and canker sores. Gluten sensitivity can cause even a mild case of canker sores.
Some people are sensitive to gluten without having noticeable symptoms. A recent study examined 10 patients with severe cases of recurrent painful canker sores. All had small intestine biopsies that were normal. This means there was no evidence of celiac disease.
Four of these 10 patients had high levels of gliadin, the protein in grains containing gluten. A gluten-free diet eliminated canker sores in three out of these four patients. When they took them off this diet and gave them foods with gluten, their canker sores returned.
The remaining six patients had normal levels of gliadin and didn’t respond to a gluten-free diet. So if you get a lot of canker sores, have your gliadin level checked. You can do this through Uni Key Health Systems (800-888-4353). Tell them you want the Gluten/SIGA Test from Diagnos-Techs.
Or simply eliminate all traces of gluten from your diet and see whether or not your canker sores disappear. If they’ve been frequent and painful, this approach is worth trying. Especially since you’ll find other benefits from a gluten-free diet.
O’Farrelly, C., et al. “Gliadin antibodies identify gluten-sensitive oral ulceration in the absence of villous atrophy,” J Oral Pathol Med, November 1991.
Volkov, et al. “Effectiveness of Vitamin B12 in treating Recurrent Aphthous Stomatitis: A Randomized, Double-Blind, Placebo-Controlled Trial,” The Journ of the Amer Board of Family Med, 2009.