[Question #1807] Follow-up for Herpes Question

44 months ago
Nurse Warren, 

I had asked in an earlier thread about genital herpes and also the appearance of a cold sore on the face. I've had a cold sore on the corner of my left lip about 10 years ago. Now I believe I may be getting one on the corner of my left nostril. Do recurrences sometimes change where they appear or do they always appear in the same place? Would a new cold sore showing up suggest a 2nd new infection (perhaps of a diff strain than before)? 
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
44 months ago
In my experience, it is very common for the oral herpes virus to move around  - lip, chin, nostril.  I also get cold sores periodically and they move from my lip one time to my nose the next - it's all in the same nerve group so not surprising at all. I doesn't suggest a new second infection to me, not at all.

Terri
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44 months ago
Ok, that clarifies the possible nostril one for me. Can you give me some information on what typically causes a recurrence? What sort of circumstances lead to a cold sore outbreak?
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
44 months ago
There are probably many things that cause an outbreak, and many are not well understood.  Basically, anything that challenges the immune system is implicated as well as for oral herpes, sunlight.  Thus the name "cold sores" - people sometimes get them when they get a cold or are sick in other ways.  I can predict very clearly that I will get them with lack of sleep.  Some people get them with any significant change in their schedules.  Certainly, taking steroids can trigger one as well as things like chemotherapy which also suppresses the immune response.  And sunlight is an absolutely known trigger.

Terri
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44 months ago
I've read that stress is also a trigger. I've had some strange facial sensations, could you tell me if any of these sound like prodrome symptoms? I've had tightness and pain in my jaw and back teeth (the molars on the top and bottom of mouth), tingling in both lips, tingling in my chin and cheeks and some pain in my temples on both sides. It's been about 3 or 4 days of these sensations but no sign of sores anywhere on my face. I've read online that neck and facial tension can manifest similar sensations but I'd like your input as far as prodrome symptoms go. 
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
44 months ago
I think the research has shown that stress (which also challenges the immune system) lasting more than two weeks can be a trigger, yes. 
Your sensations are hard to nail down, but in my experience, when prodrome happens, it is only for a few days and then usually only on one side of the body

Terri
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