Q. I get recurrent sores in lips which stays for 10 to 20 days. Please help.

Answered by
Dr. Beryl Fredrick
and medically reviewed by Dr. Vinodhini. J
This is a premium question & answer published on Mar 27, 2020

Hello doctor,

I am suffering from a cold sore type infection in my mouth especially at lips. Same was occurred last year and again it repeated this year. And as on today it is the third time it is coming and curing within a period of 10 to 20 days. I want to add photographs but do not know how. Further, currently it is on my lips and additional sores are there inside the upper part of my mouth. There is no pain. Please advise so that this can be permanently cured.

I am currently taking Acivir 800.

#

Hello,

Welcome to icliniq.com.

I understand your concern. I have gone through your query, attached pictures, and your previous prescription. (attachment removed to protect patient identity).

These cold sores are of viral origin and it is called herpetic stomatitis. This has a high recurrence rate meaning as long as the immune system is little underperforming, it can come again and again. Also, taking antiviral drugs could put your immune system down. You should compensate by eating healthy foods and drinking adequate water.

There are certain instructions you can follow to reduce its recurrence:

1. Taking antiviral medicines on time without skipping or forgetting the dose. (The antiviral drug which your previous doctor had prescribed will suffice). Please take the same set of medicines for another course. This time without skipping doses and take them at the correct time.

2. Avoid hot, spicy, salty foods, citrus fruits and its juices, carbonated drinks, etc.

3. Drink lots of water. These treatments can make your body dehydrated.

4. Eat healthily. Take a balanced and nutritious diet. Increase fruits and vegetable intake.

5. You can place ice cubes intermittently over those sores for faster relief.

6. Maintain good oral hygiene. Rinse your mouth after every meal. Brush twice daily. This will prevent any bacterial or other infections over those sores and promotes faster healing.

It is highly contagious and hence limit personal contact with others and children.

I hope this helps.


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Thank you doctor,

What is the permanent solution? I am tired of this disease.

What type of fruits should I take? Last year, I took antifungal medication which acted faster than present medication. Please help me to get rid of this disease.

#

Hello,

Welcome back to icliniq.com.

I can understand your situation.

How did the sores look like when you got this for the first time (last year)? Do you have any pictures of those sores? Are you under any medicines for other conditions? Any previous dental treatment? Habits history? (smoking and others) Sores in any other part of body?

These recurrent infections are more common if there are any underlying conditions like HIV (human immunodeficiency virus). Please get complete blood work and HIV testing done. You will also require a complete dental examination done to rule out other conditions.

Avoid citrus fruits like lemon, oranges, grapes, and include other fruits in your diet (like apples, banana, mangoes, seasonal fruits, etc). It is better to try quitting the smoking or pan habit (if present) to see an improvement.


The Probable causes:

Possible immunocompromised situation.

Differential diagnosis:

Oral candidiasis.

Probable diagnosis:

Herpetic stomatitis.


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Thank you doctor,

Initially sores looks like a small pimple. And gradually it is increasing and converted to sore within three days. No additional medication I am taking. But approximately four to five years earlier I suffered from chickenpox. No dental treatment I ever took. But regular mouth ulcers occur periodically. Presently no constipation. No smoking and special habits. Sores are only on the mouth (lips) and not at other parts of body.

#

Hello,

Welcome back to icliniq.com.

There is a possible immunocompromised status (body's immunity down). So get the prescribed tests done to identify any underlying condition.

Human immunodeficiency virus (HIV) affects the body's immune system. And if the body's immunity is down, you are very prone to bacterial and fungal infections (opportunistic infections).

Get the test done immediately. Meanwhile, continue the same medicines. Maintain good oral hygiene.

I have attached the series of tests that needs to be done.


Investigations to be done:

HIV 1 and 2 antibodies (ELISA). Complete blood count.


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Thank you doctor,

I am suffering from unknown type wound inside my nose and inside the upper part of my mouth which is from the last four days but after starting the tablet. Acivir 800 dt. Further at one more site i.e. at upper lips, it has started. Is this from infection of the medicine?

#

Hello,

Welcome back to icliniq.com.

Those medicines in the previous prescription is basically an antiviral drug. Those could not have caused your wounds and ulcers. I do know that scab lesions (wound) inside the nose can occur is such scenarios as previously discussed. But a lesion regarding nose is best understood and treated by an ENT specialist.

Yes, the lesions on the roof of the mouth (palate ulcers) could be viral. But the one on the lips looks like an ulcer with the fungal association. Viral and fungal lesions occur together in immunocompromised situations. A complete history, physical examination, and lab reports are essential to diagnose and to start a more focussed treatment. Please get your blood work and HIV testing done as soon as possible. Visit the nearest venereologist with your medical reports for starting up the treatment. Meanwhile, you can continue the medicines and the instructions previously discussed.

I hope this helps.


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