What causes cold sores and rashes on the lining of my lips during periods?

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The allergic rashes if they are occurring specifically during menses and the only line the vaginal lips then the cause is unlikely to be menses per se but rather the material of the sanitary pads that you are using from day one. If you have changed the brand of the sanitary pad lately then please revert back to the earlier one and in the meantime, you may apply ointment Candid-B (Clotrimazole+Beclomethasone) locally over the labia minora and majora over the rashes thrice a day and try to keep the local area dry as much as possible. Also change pads every 3 to 4 hours, again depending on the bleeding. If possible please share the picture of the lesions to rule out allergy from herpetic eruptions.

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If it is on the oral lips and typical cold sores with fluid-filled vesicles with itching but no pain, then it is likely a herpetic rash or herpes simplex, which shall need a swab for culture to establish the diagnosis and shall require antiviral ointment local application and oral Acyclovir tablets for a week. Please share a picture of the peri-oral lesions. If diagnosed, then you must ask your partner as well as this can be transferred usually through oral kisses or oral sex. Nevertheless, let us see the lesions first.

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I have seen the picture (attachment removed to protect patient identity) and these are typical cold sores which are likely caused by herpes simplex virus type 1, flare up during stressful situations like a fever, a cold or the flu can leave you feeling run-down and on the defense against a cold sore outbreak. For women, hormonal changes during the menstrual cycle can trigger an outbreak. There is all possibility that you have been exposed to the virus earlier and though it is self-limiting in 7 to 10 days but may flare up again each time when stressors are high (menses are a stressor where immune modulation occurs). The next best step would be to opt for antiviral therapy with Acyclovir ointment application over peri-oral lesions and lips (provided you do not lick your lips again and again) and oral Famciclovir 250 mg twice a day for seven days with multivitamin capsules one tablet twice a day for seven days as well. The most common causes of HSV infection remains shared eating utensils, razors, and towels, as well as kissing, may spread HSV-1. Oral sex can spread HSV-1 to the genitals and HSV-2 to the lips.

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Rx:

1. Tablet Famciclovir 250 mg twice daily for seven days.

2. Capsule Becosules (B-complex with Vitamin C) twice daily for 10 days.

3. Ointment Acyclovir local application thrice a day for seven days.

HSV viruses remain dormant in the nerves and can flare up whenever the immune system is compromised, so keep up well.