Cold sores or something else?

Many working professionals get cold sores. Seasonal changes, stress, or lack of sleep, all increase the risk of recurrence. However, if it recurs monthly, we should focus more on prevention. The most common symptoms of herpes simplex are cold sores.

Typical herpes labialis (cold sores) symptoms

• Itching
• Tingling
• Burning pains
• Skin tightness
• Blistering rash
• Always on the lips or around it (reinjury theory)

https://www.ncbi.nlm.nih.gov/books/NBK525782/

Additionally, when should one suspect it's not the typical herpes rash.

• Fever and aches with rash (shingles)
• Beyond lips on face with pus drainage (impetigo)
• Rash not on lips but same spot recurrently (herpes gladiatorum)
• Canker sores (aphthae) are rarely due to herpes (inflammatory)
• Mouth corners rash (angular cheilitis) due to moisture (dental issues)

Helpful lifestyle modifications

• Adequate and quality sleep (sleep trackers myth)--> good sleep hygiene
• Reduce transmission by avoiding intimacy (i.e., oral-oral and oral-genital)
• Adequate hydration to reduce inflammation
• Sunscreen with adequate SPF >30 for lips
• A therapeutic vitamin D level
• Lysine is likely not effective

Available therapies

• Antivirals (i.e., acyclovir, valacyclovir) reduce duration and severity of symptoms
• Over-the-counter (OTC) topical creams are anti-inflammatories

Recurring cold sores monthly and it's affecting your routine --> time to seek care and get a HSV1 and HSV2 titer level to see if it's beneficial for a daily antiviral to reduce recurrences

https://www.uptodate.com/contents/treatment-and-prevention-of-herpes-simplex-virus-type-1-in-immunocompetent-adolescents-and-adults#H16

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