Cold sores are a common and often frustrating skin issue. While they may look like harmless blisters, cold sores are actually caused by the herpes simplex virus (HSV).

What Causes Cold Sores?

Cold sores are caused by the herpes simplex virus (HSV), which comes in two types: HSV-1 and HSV-2.

HSV-1 is the primary cause of cold sores, usually appearing around the mouth.

HSV-2 generally causes genital herpes but can also lead to cold sores.

While the appearance of cold sores caused by both HSV-1 and HSV-2 can look similar, their locations tend to differ. However, it is possible for HSV-1 to cause sores on the genitals and for HSV-2 to appear on the mouth.

How Do Cold Sores Spread?

Cold sores are highly contagious and can spread easily. The virus can be passed on through:

• Kissing or skin contact
• Sharing food, drinks, or cosmetics (such as lip balm)
• Oral sex, which can spread both cold sores and genital herpes

Even when a cold sore isn’t visible, the virus can still be spread through close contact. This makes prevention and management key to reducing outbreaks and the risk of infecting others.

Once someone contracts HSV, it stays in the body for life. While the virus remains dormant most of the time, it can reactivate and cause new sores, especially during periods of:

• Stress
• Illness
• A weakened immune system

Unfortunately, there’s no cure for the herpes virus, but the symptoms can be managed.

Symptoms of Cold Sores

Cold sores don’t just appear out of nowhere. Before the sore is visible, you may notice a tingling or burning sensation around the lips or face, which can occur several days before the sore forms. This is the best time to begin treatment to shorten the outbreak.

When a cold sore does appear, it often looks like a red, raised blister filled with fluid. The blister can be painful to touch, and there may be more than one. Cold sores usually last around two weeks and are contagious until they crust over and heal.

The Five Stages of a Cold Sore

Cold sores go through distinct stages as they develop and heal:

• Tingling and itching: You may feel these symptoms about 24 hours before the blister appears.
• Blisters: Small, fluid-filled blisters form, typically around the mouth.
• Bursting: The blisters burst and form painful sores.
• Scabbing: The sores dry out, scab over, and may itch or crack.
• Healing: The scab falls off, and the cold sore heals.

Risk Factors for Cold Sores

Certain factors can trigger the reactivation of HSV, leading to cold sores. These include:

• Infection, fever, or cold
• Sun exposure
• Stress
• Menstruation
• Dental work or injury
• Weakened immune system due to conditions like HIV/AIDS, eczema, or chemotherapy

Managing and Treating Cold Sores

There’s no cure for cold sores, but several treatments can ease the symptoms and help manage outbreaks.

Topical Ointments and Creams

Over-the-counter antiviral creams like docosanol (Abreva) or prescription ointments like penciclovir (Denavir) can help reduce the duration of an outbreak, especially if applied at the first sign of a cold sore.

Oral Medications

Prescription antiviral medications like acyclovir, valacyclovir, and famciclovir can also help, particularly for people who have frequent or severe outbreaks. Your doctor may recommend taking these medications regularly to prevent future outbreaks.

Home Remedies

There are also some home remedies that may provide relief, such as:

• Applying ice or a cold washcloth to the sore
• Using aloe vera gel or lemon balm lip balms
• Applying petroleum jelly to ease discomfort

Canker Sores vs. Cold Sores: What's the Difference?

While cold sores and canker sores may seem similar, they are quite different:

Cold sores are caused by the herpes virus, appear around the mouth, and are contagious.

Canker sores are not contagious and appear as ulcers inside the mouth or throat.

Preventing the Spread of Cold Sores

To avoid spreading cold sores:

• Wash your hands frequently
• Avoid close contact with others during an outbreak
• Don’t share food, drinks, or personal items like lip balm

Cold sores can be a persistent issue, but with proper care and management, you can reduce the frequency of outbreaks and prevent spreading the virus to others.

A sudden twitch in the eyelid can be surprisingly unsettling. For some people, it may happen occasionally and disappear on its own, while for others, repeated twitching can lead to concerns about whether something more serious is going on.

The good news is that an occasional eyelid twitch is usually harmless and self-limiting. Stress is one of the common factors associated with it, but it is not the only one.

What causes an eye to twitch?

Eyelid twitching can often be associated with everyday factors such as stress, lack of sleep, high caffeine intake, smoking and general exhaustion.

For someone going through a stressful period or not getting enough rest, the twitch may appear and become more noticeable. High coffee or caffeine consumption can also be a contributing factor.

In most cases, the twitch settles on its own once the underlying trigger is addressed. It commonly resolves within a few weeks.

This means that an isolated eyelid twitch does not necessarily indicate an underlying eye or neurological disease.

Also read: Andrew Huberman’s Sleep Trick: Can Eye Movements Help You Fall Back Asleep?

Can reducing stress help?

Since stress, tiredness and lifestyle factors can contribute to eyelid twitching, addressing these factors can often help.

Getting adequate sleep, reducing caffeine intake and making time for relaxation can be useful. Meditation and relaxation exercises may also help, particularly when stress appears to be a contributing factor.

The key is to look at the bigger picture rather than immediately assuming that the twitch itself indicates a serious problem.

When should you see an ophthalmologist?

While an occasional twitch is generally not a cause for concern, it is worth consulting an ophthalmologist if the problem continues for several weeks or is accompanied by other symptoms.

Particular attention should be paid if there are:

• Changes in vision
• Swelling of the eyelids
• Difficulty or inability to open the eyes
• Other unusual symptoms accompanying the twitch

Persistent or unusual eyelid movements can sometimes be associated with conditions such as blepharospasm or hemifacial spasm, while certain neurological conditions can also present with symptoms that may initially resemble an ordinary eye twitch.

An ophthalmologist can assess the symptoms and determine whether further evaluation is required.

Also read: The Hidden Health Cost Of Excessive Screen Time: Dry Eyes, Ringing Ears, Poor Sleep

Does an eye twitch mean you have a neurological problem?

This is one of the biggest concerns people have when their eyelid starts twitching.

An isolated eyelid twitch, by itself, is usually not a sign of a serious neurological disease. Instead of focusing only on the twitch, individuals should pay attention to whether there are other neurological symptoms occurring at the same time.

Symptoms such as facial weakness, numbness, difficulty speaking or difficulty walking warrant medical attention and should not be ignored.

The presence of these accompanying symptoms is more significant than an occasional eyelid twitch on its own.

Don't let an occasional twitch cause unnecessary worry

Eyelid twitching can be irritating and, understandably, may cause anxiety. However, in most cases, it is temporary and can settle once contributing factors such as stress, fatigue or excessive caffeine consumption are addressed.

Getting adequate rest, reducing caffeine, managing stress and incorporating relaxation techniques can be simple first steps.

At the same time, persistent twitching or twitching accompanied by changes in vision, eyelid swelling, inability to open the eyes or other neurological symptoms should be evaluated by a medical professional.

The important distinction is between an occasional, isolated twitch and a persistent or unusual pattern accompanied by other symptoms. Knowing that difference can help people avoid unnecessary worry while also recognising when professional evaluation is appropriate.

A surgeon, sitting hundreds of kilometres away, can now operate on a patient undergoing complex procedure by controlling a robotic system. This is no longer just an inexplicable futuristic idea.

India has already seen a major development in robotic telesurgery, as doctors explore whether advanced surgical systems can help connect specialist surgeons with patients in different cities where such expertise may not be accessible.

According to data presented at the Society of Robotic Surgery (SRS) India 2026 conference in New Delhi, the development comes as robotic surgery itself is expanding rapidly across India. Delhi NCR has emerged as the country's leading hub for robotic surgery.

Addressing the SRS India 2026 Conference virtually, Union Minister for Health and Family Welfare Shri J.P. Nadda said "Today India stands at an exciting juncture in the healthcare innovation, with our strength in technology, Artificial Intelligence, digital health and a rapidly expanding ecosystem of surgical robotics, we have opportunity, not nearly to adopt the technology of the future but innovate ,develop and lead. India is increasingly becoming an important global destination for healthcare innovation and advance surgical technology. I congratulate organizers for bringing this important international conference to India."

Delhi NCR Sees Five-Fold Increase In Robotic Surgeries

According to the conference data, 39 hospitals in Delhi NCR now have robotic systems, while 11 hospitals have more than one system. The number of robotic-assisted procedures in the region has also increased from 2,257 in 2021 to 10,937 in 2025. Across India, the growth in robotic surgical procedures increased from 8,912 in 2021 to 44,857 in 2025.

Urology accounted for about 30.2% of robotic procedures in Delhi NCR in 2025, while general surgery-benign procedures made up around 33% and gynaecology 22.1%.

Dr. Vivek Bindal, Organising Chairman, SRS India and Principal Director & Head, Department of Minimal Access, Bariatric & Robotic Surgery, Max Hospital, New Delhi, said, “Delhi NCR has emerged as a leading force in India’s robotic surgery journey, with the highest concentration of robotic-system installations in the country and a rapidly expanding volume of procedures. The presence of robotic systems across 39 hospitals, including 11 hospitals with multiple systems, reflects the depth of expertise and institutional adoption that has developed in the region."

He added, "Delhi has reached this position because of the combined efforts of pioneering surgeons, high-volume hospitals and multidisciplinary teams that have steadily integrated robotic technology into complex surgical care. What we are witnessing is not simply an increase in machines or procedures, but the emergence of Delhi as a centre that is helping shape the future of robotic surgery in India."

Also read: Robotics Set to Transform Every Medical Specialty, From Diagnostics to Therapy in India: Jitendra Singh

India's First Government-Institution Robotic Telesurgery

Prof. Dr. Anup Kumar, Professor & Head, Department of Urology, Robotics & Renal Transplant, VMMC & Safdarjung Hospital, New Delhi, recently performed India's first government-institution robotic telesurgery in urology.

The reconstructive procedure was performed remotely from Gurugram to Preeti Kidney & Urology Hospital in Hyderabad.

The accomplishment has raised the possibility of specialist surgeons operating on patients who are located in smaller cities with limited resources and access.

Also read: 22-Year-Old Woman Undergoes Robotic Heart Surgery After Two Strokes and Months of Delayed Treatment

Scope For Telesurgery

India's major cities have increasingly developed robotic surgery infrastructure and specialist teams. But access to highly specialised surgeons is not evenly distributed across the country. If remote robotic surgery can be safely scaled, a specialist in a major medical centre could operate on a patient in another city through a connected robotic system.

Dr. Anup Kumar said, “India is now at a defining moment in robotic surgery. The rapid rise in robotic procedures—from 8,912 nationally in 2021 to 44,857 in 2025—shows how quickly the technology is being adopted and how clinical expertise is expanding across the country. India is moving beyond being a technology adopter and is developing the experience, infrastructure and surgical capabilities required to become a global force in robotic surgery. If this momentum continues, India has the potential to emerge as a global leader by 2030 and compete with, and potentially surpass, established leaders such as the US. This is a proud moment for Indian healthcare and a significant opportunity to place India at the forefront of the next generation of surgery.”

Robotic telesurgery could also have other advantages besides bridging location gaps. The technology could support remote surgical training, tele-mentoring and collaboration between specialists when needed.

The SRS India 2026 conference also showcased a cross-border robotic telesurgery demonstration between India and China.

Dr. Vivek Bindal led the demonstration, with surgeons at Max Super Speciality Hospital, Vaishali, remotely operating a robotic console nearly 5,000 kilometres away in Chengdu, China during pre-clinical procedures.

How Can This Technology Become Routine?

Remote surgery requires more than a robotic surgical machine and a fast internet connection. The international consensus recommendations published in the World Journal of Surgery in 2026 address issues including connectivity, cybersecurity, surgeon training, credentialing, emergency preparedness and regulation.

There also needs to be a clear plan for what happens if the connection fails or the patient develops an unexpected complication during surgery.

For India, the technology could eventually help narrow the gap between where specialist surgeons are located and where patients live. But for that to happen, telesurgery will need strong infrastructure, trained teams, reliable connectivity and carefully defined safety protocols.

Fatty liver disease has traditionally been associated with obesity and alcohol consumption. However, in clinical practice, we are increasingly seeing fatty liver in individuals who may not appear overweight and who do not consume alcohol. This changing pattern reflects a larger problem: the close relationship between liver health, metabolic health, and lifestyle.

Non-alcoholic fatty liver disease (NAFLD), now increasingly termed metabolic dysfunction-associated steatotic liver disease (MASLD), occurs when excess fat accumulates in the liver in association with metabolic risk factors. A systematic review and meta-analysis of Indian studies estimated the pooled prevalence of NAFLD among adults at 38.6%, meaning that roughly one in three adults may be affected. The prevalence was approximately 28.1% in average-risk populations and increased to 52.8% among individuals with higher metabolic risk.

What is particularly important for Indians is that fatty liver cannot be identified simply by looking at body weight. South Asian populations can develop visceral or abdominal fat and metabolic abnormalities even at relatively lower body mass indices. A South Asian meta-analysis found that NAFLD affected approximately 26.9% of adults in the general population, while prevalence rose to 54.1% among people with metabolic diseases. Importantly, around 43.4% of people with NAFLD in the analysis were not obese.

Diabetes, hypertension, dyslipidaemia, central obesity and metabolic syndrome are therefore important warning signs. In my practice, I often emphasise that a normal-looking body does not necessarily mean a metabolically healthy body. Waist circumference, blood sugar, lipid profile, liver enzymes, and, when indicated, liver imaging provide a much more meaningful risk assessment.

The other misconception is that fatty liver is harmless. Simple steatosis may remain stable in many individuals, but some patients develop inflammation and progressive fibrosis, eventually leading to cirrhosis and liver cancer. A systematic review of hepatocellular carcinoma in India also found that the proportion of cases associated with NAFLD has been increasing, although viral hepatitis remains an important cause. ([PubMed][3])

There is also a broader gastroenterological concern. Digestive and liver health are closely connected with dietary patterns, physical activity, and metabolic health. Excessive intake of refined carbohydrates, sugary beverages, ultra-processed foods, and excessive calories, combined with inadequate physical activity, can contribute to metabolic dysfunction.

The good news is that lifestyle modification can make a substantial difference in fatty liver. Weight reduction, regular physical activity, improved dietary quality, adequate sleep, and better control of diabetes and cholesterol can help reduce liver fat and metabolic risk. Importantly, management should be individualised rather than based on crash diets or unregulated supplements.

Fatty liver should therefore be viewed not merely as an incidental finding on an ultrasound report, but as a metabolic warning signal. Early identification allows us to intervene before irreversible liver damage develops. For patients, the message is simple: taking care of the liver also means taking care of the heart, metabolism, and overall digestive health.

The statistics cited above are based on published systematic reviews/meta-analyses and IARC/WHO data; prevalence estimates vary depending on the population and diagnostic method.

Dr. Pradipta Kr. Sethy, Director Gastroenterology, Manipal Hospitals EM Bypass & Mukundupur