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.

GLP-1 receptor agonists (GLP-1 RAs), including semaglutide widely used to improve diabetes control and promote weight loss, may also reduce the risk of colorectal cancer, according to a new study.

The study found that the effect was particularly notable among people with inflammatory bowel disease (IBD), as well as those with both IBD and type 2 diabetes. Both conditions are associated with a higher risk of colorectal cancer due to chronic inflammation and metabolic changes that may promote tumor development.

"GLP-1 RA use was associated with a significantly reduced incidence of colorectal cancer in all patients with IBD, as well as the subpopulation with both IBD and type 2 diabetes," said lead author Sarina Ailawadi of Case Western Reserve University, US.

"Given the elevated colorectal cancer risk in IBD, these findings suggest a potential protective effect of GLP-1 RA use in this high-risk population. Prospective studies will be important to further analyze and confirm this potential benefit," she added.

The findings will be presented at the 2026 American Society of Clinical Oncology (ASCO) Breakthrough meeting, scheduled for June 25–27 in Singapore.

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How Was The Study Conducted?

This retrospective cohort study analyzed data from 69,221 people in the US, including GLP-1 RA users and non-users.

Researchers also identified 209,649 people with both IBD and type 2 diabetes, including 38,567 who had taken a GLP-1 RA.

After matching users and non-users for various characteristics, data from 37,740 patients were analyzed. The GLP-1 RA group included people taking semaglutide, dulaglutide, tirzepatide, exenatide, liraglutide, or lixisenatide.

The researchers compared the five-year incidence of colorectal cancer between GLP-1 RA users and non-users.

Among people with IBD, the five-year incidence of colorectal cancer was 0.2% in GLP-1 RA users compared with 0.42% in non-users. The odds ratio was 0.49, indicating a 51% lower likelihood of developing colorectal cancer among GLP-1 RA users.

Among patients with both IBD and type 2 diabetes, the five-year incidence of colorectal cancer was 0.31% in GLP-1 RA users and 0.57% in non-users. The odds ratio was 0.54, suggesting a 46% lower likelihood of developing colorectal cancer.

The researchers noted that prospective studies are needed to confirm the potential protective effect of GLP-1 RAs on colorectal cancer risk.

Do IBD and Type 2 Diabetes Increase Colorectal Cancer Risk?

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Inflammatory bowel disease is associated with a higher risk of colorectal cancer, likely because of chronic inflammation in the intestines. People with IBD are estimated to be six times more likely to develop colorectal cancer than those without the condition.

Type 2 diabetes, the most common form of diabetes, also increases colorectal cancer risk and is becoming more common among people with IBD. Scientists believe that individuals with both conditions may face an especially high risk because of the combined effects of chronic inflammation and metabolic dysfunction.

What Are GLP-1 Receptor Agonists?

GLP-1 receptor agonists are a class of drugs that help lower blood sugar levels and promote weight loss. Originally developed to treat type 2 diabetes, many are now widely used for weight management.

These medications mimic the action of the GLP-1 hormone by stimulating insulin release, slowing digestion, and increasing feelings of fullness.

Beyond blood sugar control and weight loss, GLP-1 RAs have been linked to several health benefits, including lower blood pressure and reduced cardiovascular risk. Previous studies have also suggested that they may lower the risk of colorectal cancer and other obesity-related cancers.

However, their specific impact on colorectal cancer risk among people with IBD has remained unclear until now.

Pop singer Madonna has opened up about knee damage caused by years of dancing in high heels.

The 67-year-old superstar said running and Ashtanga yoga also added stress to her joints, leaving her with “no cartilage” in her knee, according to Interview Magazine.

“I have a bad knee now. I have no cartilage in it, thanks to dancing for so long in high heels and running on pavement and doing Ashtanga yoga,” Madonna told the magazine.

“Up until a year ago, I was jumping on trampolines and doing dance cardio and doing a lot of what a doctor would call loading on my joints. Can’t do that anymore,” she added.

Madonna said she still works out regularly while listening to her new album Confessions II, but has had to modify her fitness routine to accommodate the injury.

The Queen of Pop said she now focuses on “Peloton bikes and the Versa Climber and high-intensity circuit training. I ride my bike outside a lot. I dance.”

Madonna has previously been open about her knee injury and its impact on her career. In October 2019, she postponed a scheduled Madame X show in Brooklyn, New York.

“It's Hard for Madame to admit that she is also a human being made of flesh and blood and she must rest for the next 3 days to insure full recovery for her knee,” she wrote on Instagram.

“I am not a quitter. This hurts me more than you can imagine. It's time to take those heels and fishnets off for a few days!”

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Can High Heels Affect Knee Health?

Knee osteoarthritis (OA), a leading cause of disability, is more prevalent in women than men. Wearing high-heeled shoes has been implicated as a potential contributing factor to the higher lifetime risk of osteoarthritis in women.

Several studies have examined the relationship between high heels and knee health. Motion analysis studies have shown changes in knee alignment while walking in heels, changes that researchers have suggested may resemble patterns seen in ageing and knee osteoarthritis progression.

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A 2025 study published in The Knee by researchers from the Singapore Institute of Technology found that wearing 8-cm high-heeled shoes significantly reduced the lateral joint space width of the knee in healthy young women during standing, suggesting increased lateral knee joint stress.

The findings suggest that high heels may specifically affect the lateral compartment of the knee, potentially contributing to increased joint stress during standing.

Wearing heels for long periods can increase the load on the knees. They alter posture and walking patterns, placing additional pressure on the knee joint. Over time, this may strain the ligaments and muscles surrounding the knee, leading to pain, stiffness, and long-term damage.

In 2025, the Nicki Minaj Challenge, inspired by the rapper's 2013 song High School, gained traction on social media. The challenge, which involved balancing in high heels, reportedly resulted in injuries including fractures and, in some cases, deaths.

Most people pay little attention to their knees, legs and ankles until something goes wrong. Once pain sets in, even simple things like walking, climbing stairs, or standing for long can become a real challenge. Left unmanaged, lower limb pain gradually affects mobility, independence and quality of life.

What Is Usually Behind the Pain?

Knee pain commonly traces back to osteoarthritis, ligament injuries, cartilage damage, or years of wear. Pain in the leg can be caused by muscle injuries or conditions involving nerves and poor blood flow. The pain in the ankle is commonly caused by sprains, tendinitis, arthritis, or any injury that may have occurred earlier without complete healing.

Age, obesity, sedentary lifestyles, and constant joint injuries contribute silently to the degenerative condition of the joints.

Signs That Should Not Be Ignored

Persistent pain, swelling, stiffness, or discomfort that keeps getting worse deserves attention. If pain is disturbing your sleep, that is a clear signal to see a doctor.

Habits That Help Protect Your Joints

Walking downstairs puts considerable pressure on the knees, so limiting stair use where possible is sensible. Squatting, sitting on the floor and using Indian-style toilets place similar strain and are better avoided.

Staying active matters just as much. Regular household chores, walking, stretching and strengthening exercises, even 15 to 20 minutes a day, keep muscles strong and reduce the load on joints. Focusing on the adductor muscles around the knee is particularly effective in improving joint support.

Non-Surgical Options Worth Knowing

Surgery is not always the answer. Two non-surgical treatments carried out by a pain physician can make a meaningful difference.

Platelet-Rich Plasma therapy, or PRP, involves concentrating platelets from the patient's own blood and injecting them into the affected joint. In osteoarthritis, where cartilage gradually thins, PRP may help support regeneration and ease symptoms.

Radiofrequency Ablation, or RFA, uses a specialized needle to deliver targeted heat that interrupts the nerves responsible for sending pain signals to the brain. Relief typically lasts one to two years. The procedure is done as day care with no cuts, no stitches and no anesthesia required.

A concern many patients raise is that pain stops them from exercising or losing weight. Once pain is controlled through these treatments, walking and light activity become manageable again, which in turn supports weight loss and takes further pressure off the joints.

Custom Knee Supports

Off-the-shelf knee caps have limited effectiveness. A custom-made support, designed to redistribute body weight and reduce joint stress, works considerably better, especially in early arthritis. Many patients notice relief shortly after wearing one. They are an investment, but a worthwhile one that can reduce dependence on medication while the surrounding muscles gradually strengthen.

When to See a Doctor

If pain has lasted several weeks, is worsening, or is getting in the way of daily life, it is time to consult a specialist. Early diagnosis and the right treatment can protect joint function, restore mobility and often avoid the need for surgery.

(By Dr. Aanchal Sharma, Pain Physician, Principal Consultant and Head of Department, Department of Pain Medicine at BLK MAX Hospital, New Delhi)