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.

The recent launch of the indigenous Td vaccine in India by Union Health Minister JP Nadda will boost immunity and reduce the risk of tetanus and diphtheria in children and adults, said health experts.

Union Health Minister JP Nadda formally launched the indigenously manufactured Td vaccine in Himachal Pradesh last week.

With the launch, the Tetanus Toxoid (TT) vaccine has been replaced with the Tetanus and adult diphtheria (Td) vaccine in India’s immunization program for all age groups, including pregnant women.

The move comes amid increasing numbers of cases of diphtheria amongst older age groups. Tetanus and diphtheria can lead to hospitalizations or even cause death. The Td vaccine will help to decrease diphtheria outbreaks.

“In keeping with global practice, India has shifted from TT, which covers for tetanus, to Td, which covers for both tetanus and diphtheria. This vaccine is indigenously manufactured and is expected to significantly reduce the risk of both these diseases in older children as well as adults,” Dr. Rajeev Jayadevan, Ex-President of IMA Cochin and Convener of the Research Cell, Kerala, told HealthandMe.

What Is The Td Vaccine?

The Td vaccine, indigenously manufactured at the Central Research Institute (CRI), Kasauli in Himachal Pradesh, is a combination of tetanus and diphtheria with a lower concentration of diphtheria antigen (d), and is recommended for older children and adults.

The use of Td, instead of TT, is recommended during pregnancy to protect against maternal and neonatal tetanus and diphtheria during prenatal care.

Vaccination during pregnancy also serves to boost immunity and increase the duration of protection in pregnant women who have not received the full set of recommended booster doses.

The Td is a safe vaccine, and 133 countries are currently using it.

The Health Ministry, in a statement, said that the Central Research Institute will supply 55 lakh doses to the UIP by April 2026, with production expected to scale up progressively in subsequent years to further strengthen the Universal Immunization Program in India.

“India’s indigenous Td vaccine rollout marks a significant milestone in strengthening the nation’s immunization program by enhancing self-reliance, affordability, and supply stability,” Dr. Neha Rastogi, Senior Consultant - Infectious Diseases, Fortis Gurugram, told HealthandMe.

“Locally produced vaccines reduce dependency on imports, ensuring uninterrupted protection for adolescents and adults against tetanus and diphtheria. This initiative supports wider coverage, faster distribution to remote regions, and improved public health preparedness,” she added.

Tetanus And Diphtheria: Disease burden In India

As per the National Health Profile 2022, India has reported 1,586 cases and 22 deaths due to diphtheria in 2020, and 3,677 cases and 47 deaths in 2021.

Around 10 Indian states report the majority (84 per cent) of the cases.

As of 21 June 2024, Orissa has also reported six deaths and 21 suspected diphtheria cases. There has been more than 90 percent coverage of diphtheria vaccination in birth cohorts since 2014, but gaps in booster dose coverage are widely prevalent.

Plugging of gaps in the routine immunization, coupled with inclusion of booster doses in the national data on diphtheria vaccination, is the need of the hour.

“Diphtheria is one of the most dangerous infectious diseases known to man; it spreads easily through the respiratory route. It can cause death due to the bacterial toxin affecting the heart (Myocarditis). It is vaccine-preventable, but the immunity fades over time,” Dr. Jayadevan said.

Therefore, the Td booster shots at ages 10 and 16 are essential to maintain protection. Similarly, pregnant women should receive two doses to protect both mother and child.

Given the recent outbreaks of diphtheria in India and elsewhere, this transition is a public health priority, the expert said.

Cardiovascular emergencies remain among the most time-critical and life-threatening events in modern medicine. From sudden cardiac arrest to acute coronary syndromes and hypertensive crises, these conditions demand not only clinical excellence but also seamless systems of care. In an era where cardiovascular disease continues to dominate global mortality charts, preparedness is imperative.

Understanding Cardiovascular Emergencies

Cardiovascular emergencies encompass a spectrum of acute conditions that compromise cardiac output, coronary perfusion, or vascular integrity. These include myocardial infarction, cardiac arrhythmias, acute heart failure, aortic dissection, pulmonary embolism and cardiogenic shock. What unites them is speed: the window between reversible injury and irreversible damage is often measured in minutes.

Timely recognition of symptoms like chest pain, breathlessness, syncope, palpitations or sudden neurological deficits can dramatically alter outcomes. Delays, even minor ones, translate into myocardial loss, cerebral injury or death.

Acute Coronary Syndromes

Acute coronary syndromes (ACS) remain the cornerstone of cardiovascular emergencies. Plaque rupture and thrombosis can abruptly occlude coronary arteries, leading to unstable angina or myocardial infarction. Early electrocardiographic evaluation and cardiac biomarker guide diagnosis, but decisive action is paramount.

Rapid reperfusion, whether via thrombolysis or primary percutaneous coronary intervention, restores blood flow and salvages myocardium. Modern emergency cardiac care prioritises well-rehearsed protocols, ensuring that “door-to-balloon” times are aggressively minimised. In cardiovascular emergencies, hesitation is the enemy of survival.

When the Heart Loses Its Rhythm: Arrhythmias and Cardiac Arrest

Sudden cardiac arrest, often precipitated by malignant arrhythmias such as ventricular fibrillation or ventricular tachycardia, is the most dramatic cardiovascular emergency. Survival hinges on immediate cardiopulmonary resuscitation (CPR) and early defibrillation.

Equally dangerous are unstable bradyarrhythmias and supraventricular tachycardias, which can compromise haemodynamics within moments. Advanced cardiac life support protocols, continuous monitoring, and access to defibrillation and pacing are non-negotiable components of any emergency-ready healthcare facility.

Hypertensive and Aortic Emergencies

Hypertensive emergencies occur when severely elevated blood pressure causes acute target-organ damage, affecting the brain, heart, kidneys, or eyes. Stroke, acute left ventricular failure, and myocardial ischaemia are common and devastating consequences.

Aortic dissection, though less common, is among the deadliest cardiovascular catastrophes. Sudden tearing chest or back pain, pulse deficits, and blood pressure differentials demand immediate imaging and surgical consultation. Here, precision in diagnosis and blood pressure control can mean the difference between life and sudden death.

The System Behind The Save: Integrated Emergency Cardiac Care

Effective management of cardiovascular emergencies extends beyond individual expertise. It relies on an integrated ecosystem, trained emergency teams, rapid diagnostics, catheterisation laboratories, cardiac intensive care units, and post-event rehabilitation.

Hospitals that invest in protocol-driven care pathways, continuous staff training, and advanced cardiac technology consistently achieve superior outcomes. Equally vital is public awareness: early symptom recognition and prompt presentation to medical facilities significantly reduce mortality.

Preparedness Is The New Prevention

While prevention remains the long-term strategy against cardiovascular disease, preparedness defines survival during emergencies. From ambulance services equipped with defibrillators to hospitals offering round-the-clock cardiac intervention, readiness saves lives.

Cardiovascular emergencies do not announce themselves politely. They arrive uninvited, escalate rapidly, and punish complacency. In these moments, excellence is measured not in intent but in response.

A viral TikTok has been telling women to toss their underwear every six to nine months, warning that anything older could be unhealthy. The internet reacted exactly how you would expect. Some people were shocked. Others admitted they still own pairs from years ago. Many simply wondered if they had been doing hygiene wrong all along. In fact, a report by The Asian News Hub also echoes the same claim that underwear must be changed in every six to nine months.

Health and Me ran a fact check to see whether there is a mandate on when to change your underwear and here is what we found:

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Speaking to Today.com, Dr. Jen Gunter, OB-GYN and author of The Vagina Bible, pushed back strongly against the claim on social media. She explained that underwear does not suddenly become dangerous after a specific time period.

The idea, she said, reflects cultural anxiety around the vulva rather than science. Many people grow up hearing the vagina is fragile, dirty, or constantly at risk of infection, which fuels rigid hygiene rules that are not medically necessary.

Doctors agree there is no expiration date.

“There is no rule that says after six months you must replace your underwear,” Dr. Chavone Momon-Nelson, an OB-GYN at UPMC in Pennsylvania, told Today.com. She added that social media often turns suggestions into hard rules, even when evidence does not support them.

However, Dr Shirin Lakhani of Elite Aesthetics told Independent that underwear is in close contact with skin and intimate areas and could take in a lot of dead skin and bacteria, including naturally occurring ones and the harmful ones, which could lead to infection. She said that even regularly washing your underwear in a washing machine "won't always rid it completely of bacteria such as E.coli."

Another gynecologist Narendra Pisal at London Gynaecology suggests a 50-wash rule for discarding underwear.

What Actually Matters For Vaginal Health

Instead of the age of underwear, doctors say cleanliness and dryness are what really affect health.

Dr. Christine Greves, who practices at the Center of Obstetrics and Gynecology in Orlando, explained that clean underwear made from breathable fabric is usually sufficient. Cotton is commonly recommended because it allows airflow and reduces moisture buildup.

Damp or sweaty underwear can irritate skin and increase the chance of infection, but that problem has nothing to do with how long you have owned the garment. It has to do with whether it is clean and dry.

Momon-Nelson, DO, who specializes in obstetrics and gynecology and is board-certified in obstetrics and gynecology by the American Osteopathic Board of Obstetrics & Gynecology, added that normal washing removes bacteria effectively, especially in warm or hot water. Regular laundry habits are enough for hygiene in most cases.

The Yeast Infection Fear

One persistent fear behind the viral claim is yeast infections. Some believe old underwear stores fungus even after washing.

Greves pointed to an older study examining whether candida could survive laundering. The research found that routine washing removed the organism and did not transmit infections when the underwear was reused.

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In other words, properly washed underwear does not act as a hidden infection source. However, constant washing, body oils, residual detergent, and dried sweat could make the underwear stiff, which could ruin its soft texture and cause chaffing. Pisal says, "If your underwear is causing chaffing, skin irritation or is torn", you may need to replace your underwear sooner.

Why The Myth Keeps Spreading

Experts say the rule survives because of long-standing stigma around female anatomy. Many products and trends market special cleansers, wipes, sprays and frequent replacement routines as necessary maintenance.

But medically, the vulva is simply skin. Gentle washing with soap and water externally is usually enough.

That does not mean buying new underwear is bad. Comfort, fit, and personal preference matter. Replacing worn-out elastic or damaged fabric makes sense. What doctors reject is the idea of a strict timeline.

As Momon-Nelson told Today.com, there is nothing wrong with enjoying new underwear. The problem begins when people feel forced by fear rather than choice.