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.

For some women with endometriosis, getting a diagnosis is only the beginning of a long struggle to access treatment and navigate management.

In Canada, long waitlists for specialist appointments are pushing patients to consider expensive surgery abroad, highlighting how delays in care can prolong pain and disrupt everyday life.

Noelle Menu, 37, from Calgary, said her symptoms intensified after she stopped taking birth control while trying to conceive at 26.

Years of pain, emergency room visits, surgery and delays in specialist care eventually led her and her husband to seek private treatment in Tijuana, Mexico.

After being told that waiting several years to see a specialist in Canada was possible, Menu said: “We can’t deal with it in Canada.”

The couple used their savings and went into debt to pay for treatment at EndoGlobal in Mexico. The total cost was approximately $35,000, including travel, accommodation and other expenses, according to CBC News.

Her experience highlights the delay in addressing endometriosis that can intensify debilitating symptoms.

What Is Endometriosis And Why Can It Be Difficult To Diagnose?

Endometriosis is a chronic condition in which tissue similar to the lining of the uterus grows outside it, potentially affecting the ovaries, bowel, bladder and other areas. The resulting inflammation and scar tissue can cause severe menstrual cramps, persistent pelvic pain, painful sex, bowel or urinary symptoms and difficulties conceiving.

The World Health Organization estimates that endometriosis affects around 10% of reproductive-age women worldwide, or approximately 190 million people.

Diagnosis can be challenging because symptoms vary and may overlap with other conditions. There is no single definitive test that identifies every case. Doctors may use a detailed medical history, pelvic examination, ultrasound or MRI, with surgery sometimes needed to investigate or treat suspected disease.

The WHO estimates that diagnosis commonly takes between four and 12 years, leaving many patients managing symptoms without a clear explanation for prolonged periods.

Also read: Endometriosis: Repurposed Anti-Parasite Drug Shows Promise In Mouse Study

How Do Delays Affect Patients?

For patients with severe disease, waiting for specialist care can mean continuing to live with pain that interferes with work, relationships, sleep and fertility plans.

Another Canadian patient, identified in CBC's report as Papiernik, described discovering that endometriosis had infiltrated her colon after a colonoscopy detected a mass. She was referred for specialist care but faced further waits for an appointment and surgery.

“Living like this for two years was just not an option for me,” she said.

Canada's House of Commons health committee has identified gaps in endometriosis care, while the condition's economic impact includes lost productivity and healthcare costs. The issue is not simply whether treatment exists, but whether patients can access appropriate care before symptoms and complications become harder to manage.

Also read: Urine & Vaginal Samples May Help Detect Womb Cancer: Lancet Study Suggests Less Invasive Way To Triage Patients

Does Surgery Cure Endometriosis?

Surgery can remove endometriosis lesions, adhesions and scar tissue, reducing pain and treating complications. However, it is not a guaranteed cure. Symptoms may persist or return, and treatment decisions depend on disease severity, the organs involved, fertility goals and previous treatment.

Hormonal medicines and pain management can also help control symptoms. Some patients benefit from a combination of medical treatment, surgery and ongoing follow-up.

Travelling abroad may offer faster access to specialist treatment, but it comes with financial costs and other challenges. Patients should consider the surgeon's experience, the facility's standards, the possibility of complications and arrangements for follow-up after returning home.

A routine heart scan helped doctors detect pancreatic cancer in a 72-year-old US woman before it was too late. Vicky Titcomb, a Cape Cod bookstore owner and great-grandmother, underwent the scan at Mass General Brigham in March 2025, before traveling to New York City to visit her son.

Although she felt healthy, the scan revealed an abnormality on her pancreas. Further testing confirmed pancreatic cancer, one of the deadliest forms of cancer, CBS News reported.

“I felt like my life just switched in that moment,” Titcomb said. “It was a very weird feeling.”

Titcomb had undergone treatment for breast cancer in 2012.

In 2025, she was diagnosed with stage 1 breast cancer as well as pancreatic cancer. Doctors also found a mass on her ovary, which proved benign after the ovary was removed.

Why Early Detection Matters In Pancreatic Cancer

Pancreatic cancer is often diagnosed after it has spread to other organs. Its five-year overall survival rate is 13%.

The American Association for Cancer Research noted in its 2026 Cancer Progress Report that pancreatic cancer survival rates have shown little improvement despite advances in cancer care.

Doctors at Mass General Brigham planned chemotherapy and radiation to shrink Titcomb’s pancreatic tumor before surgery.

“I was told the size of the (pancreatic) cancer was about the size of a grape. The goal, to me, was trying to make this cancer a raisin,” she said. “That's the way I visualized it.”

The plan was to perform a Whipple procedure, a complex operation that removes the head of the pancreas, part of the small intestine, the gallbladder and the bile duct. Only about one in five pancreatic cancer patients is eligible for this surgery.

Titcomb’s early diagnosis made the operation possible.

“If I had not had that scan when I did, the outcome would have been bad,” she said.

Chemotherapy, Radiation And Surgery

Titcomb began chemotherapy in June 2025, receiving eight doses over four months. She then underwent three weeks of radiation and additional chemotherapy.

Surgical oncologist Dr. Thomas Clancy said she tolerated the treatment “very well.” The therapy shrank the pancreatic tumor enough for surgery.

On November 4, Titcomb underwent surgery to treat her breast cancer. Just over two weeks later, Clancy performed a robotic Whipple procedure to remove the affected part of her pancreas and other structures.

The operation was successful, and Titcomb said she was walking that night. She returned home after several days in the hospital.

Although she was recovering well, Clancy recommended two more months of chemotherapy because pancreatic cancer can be aggressive.

“There was a lot going on,” Titcomb said. “I just tried to cope with the day-to-day.”

No Evidence Of Cancer After Treatment

In March 2026, after further treatment, Clancy told Titcomb she had no evidence of cancer. She will continue to undergo scans every three months.

“She’s living her life. I generally tell patients at this point, ‘You’re done with therapy ... you go about your days,’” Clancy said. “The goal is to not be thinking about it all the time.”

Titcomb is returning to running her bookstore, which family members helped manage during her treatment. She is also spending time with her children, grandchildren and great-grandchildren, keeping in touch with those who live far away through photos, videos and phone calls.

Arthritis can affect people at different stages of life, limiting their ability to walk, climb stairs or carry out everyday activities with ease. While treatment largely depends on the extent of joint damage and the patient's condition, treatment approaches ranging from joint-preserving surgery to knee and hip replacement can help restore mobility. Rehabilitation still remains an essential part of recovery.

On World Arthritis Day, doctors explain how arthritis is treated and managed at different ages using real-life cases and highlighting how they assess joint damage, choose strategies and use physiotherapy to help patients return to their routines.

Knee Preservation Before Replacement

A 42-year-old man with grade 3 osteoarthritis in his right knee had been experiencing pain and locking. His symptoms began after a knee injury six years earlier and worsened with time. X-rays revealed marked varus alignment, cartilage and meniscus damage. Earlier consultations had suggested knee replacement, but given his age, doctors opted for knee preservation surgery.

Dr. Tapish Ravindra Shukla, Consultant Orthopaedics and Sports Medicine, Fortis Escorts Hospital, Amritsar, told HealthandMe that he performed three procedures in a single sitting: high tibial osteotomy to correct alignment and shift weight away from the damaged inner compartment, bone marrow aspirate concentrate (BMAC) to treat the cartilage defect, and meniscus repair.

The patient walked with a walker for approximately three weeks, began jogging at six weeks and was running by three months.

The case brings us to an important point, i.e., assessing whether a damaged joint can be preserved, especially in younger patients who may otherwise face joint replacement early in life.

Also read: Arthritis Day: Stanford Researchers Explore Possibility To Treat Osteoarthritis Without Knee Replacement Surgery

When Hip Replacement Becomes Necessary?

In another case, a patient developed pain in both hips after recovering from a major head injury. During prolonged rehabilitation, he had received steroids and anti-epileptic medication for an extended period. He was subsequently diagnosed with bilateral avascular necrosis, a condition in which compromised blood supply damages bone and can lead to joint destruction.

Initially, doctors performed core decompression to relieve pressure within the affected bone and attempt to preserve the joints. The patient experienced relief and continued his routine activities for nearly two years.

However, following a minor slip and fall, the pain returned. Further evaluation and X-rays showed significant progression of arthritis, prompting a recommendation for total hip replacement.

Dr. P Keerthivasan, Senior Consultant and Spine Surgeon, Kauvery Hospital, Alwarpet, Chennai, explained to us the importance of understanding the condition, accepting when treatment needs to change and planning for recovery. Following hip replacement, the patient began mobilising the next day and progressed well during the immediate recovery period.

The case illustrates that joint-preserving procedures may provide relief in selected patients, but progressive joint damage can make replacement necessary.

Also read: Joint Pain In Your 30s And 40s: When Should You Worry?

Knee Replacement To Improve Quality Of Life

A 65-year-old woman with osteoarthritis in both knees had severe pain and difficulty walking, climbing stairs and performing daily activities. She had become dependent on painkillers, raising concerns about potential kidney damage with prolonged use. Doctors recommended total knee replacement.

Dr. Rishabh Tiwari, Consultant (JR), Orthopaedics, and Dr. Vivek Allahbadia, Consultant, Orthopaedic Surgery, P.D. Hinduja Hospital & Medical Research Centre, Khar, treated the patient using a minimally invasive technique in which the tendon was lifted rather than cut. The posterior cruciate ligament (PCL) was also preserved.

According to the doctors, these approaches can help reduce postoperative pain, limit bone loss and provide a more natural feel to the replaced knee.

The patient could lift her leg on the night of surgery. The following day, she was walking with full weight-bearing, bending and straightening her knee, and using the washroom independently. Training to climb stairs began on the second day, and she was discharged that day.

At one-and-a-half months, she could perform daily activities without pain and travel independently to nearby friends and relatives. The case stresses upon how surgical technique and early mobilisation can contribute to a patient's return to everyday activities.

In another case of knee replacement, a 62-year-old woman with severe osteoarthritis in both knees had spent nearly four years avoiding stairs, temples and long walks with her grandchildren. Pain, stiffness and fear of falling had increasingly restricted her activities. “She stopped joining family outings because I couldn’t keep up,” she told her doctor.

Dr. Bhushan Shitole, Consultant Orthopaedic Surgeon and Director at Vencer Hospital, told us that he recommended robotic-assisted total knee replacement using an imageless robotic system. The technology creates a three-dimensional plan of the joint before surgery and helps the surgeon plan implant positioning according to the patient's anatomy.

“Robotic planning lets us match the implant to the patient’s unique anatomy so the first steps after surgery are already better aligned,” Dr. Shitole said. “That first confident walk is often the real turning point.”

Following surgery, the patient began walking with minimal support within days. Structured physiotherapy focused on strength, balance and gait training. By the end of the first month, she was moving independently at home. Three months later, she boarded a cruise she had postponed.

“The robot didn’t just replace my knee. It gave her back the confidence to live the life she wanted,” Dr. Shitole said.

The case highlights that recovery involves more than replacing the damaged joint. Regaining balance, strength and confidence is also central to returning to normal activities.

Severe Arthritis In Children

Arthritis and joint destruction are not restricted to older adults. A 15-year-old boy with Morquio syndrome, a rare genetic disorder affecting skeletal development, developed severe arthritis in both hips. Pain and complex hip deformities made walking and everyday activities difficult.

Because of his small skeletal anatomy and the complexity of the deformities, doctors opted for staged bilateral hip replacements. The surgical team used CT scans to create a three-dimensional printed model of the pelvis and specialised R.I Hip software to simulate the procedures virtually. This helped them select correct sized implants, plan positioning and anticipate physiological challenges.

The two hip replacements were performed three days apart. The boy was able to stand and walk with support the day after each procedure.

The treating doctor, Dr. Vaibhav Bagaria, Director, Orthopaedics- Sir HN Reliance Foundation Hospital, Mumbai, told us that rehabilitation played a huge role.

“A successful joint replacement restores the mechanics of movement, but rehabilitation helps restore the confidence to move. Both are equally important for meaningful recovery, ” he said.

Physiotherapy focused on progressive walking, muscle strengthening, balance and functional independence, with the programme tailored to the boy's underlying skeletal condition.

The case also highlights the additional considerations involved in treating young patients, including implant longevity and the possibility of revision surgery in the future.

Across these cases, treatment ranged from procedures intended to preserve a joint to partial or total replacement of severely damaged joints. The choice depended on the patient's age, the extent of joint destruction, associated conditions and the likelihood of preserving function.

Rehabilitation was central to each case. Early mobilisation helped patients use their joints after surgery, while physiotherapy helped with strength, balance, walking and daily independence.