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.

One in four or 25 percent of adults with type-2 diabetes in India also suffer from liver fibrosis, according to an alarming study published in The Lancet Regional Health Southeast Asia journal today.

With data from more than 9,000 patients across the country, it is the largest ever real-world survey of liver fibrosis in type 2 diabetes from any low- or middle-income country.

While fatty liver disease has been touted as the most common liver condition among diabetes patients, the new study established liver fibrosis as the real danger among people with high blood sugar.

“Type 2 diabetes is closely linked to fatty liver disease (also known as MASLD). But how common is liver Fibrosis — the real danger — in Indian diabetics? Our answer: 1 in 4 has clinically significant liver fibrosis. One in 20 already has probable cirrhosis. Most had no symptoms. We propose liver fibrosis as the ‘4th major complication’ of diabetes,” said Ashish Kumar, from Ganga Ram Postgraduate Institute of Medical Education and Research (GRIPMER), from Sir Ganga Ram Hospital, in a post on social media platform X.

Also read: About 84% IT Employees Are Suffering With Fatty Liver Disease - Why Screenings Are Necessary For Corporate Workers

What Did The Study Find?

Fatty liver is typically the first and reversible stage of liver disease, where excess fat builds up in liver cells. Left untreated, it progresses to liver fibrosis, which is the excessive accumulation of scar tissue (collagen) in the liver resulting from chronic inflammation. The condition then progresses to the third and late stage, irreversible scarring (fibrosis) of the liver. The final stage is liver cancer.

The DiaFib-Liver Study included a total of 9,202 adults with type-2 diabetes patients who underwent FibroScan (VCTE) to assess liver fibrosis in routine diabetes care.

Of these:

• 26 percent had clinically significant fibrosis,
• 14 percent had advanced fibrosis,
• 5 percent had probable cirrhosis
• 65 percent had fatty liver disease.

• obesity
• dyslipidaemia
• kidney problems
• diabetes duration ≥10 years.

Fibrosis: The Screening Target

The study suggested the urgent need to integrate fibrosis screening into national diabetes programs.

“One in four adults with type 2 diabetes in India has clinically significant liver fibrosis and one in twenty already has probable cirrhosis, establishing advanced liver disease as a 'fourth major complication' of diabetes,” said the researchers.

“The DiaFibLiver Study calls for: Fibrosis — not steatosis — as the screening target. FibroScan integration into routine diabetes care. Moving beyond ultrasound-based referral,” Jha said.

“We hope this data from India adds to the global conversation on diabetes and liver disease,” he added.

Also read: The Silent Rise of Fatty Liver Disease: How India-Specific Guidelines Can Help

The findings highlight the urgent need to:

• move beyond steatosis
• systematically integrate fibrosis assessment into routine diabetes care,
• deploy non-invasive tools such as vibration-controlled transient elastography (VCTE) in community practice
• define screening strategies,
• evaluate therapeutic interventions.

Everyday Habits That Harm the Liver

Certain lifestyle choices can accelerate liver damage, such as:

Overeating processed or fried foods

High sugar intake (soft drinks, sweets, desserts)

Physical inactivity or prolonged sitting

Ignoring health issues like diabetes or hypertension

Crash dieting or taking unprescribed supplements.

How To Improve Liver Health?

Early screening and detection are key to prevent irreversible stages. Yet liver disease can be prevented with lifestyle changes such as:

• Eating a balanced diet with vegetables, fruits, whole grains, and lean protein
• Engaging in at least 30 minutes of exercise daily
• Staying hydrated to help the liver flush out toxins
• Avoiding alcohol and smoking
• Avoiding self-medication and unnecessary pills
• Getting routine health screenings.

While fevers are often overlooked and brushed aside or even managed with antibiotics — a dangerous trend — an alarmingly nationwide study linked it to infectious diseases with far-reaching consequences.

The report, based on data of over one lakh individuals in India with fever, between 2023 and 2025, showed that these were not vague or self-limiting, but in more than 30 percent or one-third cases had clear links to serious infections, such as dengue, and typhoid.

According to the report by healthcare diagnostics company Thyrocare, the fevers were mostly linked with

• typhoid – in over 18 percent cases
• dengue -- over 14 percent cases.
• Other diseases include malaria, chikungunya, and leptospirosis.

Presence Of Multiple Infections

Importantly, the findings highlighted the presence of co-infections in 10 per cent cases. The most common was a combination of dengue and typhoid.

Dr Preet Kaur, Chief Scientific Officer, Thyrocare, said that a significant number of patients carry serious infections, sometimes more than one at a time, revealing patterns that simple assumptions cannot capture.

"Beyond the visible rise in temperature, laboratory markers highlight hidden stress on organs, from drops in platelet counts to elevated liver enzymes, underscoring that fever is a systemic signal, not an isolated event," she added.

Also read: ‘Breakbone Fever’: US CDC Warns Of Dengue Surge Across 17 Countries

Further, the report noted that dengue positivity declined significantly over the three-year report period, malaria increased despite its lower overall base.

Typhoid and chikungunya rose in 2024 before easing in 2025 but remained present across the testing population.

Also read: Drug Resistance Driving Severe Typhoid Disease, Death Among Children Under-5s in India: Lancet Study

Fever: Men Vs Women

The report noted that more women were affected with typhoid than men. On the contrary, men reported more malaria cases.

More than 32 percent of females had fevers compared to 29 percent of men. Fevers in women was largely driven by higher typhoid detection (21 percent vs 15 percent).

Malaria affected men more than twice as often as women (1.1 percent vs 0.5 percent).

The lab reports also revealed key physiological markers such as platelet counts and liver function among people with fever, dengue, and malaria.

Low platelet levels were seen in

• 27 percent of patients with fever
• 80 percent malaria positive patients
• 37 percent dengue-positive patients

• All fever patients (56 percent) showed elevated SGOT levels and 37 percent SGPT
• Liver stress was seen across patients with dengue, malaria and leptospirosis.

Dengue cases rose throughout the year and typically peaked around October.

Typhoid positivity steadily fell from 2023 to its lowest in 2025. Despite a mild monsoon spike each year, 2025 remained consistently lower overall.

Chikungunya cases rose gradually from lower, volatile levels in 2023, peaked sharply in 2024, and moderated to a softer trend in 2025.

Malaria positivity remained relatively low overall but increased during the monsoon months, with transmission peaking between May and September.

Over the three-year period, malaria positivity rose from 0.5 percent to 1.1 percent, indicating a gradual increase despite its lower overall base.

New Delhi: There is a particular kind of frustration that comes with lying in bed, physically spent after a long day, and finding that sleep simply will not arrive. The body is done. The mind is not. This experience has a name in sleep medicine, and it is becoming less of an anomaly and more of a pattern for a growing number of people.

In an interview with Health and Me, Dr Shivani Swami, Additional Director – Pulmonology, CK Birla Hospitals, Jaipur, decoded the role of cortisol in affecting sleep and rest patterns.

The explanation starts with cortisol

Stress, whether from work pressure, unresolved worry, or the accumulated friction of a demanding day, keeps cortisol levels elevated into the evening. Cortisol is the hormone that keeps the brain alert and ready to respond. It has an important job during the day. The problem arises when it does not fall away as the evening progresses, which is what stress prevents. The brain receives no signal that the threat has passed, so it stays primed. Sleep requires the opposite of primed.

Screen use in the hours before bed adds another layer. The blue light that phones, laptops, and televisions emit suppresses melatonin, which is the hormone the body uses to initiate sleep. This is not a subtle effect. It shifts the body’s internal clock, making the brain read the late evening as daytime. People who spend an hour on their phone before bed are, in physiological terms, making sleep harder to reach.

Read more: Just 3 Nights Of Poor Sleep Is Enough To Harm Your Heart Health

Irregular schedules create their own complications

The body’s circadian rhythm is calibrated by consistency. When sleep and wake times shift from one day to the next, the rhythm loses its anchor. The body cannot predict when rest is coming, so it stops preparing for it at a reliable time. This is why erratic schedules, even among people who eventually get enough total sleep hours, tend to produce poor-quality rest.

The mental dimension sits separately from all of this. A mind that is processing, planning, replaying, or anticipating does not transition easily into sleep, regardless of how exhausted the body is. The cognitive activity itself is stimulating enough to override physical fatigue. This is what produces the wired quality that makes the tiredness feel irrelevant.

Left unaddressed, the pattern compounds

Shortened or fragmented sleep affects concentration, mood, immune function, and judgement. People become harder to disturb at first and then more fragile over time as the deficit accumulates.

What interrupts the cycle is not dramatic. A consistent bedtime and wake time, maintained even when it feels inconvenient, gives the circadian rhythm something to organise around. Screens set aside an hour before bed allow melatonin to do its work. A brief wind-down practice, whether reading, stretching, or simply sitting quietly, gives the brain a transition rather than asking it to move directly from full engagement to sleep. Stress that is processed during the day through breathing, reflection, or physical activity is less likely to resurface at night looking for somewhere to go.

Read more: Struggling With Sleep? Neurologist Shares 3 Simple Tips For Better Sleep Health

The ideal sleep set-up

A cool, dark, and quiet sleep environment reduces the stimulation the brain has to work against. None of these are large interventions. The difficulty is the consistency they require, which is harder to maintain than any single habit change.

When the pattern persists despite reasonable adjustments, it warrants clinical attention. Chronic sleep disruption rarely resolves without some form of structured support, and the longer it continues, the wider its effects spread.