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.

AIIMS New Delhi has successfully performed its second dual kidney transplant using organs from a marginal donor. The procedure highlighted a strategy that could help make greater use of kidneys that may otherwise be rejected for transplantation.

The procedure was carried out on July 28 by a multidisciplinary team from the Departments of Surgical Disciplines, Nephrology, Anaesthesia, Transplant Immunology and the Organ Retrieval Banking Organisation (ORBO).

The donor was a 70-year-old woman from Command Hospital, Chandimandir, Chandigarh. Because of her advanced age and the marginal characteristics of the donated kidneys, doctors transplanted both kidneys into a single 56-year-old woman.

The organs were transported from Chandigarh to New Delhi by an Army helicopter. According to AIIMS, despite a cold ischaemia time of 12 hours, both kidneys were functioning immediately after transplantation.

The recipient showed no complications after the transplantation and was discharged after 10 days with normal kidney function.

What Is A Dual Kidney Transplant?

In a conventional kidney transplant, one donated kidney is transplanted into a recipient. Meanwhile, in a dual kidney transplant both kidneys are placed into one patient from the same deceased donor.

The approach is considered when the donor is older or the kidneys have characteristics that suggest that a single kidney may not provide sufficient function.

In simple terms, two kidneys that have lower individual functional capacity may be able to provide adequate overall kidney function when transplanted together.

Research has previously found that dual kidney transplantation can be a viable option for kidneys from older or marginal donors. Transplant teams carefully assess the donor organs and recipient before deciding whether using both kidneys together could provide adequate renal function.

A 2025 analysis comparing single and dual transplantation from marginal donors also highlighted the potential of using kidneys from a deceased donor.

Also read: The Hidden Cost Of Self-Medicating UTIs. How Antibiotic Misuse Is Fueling Resistance

Need Of The Hour

The milestone comes as India faces shortage of transplantable organs. India recorded 20,138 organ transplants in 2025, crossing the 20,000 mark for the first time, but the number of patients needing transplants remains far higher than the available organs.

Recent reports has also highlight the country's mounting transplant needs that still remain unmet despite its position as one of the world's largest transplant centres by volume.

This makes the ability to safely use organs from older or marginal donors particularly important.

“Dual kidney transplantation from carefully selected marginal donors represents an important strategy for increasing the utilization of deceased-donor organs,” AIIMS said in the press release.

AIIMS said the successful transplant demonstrates its efforts to “maximize the utilization of marginal donor organs” and help patients with end-stage kidney disease receive organs at the earliest.

Also read: US HHS Action Against Kentucky Organ Donation Group Raises Questions About Transplant Safety

Encouraging Development

The immediate functioning of both kidneys despite around 12 hours of cold storage is certainly encouraging. However, the patient’s discharge with normal kidney function represents an early outcome.

Longer follow-up will be needed to determine how well the transplanted kidneys perform over the months and years ahead.

The AIIMS team was led by Prof. Asuri Krishna, with support from the nephrology, anaesthesia, transplant immunology, ORBO and organ retrieval teams.

It is a common belief that metabolic dysfunction-associated steatotic liver disease (MASLD)—formerly known as non-alcoholic fatty liver disease (NAFLD)—is primarily associated with diet, sedentary lifestyles, and obesity. However, there are other factors as well affecting this aspect. Post-menopausal women experience a significantly higher incidence and faster progression of fatty liver disease, even when maintaining a stable body weight.

Why Menopause Increases Fatty Liver Risk

In pre-menopausal women, oestrogen plays a central role in metabolism, by promoting healthy fat accumulation in subcutaneous tissue (below the skin) rather than around internal organs, it also increases insulin sensitivity and suppresses liver inflammation.

After menopause when oestrogen levels drop, this protective function is lost, there is redistribution of fat leading to more fat accumulation around internal organs including liver thus leading to increase chances of NAFLD and also increasing insulin resistance, needless to say that with age our metabolic rate also goes down which also plays a role in this.

Also read: Decoding The Fertility Markers

Early Detection Is Key

The important part lies not only in understanding above but to go further in early detection and prevention of menopause associated NAFLD. As we know that fatty liver is a silent disease and often does not causes any signs and symptoms till very advanced stage.

First and foremost is to change lifestyle with advancing age, changing both the dietary habits and physical activity. Regular screening and monitoring is warranted with blood tests, routine metabolic panels, keeping a tab on weight, sugar and cholesterol levels and a basic ultrasound of abdomen.

For someone already diagnosed with 2nd or 3rd stage fatty liver, a simple non-invasive. Fibroscan can help monitor and assess the response to treatment.

Also read: How Menopause Changes Heart Health Risks?

Understanding The Impact Of Menopause On Liver Health

Coming to treatment part of NAFLD in post-menopausal women, it being primary a lifestyle disease so the core of management also lies around managing lifestyle. Medicines are available for treating and controlling NAFLD in conjunction with lifestyle management.

Hormone replacement therapy (HRT), when initiated early in post-menopausal women for symptomatic relief may offer secondary benefits by maintaining metabolic health. However HRT should always be initiated after proper evaluation and expert guidance.

NAFLD is a silent epidemic and primarily a life style disease, knowing about it and knowing triggering and precipitating factors helps understanding and prevention better.

Menopause being a natural biological phenomenon in every female’s life, it becomes essential for us to know how it affects our liver health and overall health as well.

By Mr. Ankur Garg, Group Director Liver Transplant & GI Surgery, Paras Health, Gurgaon

Every year, as the monsoon rolls in, hospitals and clinics across India see a familiar pattern: a sharp uptick in children and elderly patients presenting with vomiting, diarrhoea, and dehydration.

Doctors attribute this seasonal surge to a combination of contaminated water supplies, deteriorating food hygiene, and warm, humid conditions that favour the spread of viruses like rotavirus and norovirus.

Why Monsoon Fuels Gut Infections

Heavy rains and flooding routinely compromise municipal water lines, allowing sewage to mix with drinking water. Street food and produce are more prone to contamination during this period, and the humidity itself accelerates bacterial and viral growth.

Acute gastroenteritis, an inflammation of the stomach and intestines, is consistently one of the fastest rising monsoon health conditions, with rotavirus being a leading cause in children and norovirus a common culprit across age groups.

Understanding Rotavirus

Rotavirus is a highly contagious, wheel shaped virus and remains the leading cause of severe diarrhoeal illness and death in children under five worldwide. It spreads through the faecal oral route via contaminated water, food, surfaces, or close contact with an infected person, and can cause several days of intense vomiting and watery diarrhoea, putting young children at real risk of rapid dehydration.

The good news: Rotavirus vaccines, given orally in a series of doses before 8 months of age, are highly effective at preventing severe disease and are recommended as part of national immunisation programmes.

Also read: Climate Change And Progressive Urbanization Call For An Integrated Approach To Infectious Disease Surveillance

Expert Recommended Prevention Measures

1. Water safety first

Boil or filter all drinking water during the monsoon months. Avoid ice and beverages of uncertain origin, especially from street vendors.

2. Food hygiene

Steer clear of cut fruits, chaat, and other street food that has been sitting exposed. Cook food thoroughly and eat it hot. Avoid reheated leftovers stored without refrigeration.

Also read: Dengue & Guillain-Barré Syndrome: Can A Common Monsoon Illness Trigger A Serious Nerve Disorder?

3. Hand hygiene

Frequent handwashing with soap before eating, after using the toilet, and after changing diapers remains one of the single most effective, low cost interventions against faecal oral transmission.

4. Vaccination

Ensure infants complete their full rotavirus vaccine schedule on time. Vaccination substantially reduces hospitalisations and severe outcomes, even though it does not eliminate all seasonal transmission.

5. Isolate and disinfect

Because these viruses spread easily within households and childcare settings, keep infected individuals' utensils and linens separate, and disinfect surfaces regularly during an active infection.

Recognising The Warning Signs

Most cases of viral gastroenteritis are self limiting, but caregivers should watch for signs of dehydration that require urgent medical attention:

• Sunken eyes, dry mouth, or reduced tears when crying (in infants)
• Little or no urination for 6+ hours
• Lethargy or unusual drowsiness
• Persistent vomiting that prevents fluid intake
• High fever or blood in the stool

Also read: Beware! Common Mistakes New Parents Make During Their Baby’s First Monsoon

Treatment: What Actually Helps

Oral Rehydration Solution (ORS) is the cornerstone of management.

A simple homemade version consists of 1 litre of boiled and cooled water, 6 teaspoons of sugar, and half a teaspoon of salt. It can be lifesaving when commercial ORS packets are not available, though pre mixed WHO formula ORS is preferable when accessible.

Zinc supplementation (around 20 mg daily for 10 to 14 days) is recommended for children under five, as it has been shown to reduce the duration and severity of diarrhoeal episodes.

Antibiotics are not effective against viral gastroenteritis and should only be used if a bacterial cause, such as cholera, is confirmed by a doctor. Inappropriate antibiotic use can do more harm than good.

Continue feeding. For breastfed infants, continue breastfeeding throughout the illness. For older children and adults, small, frequent sips of fluids and bland, easily digestible food are better tolerated than large meals.

When to See a Doctor

Seek medical care promptly if there is persistent high fever, visible blood in the stool or vomit, signs of moderate to severe dehydration, or if symptoms do not improve within 2 to 3 days, particularly in infants, the elderly, or anyone with underlying health conditions.

By Dr. Geeta Malkan Billa, Director of Gastroenterology & Hepatology at Dr. L. H. Hiranandani Hospital