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.

Tramadol: A broad review of previously published studies suggests that tramadol, a powerful opioid often prescribed for long-term pain, provides only modest pain relief for the conditions it is most commonly used to treat. The conclusions come from a combined analysis of existing research, published online in BMJ Evidence-Based Medicine.

The review also highlights a greater risk of serious side effects, including heart-related problems. In light of these findings, the researchers say tramadol’s potential harms are likely to outweigh its benefits and advise that its use should be scaled back.

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What Is Tramadol?

Tramadol is a dual-mechanism opioid prescribed for moderate to severe pain, both short-term and long-lasting. For this reason, it features in several medical guidelines as an option for pain control, the researchers note. Prescriptions for tramadol have increased sharply over the past few years, making it one of the most widely used opioids in the United States.

This rise may be linked to the belief that tramadol causes fewer side effects and carries a lower risk of dependence than other fast-acting opioids. Although earlier systematic reviews have looked at tramadol, the researchers point out that no previous review has fully assessed both its effectiveness and safety across a wide range of chronic pain conditions.

Tramadol: Why Are Scientists Cautioning Against Tramadol Use?

According to Scitech Daily, the research team searched medical databases for randomized clinical trials published up to February 2025. These studies compared tramadol with a placebo, or dummy treatment, in people living with chronic pain, including cancer-related pain.

Nineteen clinical trials involving 6,506 participants with chronic pain met the criteria for inclusion. Five studies examined tramadol’s effect on nerve pain; nine focused on osteoarthritis; four assessed chronic lower back pain; and one looked at fibromyalgia. Eight trials also reported the rate of serious side effects during follow-up periods ranging from seven to sixteen weeks.

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Statistical analysis showed that tramadol was linked to about twice the risk of harm compared with placebo. This increase was largely driven by a higher number of cardiac events, including chest pain, coronary artery disease, and congestive heart failure. Tramadol use was also associated with a greater risk of certain cancers, although the researchers describe this finding as “questionable” due to the short follow-up period.

When all trial data were pooled, tramadol treatment was also tied to a higher likelihood of less severe side effects such as nausea, dizziness, constipation, and drowsiness. The researchers acknowledge that the study outcomes carried a high risk of bias. However, they add that this likely means the benefits of tramadol may be overstated while its risks could be underestimated.

Tramadol Side Effects

According to the NHS, like most medicines, tramadol can cause side effects, although not everyone experiences them. You should speak to your doctor or pharmacist if any of the side effects listed below trouble you or persist.

• Very common side effects
• Very common side effects affect more than 1 in 10 people and include:
• feeling sick
• feeling dizzy

Tramadol: Common Side Effects

These occur in more than 1 in 100 people. There are steps that can help manage them.

• headaches
• feeling sleepy, tired, dizzy, or “spaced out”
• nausea or vomiting
• constipation
• dry mouth
• sweating
• low energy

Tramadol: Serious Side Effects

Serious side effects affect fewer than 1 in 100 people.

Call your doctor or contact 111 immediately if you:

• feel dizzy, tired, and unusually low on energy, which may signal low blood pressure
• experience hallucinations, such as seeing or hearing things that are not there
• feel confused
• feel extremely sleepy
• have difficulty passing urine or are unable to urinate

Does Tramadol Lower Blood Pressure?

Yes, tramadol can cause a drop in blood pressure, known as hypotension, particularly when standing up suddenly. This can lead to dizziness or fainting, although it is not very common. In rare cases, tramadol may also raise blood pressure, and stopping the drug suddenly can trigger a spike in blood pressure. For these reasons, anyone with concerns about blood pressure should discuss them with their doctor, according to the NHS.

Waking up with a sore, scratchy throat can feel like a dry-air problem, especially during colder months. In reality, it is often one of the first signs that your immune system has started responding to a viral infection.

What Can Cause Throat Discomfort?

Throat discomfort is often the earliest symptom because viruses tend to attach themselves to this area first, explained Benjamin C. Tweel, an assistant professor of otolaryngology at the Icahn School of Medicine at Mount Sinai, as per The Washington Post.

“The virus enters the cells that line the throat, which likely triggers an inflammatory response from the immune system,” said Tweel, who also serves as medical director for the department of otolaryngology at Mount Sinai Health System. Once the body detects the virus, lymphatic tissue at the back of the nose and throat becomes swollen and inflamed, leading to pain, experts noted.

“Sometimes your body manages to fight it off before it turns into anything major,” Mock said. In other cases, familiar upper respiratory symptoms soon follow, such as a runny nose, nasal congestion and coughing.

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Home Remedies For Sore Throat

According to the Centers for Disease Control and Prevention, throat pain linked to an upper respiratory infection usually improves within about a week. Over-the-counter pain relievers like ibuprofen or naproxen can help ease discomfort and may be more effective than acetaminophen because they reduce both pain and inflammation, Tweel said. Alongside medication, certain home remedies may also provide relief. Here are some options worth trying.

Saltwater Gargle

Gargling with salt water has long been recommended for sore throats, and limited research suggests it may help. A small randomized controlled trial published in 2019 in the Journal of Complementary and Alternative Medical Research found that people with nonbacterial sore throats who used saltwater gargles reported less pain and less difficulty swallowing after one week compared with those who used a thymol-based antiseptic mouthwash.

Salt may help by reducing swelling in throat tissue, said Cameron Wick, an otologist and neurotologist at University Hospitals. “This is basic osmosis,” he explained. “Some of the fluid inside the throat tissue moves into the salt solution, which can lessen inflammation.” Saltwater gargling may also help clear away debris and viral particles, Tweel added.

While the evidence is limited, saline gargles are unlikely to cause harm, Mock said. “It might offer a small benefit, and it is generally safe.” Wick recommends mixing 1 teaspoon of salt into 8 ounces of warm water. Saltwater rinses may also help with thick mucus, nasal congestion or allergy symptoms. Wick said over-the-counter saline sprays or nasal irrigation devices can help clear nasal passages, improve breathing, hydrate tissues and reduce swelling.

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When using nasal irrigation devices, only distilled, sterile or boiled and cooled water should be used. Tap water can contain microorganisms that are unsafe if they enter the sinuses.

Honey

Honey is known for its antibacterial properties, Wick said, and its thick texture can coat and protect irritated throat tissue. “It feels soothing on mucosal surfaces,” he explained. By forming a barrier, honey may reduce irritation from air, liquids and swallowing.

Some research supports honey for easing symptoms of upper respiratory infections, including sore throat and cough. A small study published in 2023 found that gargling with a mixture of honey and water helped reduce throat pain after tonsillectomy surgery.

Honey can also be helpful for children over the age of 1 who have sore throats or coughs. The American Academy of Pediatrics recommends honey over many over-the-counter cold medicines for young children, as those products offer limited benefit. “For kids older than 1, a teaspoon of honey or honey mixed into warm liquid can help soothe the throat and improve sleep,” Mock said. Honey should never be given to infants under 12 months due to the risk of infant botulism.

Tea

Warm tea can feel comforting on a sore throat, but not all teas are ideal during an infection. “Stick to non-caffeinated options,” Wick advised. Black teas and other strong, tannin-rich teas often contain caffeine, which can increase urine output and contribute to dehydration.

There is limited research on herbal teas for throat pain, but chamomile, ginger and turmeric are commonly recommended, Wick said.

Adding honey and lemon can enhance tea’s soothing effects. Lemon provides vitamin C, which supports immune function, and stimulates saliva production, Wick explained. Increased saliva can help thin mucus and support the many small glands beneath the throat’s surface, making it easier for the body to manage congestion.

Warm Beverages

If tea is not your preference, other warm drinks such as warm water, vegetable broth, bone broth or soup may provide similar comfort. “Warm liquids have a calming effect,” Wick said.

These beverages may also encourage better hydration, which is important for recovery. “Staying hydrated is one of the most helpful things you can do for a sore throat,” Tweel said. Dryness tends to worsen throat pain. Soup can also be soothing, as long as it does not contain ingredients that irritate the throat, Mock added.

Cool Foods

Some people find relief from cold items like ice chips or ice pops, especially when throat pain is more intense, Wick said. After tonsil removal surgery, children are often encouraged to eat ice cream or popsicles because cold temperatures can calm pain-sensitive nerve endings.

There is little research specifically on cold foods for sore throats caused by infections, but cooling therapies have been shown to reduce throat discomfort after medical procedures such as surgery or intubation.

Using A Humidifier

Dry air can worsen irritation in the nose, mouth and throat. “This helps explain why people often feel worse after flying,” Tweel said. A cool-mist humidifier or vaporizer can reduce dryness and ease scratchiness.

However, these devices must be cleaned carefully. “I personally avoid them because proper sanitation can be difficult,” Tweel said. Mold and bacteria can grow in humidifiers, and inhaling contaminated mist may increase the risk of illness.

The CDC advises cleaning humidifiers according to manufacturer guidelines, emptying water tanks daily, and using distilled or boiled and cooled water to reduce microbial growth.

If maintaining a humidifier feels overwhelming, steam from a hot shower or from a cup of hot tea or boiling water may offer similar benefits, Tweel said.

Lozenges

For adults, lozenges or cough drops can stimulate saliva production, which helps combat dryness, Tweel said. “A lot of throat soreness comes from being dry or dehydrated,” he explained. Increasing moisture can make a noticeable difference.

There are many lozenge options available, and choosing what feels soothing is reasonable. Some people prefer lozenges with menthol or eucalyptus for their cooling sensation. Lozenges and cough drops should not be given to children under 4 years old due to choking risks.

When To See Your Doctor For A Sore Throat

Most sore throats improve after a few days, Mock said, often followed by nasal symptoms and then a chest cough. “That pattern is typical for a viral upper respiratory infection,” she said. As long as symptoms are improving and not worsening, the illness usually resolves within one to two weeks.

Medical care may be needed in certain situations. You should contact your primary care provider if throat pain is accompanied by fever, severe pain, difficulty breathing or swallowing, white patches at the back of the throat, or noticeable differences in tonsil size, Wick said. These signs may point to a bacterial infection such as strep throat, which may require antibiotics.

Persistent throat pain should also be evaluated. “A severe sore throat lasting more than seven days is not normal,” Mock said. “By that point, it should be improving.”

As flu season approaches, many people wonder whether getting vaccinated twice in the same year might offer extra protection. With immunity known to fade and flu viruses changing fast, the question sounds reasonable. But according to public health experts, doubling up on flu shots rarely delivers added benefit for adults.

Flu Shot: Why a Second Flu Shot Usually Does Not Help

There is no known harm in receiving two flu shots in one year, but research shows it is largely unnecessary. Katrine Wallace, an epidemiologist at the University of Illinois at Chicago, explains that most adult immune systems have already been exposed to both the influenza virus and the vaccine over the years.

Because of this prior exposure, studies have not found improved protection from a second flu shot, even among older adults whose immune responses may be weaker. For the majority of people, one influenza vaccination per year is sufficient to reduce the risk of severe illness and complications.

The guidance is different for children. The US Centers for Disease Control and Prevention recommends that children under the age of nine who have never received a flu vaccine should get two doses during their first vaccination season to build adequate immunity.

Flu Shot: Why You Still Need a Flu Shot Every Year?

While a second shot in the same season does not add much value, annual vaccination remains important. Flu viruses mutate quickly, far faster than viruses like Covid. This means last year’s vaccine is less effective against the strains circulating this season.

In addition, immunity from the flu shot gradually declines over time. These two factors make yearly vaccination necessary, even for people who rarely fall sick.

Flu Shot: Which Flu Vaccine Should Children Get?

As per CDC, there are two kinds of influenza vaccines in use. One is the injectable vaccine commonly known as the flu shot. The other is given as a nasal spray.

This year, all flu vaccines approved for children are designed to protect against three strains of the virus, including two influenza A strains and one influenza B strain. During any flu season, several types of flu viruses can circulate at the same time, and in some cases, these viruses may shift or evolve as the season progresses.

Flu Shot: Timing Matters More Than Taking Two Shots

Experts also stress that when you get the flu shot matters almost as much as getting it at all. Wallace notes that vaccination in August or early September is generally not advised for most adults, since protection may weaken before flu activity peaks.

There are exceptions. Pregnant people in their third trimester may be advised to get vaccinated earlier to pass antibodies to their baby, who cannot receive a flu shot immediately after birth, as per the CDC.

For most adults, the best approach is simple: get one flu shot per year and get it at the right time. There is no need to worry about doubling doses unless advised by a doctor. One well-timed vaccination remains the most effective and evidence-backed strategy