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.

Colorectal cancer (CRC), a term encompassing cancer of the colon and rectum, is not only a growing burden in India, but a significant proportion of patients are now being diagnosed at a young age. While colorectal cancer is more common in older adults, Indian clinical studies have identified the phenomenon of young onset colorectal cancer (YO-CRC), typically diagnosed before the age of 50. An experts’ review on epidemiology of colorectal cancer with special emphasis on India, an article in 2025 was published in the Indian Journal of Gastroenterology. The review found that there has been an annual rise of 2-3% in the incidence of colorectal cancer over the past two decades.

In the area of Young Onset Colorectal Cancer, an editorial in 2024 in the South Asian Journal of Cancer noted that one quarter to one-third of colorectal cancer patients in India were below 40 years, and many were diagnosed at stage III or IV. Titled Clinicopathologic Profile and Treatment Outcomes of Colorectal Cancer in Young Adults, A Multicenter Study from India, an article published in JCO Global Oncology studied colorectal cancer among adolescents and young adults. The study revealed 62.70% had colon cancer and 37.30% rectal cancer, with 67% being aged 30-39 years and no significant gender predisposition, though females had a higher metastatic burden.

Why is colorectal cancer affecting younger Indians?

There is no single explanation. Researchers have studied factors like dietary changes, obesity, physical inactivity, altered metabolism, alcohol consumption, smoking, and environment as possible contributors. Increasing urbanisation and changing food habits could also be playing a role in India’s shifting colorectal cancer profile. But not all patients present with conventional risk factors, and in many patients, the causes remain unclear.

Genetic predispositions need special mention. Conditions such as Lynch syndrome and familial adenomatous polyposis (an inherited genetic condition that causes precancerous polyps to form in the large intestine) can raise the risk of colorectal cancer at a young age, but most young-onset cases are not explained by an inherited cancer syndrome.

Also read: Pope Leo XIV, Diagnosed With Lung Cancer, Undergoes Surgery As His Brother Battles Relapsed Multiple Myeloma

The problem of missed symptoms

One of the biggest problems in cancer treatment is delayed diagnosis. Because cancer is associated with older age, the symptoms in younger people may be mistaken for piles, constipation, diet-related problems or even irritable bowel syndrome. Rectal bleeding, persistent changes in bowel habits, unexplained weight loss, abdominal pain, iron-deficiency anaemia, persistent fatigue, or a feeling of incomplete bowel evacuation is usually dismissed as minor issues in younger people.

What should young Indians do?

Colonoscopy is not a solution that can be recommended for every young adult. Symptoms- and risk-based screening is a more reasonable approach. People with persistent symptoms, a strong family history of colorectal cancer, hereditary cancer syndromes, inflammatory bowel disease, or unexplained anaemia may require more intensive evaluation (including colonoscopy) if clinically indicated. This are high risk group, and they need regular screening lifelong. India’s colorectal cancer burden is rising, and younger patients are important segment of this burden.

The evidence available does not prove a nationwide explosion of colorectal cancer in under-50 age groups in India, but it does demonstrate an increasing overall incidence, a significant presence of young onset colorectal cancer, and frequent late presentation. If someone have a first degree relative with colon or rectal cancer like parents, ideally, they should have a colonoscopy done by the age of 45. For younger Indians, early recognition of warning signs may be one of the most critical steps for timely diagnosis and improved outcomes.

By Dr. Abhishek Gangopadhyay, Consultant - Surgical Gastroenterology, Surgical Oncology, Narayana RN Tagore Hospital, Mukundapur, Kolkata

At 42, Danielle Ripley-Burgess of Kansas City, Missouri, has survived colon cancer three times, at 17, 25 and 39.

The disease often begins as noncancerous growths called polyps in the colon or rectum. Early-stage cancer and precancerous polyps may cause no noticeable symptoms. Ripley-Burgess spotted her first symptom at the age of 14 but ignored.

Her First Symptom At 14

At 14, Ripley-Burgess noticed specks of blood in her stool but hid them out of embarrassment, believing red foods might be responsible.

“I thought, I’m eating something red and that’s probably what I see,” she told Today. “So I put myself on a ‘no red foods diet’ and stopped eating anything that was red in color: everything from candy to pizza to salsa to raspberry popsicles.”

After two years she eventually told her mother, who believed it to be a case of hemorrhoids. As her bleeding worsened, and she developed fatigue and severe stomach pain, she was taken to a gastroenterologist.

Colon Cancer Diagnosis At Age 17 And 25

A few weeks after her 17th birthday, Ripley-Burgess was diagnosed with stage 3 colon cancer. She underwent chemotherapy, radiation and surgery. But years later, a follow-up colonoscopy revealed another cancerous polyp.

“I thought I had beaten cancer. I was getting colonoscopies every three years, and after one of them, I woke up and saw the very same look on the doctor’s face that I had seen eight years prior,” she said. “He saw a polyp that later turned out to be cancerous. I had no symptoms. At 25, I had stage 1 colon cancer.”

The second diagnosis was emotionally difficult as she feared losing the life she had built with her husband and the future they had planned.

Lynch Syndrome Increased Her Cancer Risk

Further testing revealed that Ripley-Burgess had Lynch syndrome, an inherited condition that increases the risk of colorectal, uterine and other cancers, according to the Mayo Clinic.

She underwent a preventive hysterectomy and subtotal colectomy, which removed all but about 13 inches of her colon.

Despite these measures, a colonoscopy in 2023 yet again detected a recurrence. At 39, she opted to have the remaining colon removed and a permanent ileostomy.

“I wasn’t expecting it, but I also wasn’t completely shocked,” she said, explaining that living with Lynch syndrome meant knowing cancer could return.

Why Blood in Stool Should Not Be Ignored

Ripley-Burgess now shares her story to encourage people, especially younger adults, to seek medical attention for unusual symptoms.

“If I could go back and tell my younger self something, it would be: Don’t be embarrassed about your body,” she told the outlet. “If you’re seeing something with your body that’s uncomfortable and weird, and you’re not ready yet to tell a doctor, tell somebody — a friend or family member. Don’t sit in that place of: something is wrong with your body, and you don’t know what it is. Don’t sit there alone. Don’t downplay what you’re seeing,” she

Colorectal cancer is expected to cause 158,850 new cases and 55,230 deaths in the US in 2026, according to the American Cancer Society.

Dr. Sajjan Rajpurohit, medical oncologist at BLK-Max Super Speciality Hospital, said, “Blood in the stool is one of the most common and concerning signs. While it might be due to hemorrhoids or fissures, it’s important not to assume. A proper evaluation is critical.”

Rectal bleeding can have several causes, but it should not automatically be attributed to hemorrhoids. Timely medical evaluation can help identify the cause and ensure appropriate treatment.

Six unvaccinated people, including children, have died from measles in the US this year. As of October 8, the country had reported 4,080 confirmed cases, according to the Centers for Disease Control and Prevention (CDC).

Measles spreads easily through the air and can remain infectious for up to two hours. Symptoms include high fever, cough, runny nose, red, watery eyes, and a rash that typically starts on the face. Infected people can spread the virus before the rash appears.

Two doses of the measles, mumps, and rubella (MMR) vaccine are approximately 97% effective against measles and remain the best protection against the disease and its complications.

Measles Can Cause Complications Years Later

Also read: Sixth Measles-Associated Death Reported In Pennsylvania As Cases Cross 1,100

Measles also causes pneumonia, brain inflammation, and death. Some complications emerge weeks or years after the initial infection.

Three serious consequences are acute disseminated encephalomyelitis (ADEM), immune amnesia, and subacute sclerosing panencephalitis (SSPE).

According to the CDC, one to three out of every 1,000 children with measles die from respiratory and neurological complications.

ADEM: When the Immune System Attacks the Brain

An 18-year-old from Mifflin County, Pennsylvania, died from acute disseminated encephalomyelitis (ADEM), reported as the state's fourth measles-associated death this year.

ADEM causes inflammation in the brain and spinal cord when the immune system mistakenly attacks nervous system tissue. It can develop weeks after infections such as measles or influenza.

Symptoms include weakness, confusion, vision problems, and seizures. Severe cases can be fatal.

ADEM occurs in approximately one out of every 1,000 measles cases. Treatment may include steroids, intravenous immunoglobulin, and plasma exchange.

Most patients recover, but lasting problems can include motor weakness, cognitive impairment, seizures, and vision loss. In a 2022 study of 77 children with moderate to severe ADEM, nearly a quarter had persistent health issues.

Immune Amnesia: Measles Can Erase Immune Memory

Read More: Measles Cases Are Rising in US—Who Should Get A Booster Shot?

Measles can destroy immune cells that remember previously encountered pathogens, weakening protection built through past infections and vaccinations. This is known as immune amnesia.

“Immune amnesia basically destroys your immune system,” said Dr. Stephen J. Elledge, professor of genetics and medicine at Harvard Medical School. “It infects and kills the cells that store immune memories — plasma cells, B cells, and T cells. It’s like burning down a library full of immunological knowledge.”

A 2019 study published in Science, co-authored by Elledge, found that measles could erase up to 73% of a person's antibody repertoire.

This loss can leave people vulnerable to infections their immune systems had previously learned to fight. Research published in 2015 suggested that rebuilding immune protection can take two to three years.

SSPE: A Fatal Disease That Can Emerge Years Later

Subacute sclerosing panencephalitis (SSPE) is a rare, progressive neurological disease caused by a persistent measles virus infection in the central nervous system.

SSPE is "the most enigmatic and terrifying consequence of measles", Andrew Pavia, MD, a pediatric infectious disease epidemiologist at the University of Utah, told CIDRAP News.

Symptoms may appear seven to 10 years after measles, even in people who initially recover. Early signs include personality changes, mood swings, and headaches. The disease can progress to involuntary movements, seizures, vision loss, cognitive decline, coma, and death.

There is no known cure, and SSPE is ultimately fatal.

Infants Face a Higher SSPE Risk

Children who contract measles during infancy face a particularly high risk of SSPE.

The CDC estimated that seven to 11 out of every 100,000 people infected during the US measles resurgence of 1989–1991 were at risk of developing the disease.

A 2016 review of California health records estimated that SSPE occurred in approximately one out of every 609 children who contracted measles before 12 months of age.

A child in Los Angeles died of SSPE last year after contracting measles as an infant, before becoming eligible for the MMR vaccine. In the United States, the first dose is generally recommended at 12 to 15 months.

With measles cases continuing to rise, Pavia warned that SSPE "is a potential time bomb."