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.

In my 13 years of working with clients as a trauma-informed consulting psychologist, I have often noticed that people recognise nervous-system overload only after their body forces them to slow down.

Until then, they may describe themselves as “too sensitive”, “lazy” or “unable to cope”. In reality, these reactions are often the nervous system’s attempt to protect us.

Fight, Flight, Freeze Or Shutdown

Our nervous system continually assesses whether we are safe. When stress feels persistent or overwhelming, the body may move into fight or flight.

We might become irritable, restless, anxious or unusually controlling. The heart may race, muscles tighten and sleep become disturbed. At other times, the system may shift towards freeze or shutdown, showing up as exhaustion, emotional numbness, procrastination, forgetfulness or a strong desire to withdraw.

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When Everyday Reactions May Signal Overload

For example, someone who becomes disproportionately angry over a minor delay may not simply have an “anger problem”; their system may already be carrying days or months of accumulated stress. Another person may sit before a simple email for hours, unable to respond.

What looks like avoidance may actually be a freeze response. Some people remain highly productive while feeling disconnected from their bodies, until headaches, digestive difficulties or fatigue begin demanding attention.

These signs do not automatically indicate trauma or a mental health condition. They are invitations to become curious: What has my system been carrying? When did I last feel rested, supported or genuinely safe?

Small Ways To Help The Body Feel Safer

If you notice these patterns, begin gently. Reduce unnecessary stimulation, eat regularly, protect your sleep and spend time with people around whom you do not have to perform. Slow breathing—particularly allowing the exhale to be longer—may help signal safety. You can also look around the room, notice your feet on the floor and name what you can see and hear. Small, repeated experiences of safety are often more helpful than forcing yourself to “calm down”.

If symptoms persist, interfere with daily life or feel difficult to manage alone, speaking with a trauma-informed therapist can help you understand the patterns beneath them. Therapy is not only for moments of crisis; it can offer a safe space to listen to what the nervous system has been communicating all along.

The body is rarely working against us. Often, it is asking for care in the only language it knows.

By Ms Arouba Kabir, Psychologist & Therapist, Founder - Enso Wellness

Someone who is dying may start to their loved ones who passed away years ago. This could be unsettling and confusing for families and relatives who may assume that the person is just hallucinating or undergoing a deeper neurological issue.

But hospice physician Dr Christopher Kerr says such experiences are a known phenomenon called end-of-life dreams and visions (ELDVs). Kerr, chief medical officer of Hospice Buffalo, has spent decades studying these experiences in dying patients extensively.

Appearing on The Oprah Podcast, he told Oprah Winfrey that many patients near death describe seeing deceased relatives or people who cared for them during their lives. The experiences can feel completely real to them.

Why Do People Near Death See Deceased Loved Ones?

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One of the possibilities is that the brain experiences significant changes as the body starts to shut down.

Alterations in sleep, consciousness, metabolism, oxygen levels, medications, and brain chemistry can all affect perception during the final stages of life.

Dr. Rakesh Lalla, Additional Director - Neurology, Fortis Hospital, Mumbai, told HealthandMe, " These visions could be explained by the alterations that occur within the brain as the body starts to close down. Due to oxygen deprivation and altered brain activity, the brain would process memories, feelings, and stimuli differently. The areas responsible for memory processing and vision could become stimulated or disrupted, which could result in some vivid visions or experiences."

The expert also said that these visions do not mean that the person has a neurological or psychiatric issue.

Dr. Lalla said, "They do not necessarily mean that the person is confused or suffering from a psychiatric condition. In many cases, they are brief, peaceful, and emotionally meaningful to the individual. We still do not fully understand why particular people or memories appear."

The neurologist also advised families to stay supportive and calm during such situations.

He added, "The brain’s complex relationship between memory, emotion and perception is likely to play an important role. For families, the key is to remain calm, listen without dismissing the experience, and provide reassurance and comfort."

Also read: Global Life Expectancy Returns To Pre-Pandemic Levels, But NCDs Resulted In 8 Out 10 Deaths: WHO

Hallucinations Or Part Of The Dying Process?

Experts who have been studying ELDVs have also found that these experiences have some distinctive patterns that do not resemble random hallucinations.

In a 2014 longitudinal study led by Kerr, most of the 59 hospice patients who completed the study reported at least one dream or vision. Almost half occurred during sleep, and nearly all patients said the experiences felt real. The most common involved deceased friends or relatives or other loved ones. In fact, comforting visions of deceased people became more common as patients moved closer to death.

A 2026 systematic review of 13 studies similarly found that ELDVs occurred in at least one in five dying adults.

The National Institute on Aging also states that dying people may appear to see or talk to someone who is not present and may report dreams involving deceased relatives or friends. Such experiences are often comforting, and caregivers are generally advised not to immediately correct or challenge the person.

Seeing Loved Ones Could Be A Comforting End

Kerr said that patients seeing deceased loved ones in their visions appeared calmer afterward. His research suggests that these experiences may carry deep emotional meaning for patients.

“Very little is said between the person in the dream and the dreamer, but everything seems to be understood,” Kerr told Oprah.

Scientists still cannot say exactly what produces these experiences or whether they represent anything beyond changes occurring in the dying brain.

India accounts for one-fifth of global deaths due to cardiovascular diseases (CVDs) or complications related to the heart and blood vessels. Moreover, women are more vulnerable to these complications. Recent data show that women (14%) have a higher prevalence of CVD than men (12%), making preventive care very important for all.

When Should A Heart Check-up Be Done?

The human heart works constantly and efficiently and can compensate for metabolic stress and narrowing of blood vessels without showing any obvious symptoms. Hence, a heart health evaluation should ideally take place when the person is feeling completely well, long before any warning signs appear.

While acute symptoms, such as chest pressure or tightness, unexplained breathlessness, fainting, or unusual fatigue on effort, demand immediate attention, true heart protection occurs through early and planned tests. While heart check-ups are routinely recommended starting at age 40, screening should ideally begin earlier, around ages 30 to 35, especially if risk factors are present.

Starting check-ups at age 30 is important because certain congenital and structural heart conditions remain completely silent for years, and early screening ensures timely, targeted treatment when it is most effective.

Regular screening helps detect and rule out underlying issues early, including congenital heart defects (commonly known as holes in the heart) and conditions such as Atrial Septal Defect (ASD), Ventricular Septal Defect (VSD), or Patent Ductus Arteriosus (PDA). Structural and muscle diseases, on the other hand, include valve disorders, heart muscle weakness, or abnormal thickening of the heart walls (e.g., Hypertrophic Obstructive Cardiomyopathy (HOCM)).

Key Risk Factors

In addition to age, patients should seek a heart check-up sooner if they have any of the following risk factors:

• Strong family history of premature heart disease in immediate relatives.
• History of active or past smoking and tobacco use.
• Metabolic conditions such as diabetes, hypertension, or elevated blood cholesterol.

Excess body weight, especially central or abdominal obesity. Excess body weight damages the kidneys, leads to fat deposits in the liver and increases the risk of developing diabetes, and ultimately increases the strain on the heart and blood vessels (cardiovascular system). These interconnected conditions are known as Cardiovascular-Kidney-Metabolic (CKM) syndrome and include heart disease, kidney disease, diabetes, stetotic (fatty) liver disease, and obesity.

Effective weight and metabolic management, through modern options such as oral or injectable GLP1 therapies, can improve long-term heart health.

Tailoring care

A heart check-up can involve several tests, from blood tests to invasive or non-invasive ones (with/without needles, catheters, or probes entering the body). The most common blood tests include fasting and post-prandial or after-meal blood sugar (FBG/PPBG), HbA1c (glycated haemoglobin), lipid and thyroid profile, and kidney function tests. Non-invasive cardiac tests include electrocardiogram (ECG), 2D echocardiogram, and ultrasound. However, not everyone needs all of them.

Diagnostic tests should be customized based on the person’s age, symptoms, and individual risk score. Hence, skip the urge to self-order commercial diagnostic packages online. Instead, take the most important step towards protecting your heart by talking to your doctor. A personalized assessment can help determine which tests, if any, are appropriate for you, so that you can focus on the right steps to keep your heart healthy.