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.

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.

Gut chemicals may play a role in influencing the likelihood of someone developing Alzheimer's disease. A new study has a chemical produced by certain gut bacteria in focus that may affect Alzheimer’s disease risk, cognitive decline, and other changes related to the disease.

Published in Nature Communications, the study focused on imidazole propionate (ImP), a metabolite produced by some gut bacteria when they break down the amino acid histidine.

Researchers found that people with higher levels of ImP in their blood had lower cognitive scores and higher levels of biomarkers that indicate the likelihood of Alzheimer’s disease and neurodegeneration.

How Was The Study Conducted?

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

The researchers studied health data from 1,196 adults who were cognitively unimpaired, with an average age of about 61 years. Higher blood levels of ImP were associated with poorer cognitive performance and faster age-related decline.

Higher ImP was also linked to increased levels of p-tau217, a key biomarker in Alzheimer’s pathology, and neurofilament light chain, a marker of nerve-cell damage.

The finding builds on earlier work from the University of Wisconsin-Madison team showing differences in gut microbes between people with Alzheimer’s and those without the disease.

“Since then, we've been trying to figure out how this difference in the gut perhaps leads to changes in the brain,” said Barbara Bendlin, professor of medicine at the University of Wisconsin-Madison.

But ImP itself may be more relevant than simply having a particular type of gut bacteria.

“ImP-producing bacteria are present in a large fraction of people, but they're not very abundant in most people,” said Federico Rey, professor of bacteriology at the University of Wisconsin-Madison. “But something we have learned over the years is that a microbe doesn't have to be abundant to have an impact on the host.”

Also read: Could This Popular Joint Supplement Turn Mild Cognitive Impairment Into Dementia? New Study Finds Link

Could Changing Your Diet Prevent Dementia Risk?

The researchers also found genetic evidence that linked higher ImP levels with an increased risk of Alzheimer’s. In experiments on mice, long-term exposure to ImP increased amyloid-beta plaques and signs of brain inflammation.

Laboratory experiments further suggested that ImP could affect the blood-brain barrier and promote tau hyperphosphorylation, a process involved in nerve damage that occurs in Alzheimer’s.

Researchers also caution against making changes to diet to alter gut bacteria. They say ImP is produced when bacteria metabolise histidine, an amino acid that the body needs and that is found in many protein-rich foods.

“Generally improving your diet would probably help,” Bendlin said. “But it's not as easy as saying, 'Stop eating eggs' or 'Don't eat so much red meat.' Because you need histidine, and it's all over the place.”

Instead, the researchers are looking at whether ImP itself could eventually be targeted.

“It could be just like cholesterol, where people with elevated cholesterol take a drug, a statin, that reduces their risk for heart disease,” Bendlin said. “If we can find an inhibitor that can help decrease the levels of ImP in the blood, that could hopefully reduce the risk of Alzheimer's and the speed of cognitive decline for a significant number of people.”

Researchers also say that the findings do not show that ImP causes Alzheimer’s in humans, nor do they suggest that probiotics or dietary changes can prevent dementia.

But they strengthen growing evidence that suggest chemicals produced by gut microbes may affect brain health years before symptoms surface.

A sudden twitch in the eyelid can be surprisingly unsettling. For some people, it may happen occasionally and disappear on its own, while for others, repeated twitching can lead to concerns about whether something more serious is going on.

The good news is that an occasional eyelid twitch is usually harmless and self-limiting. Stress is one of the common factors associated with it, but it is not the only one.

What causes an eye to twitch?

Eyelid twitching can often be associated with everyday factors such as stress, lack of sleep, high caffeine intake, smoking and general exhaustion.

For someone going through a stressful period or not getting enough rest, the twitch may appear and become more noticeable. High coffee or caffeine consumption can also be a contributing factor.

In most cases, the twitch settles on its own once the underlying trigger is addressed. It commonly resolves within a few weeks.

This means that an isolated eyelid twitch does not necessarily indicate an underlying eye or neurological disease.

Also read: Andrew Huberman’s Sleep Trick: Can Eye Movements Help You Fall Back Asleep?

Can reducing stress help?

Since stress, tiredness and lifestyle factors can contribute to eyelid twitching, addressing these factors can often help.

Getting adequate sleep, reducing caffeine intake and making time for relaxation can be useful. Meditation and relaxation exercises may also help, particularly when stress appears to be a contributing factor.

The key is to look at the bigger picture rather than immediately assuming that the twitch itself indicates a serious problem.

When should you see an ophthalmologist?

While an occasional twitch is generally not a cause for concern, it is worth consulting an ophthalmologist if the problem continues for several weeks or is accompanied by other symptoms.

Particular attention should be paid if there are:

• Changes in vision
• Swelling of the eyelids
• Difficulty or inability to open the eyes
• Other unusual symptoms accompanying the twitch

Persistent or unusual eyelid movements can sometimes be associated with conditions such as blepharospasm or hemifacial spasm, while certain neurological conditions can also present with symptoms that may initially resemble an ordinary eye twitch.

An ophthalmologist can assess the symptoms and determine whether further evaluation is required.

Also read: The Hidden Health Cost Of Excessive Screen Time: Dry Eyes, Ringing Ears, Poor Sleep

Does an eye twitch mean you have a neurological problem?

This is one of the biggest concerns people have when their eyelid starts twitching.

An isolated eyelid twitch, by itself, is usually not a sign of a serious neurological disease. Instead of focusing only on the twitch, individuals should pay attention to whether there are other neurological symptoms occurring at the same time.

Symptoms such as facial weakness, numbness, difficulty speaking or difficulty walking warrant medical attention and should not be ignored.

The presence of these accompanying symptoms is more significant than an occasional eyelid twitch on its own.

Don't let an occasional twitch cause unnecessary worry

Eyelid twitching can be irritating and, understandably, may cause anxiety. However, in most cases, it is temporary and can settle once contributing factors such as stress, fatigue or excessive caffeine consumption are addressed.

Getting adequate rest, reducing caffeine, managing stress and incorporating relaxation techniques can be simple first steps.

At the same time, persistent twitching or twitching accompanied by changes in vision, eyelid swelling, inability to open the eyes or other neurological symptoms should be evaluated by a medical professional.

The important distinction is between an occasional, isolated twitch and a persistent or unusual pattern accompanied by other symptoms. Knowing that difference can help people avoid unnecessary worry while also recognising when professional evaluation is appropriate.