Dear Alice,

I get cold sores around my mouth and nose all the time; I have since I can remember. I know that they can be caused by both physical illness and mental stress. Is there any way to reduce the frequency with which I get them, i.e., diet? Please help me, I feel like a leper.

Yours truly,


Dear Jen,

It turns out that preventing cold sores has a lot to do with maintaining your overall wellness. Most cold sores are a result of the herpes simplex virus (HSV) that some people harbor, which crops up as an outbreak or "episode" from time to time, usually from stress, and possibly from too much sun. Staying healthy is vital to strengthening your immune system and keeping herpes outbreaks at bay. This includes:

  • Staying active: Participating in regular physical activity. For adults, this means 150 minutes of moderate-intensity aerobic activity per week, in addition to muscle-strengthening activities on two or more days per week that strengthen all major muscle groups.
  • Eating a well-balanced diet, chock-full of fruits, veggies, grains, and protein.
  • Getting enough sleep: For most people, this means seven to eight hours per night. Check out the A! Sleep Site for more information.
  • Managing your stress: Keeping your stress level down (in all realms of your life) can help keep your immune system strong.
  • In addition, some people find that keeping their lips moisturized in the winter, covered with sunscreen in the summer, and protected from the wind, seems to decrease the number of outbreaks.

Depending upon how often you get cold sores, you may want to see your health care provider. Columbia students can make an appointment by contacting Medical Services (Morningside) or the Student Health Service (CUMC). S/he may be able to describe possible treatment for your cold sores, including certain medications. For example, some people find that acyclovir ointment speeds the healing process when they apply it to their lips, five to six times a day, when they feel a cold sore coming. In severe cases, prescription drugs may be prescribed.

For more information, check out the related Q&As below. In addition, you might be interested in reading the book Managing Herpes by Charles Ebel and Anna Wald, M.D., M.P.H. It's full of great information on both oral and genital herpes.

Here’s to happy and healthy living,


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