Day and Night – Cold Sores

If you are old – sorry- I mean 65 years and over or you suffer from asthma, COPD, diabetes, heart condition, or if you are pregnant or a carer you should’ve had your flu vaccination by the time you read this article, otherwise have it now.

The jab is available to you for free from your GP or accredited pharmacies. If you do not fall under the stated categories you may have to pay.

Unfortunately Day & Night will not be participating this year. My ‘wimpness’ is legendary. If they’d told me in 1991 that pharmacists would end up jabbing people I’d have shown the school of pharmacy my heels. Ismail- my regular cover pharmacist – who is less Corbynian (less traditionalist) and adventurous, has indicated his willingness to conduct vaccinations for us next year. All good, as long as no-one faints in that small consultation room!

As ever, I shall still be available for the day job; giving advice on winter ailments and all. This reminds me of an important incident to share… one of my students asked why I had not offered an anti-viral cream to a person who had had a cold sore. I apologised that I probably had been in a hurry and I might have under-explained my reasoning to the patient; which is unusual because my attempts at simple advice tend to tantalisingly meander into a lecture.

Anyhow, I asserted that- amongst other things- I tend to make my therapeutic decisions based on my knowledge of how the drug works. The cold sore virus (herpes simplex 1) invades cells in our lips (and elsewhere) and uses the machinery in these cells to produce copies of ‘itself’. It does this fairly quickly and the combination of the virus multiplying and our body mounting an immunological fight results in a blister erupting. After the eruption has stopped, the virus goes back into the dormant stage in which it awaits another moment of the host’s weakness before erupting again.

Aciclovir- the active ingredient in cold sore creams or any of its family members in the fight against the herpes virus- only becomes active after exposure to an enzyme produced under the command of the virus. Which means; no active virus, no activation of the drug. It therefore follows that more than 24 hours after eruption of the blister the cold sore cream is unlikely to work. I may at times offer an anti-sceptic cream to protect against possible secondary bacterial infection if the blister is bad but, in my opinion, antiviral treatment is a definite waste of money at that stage. A good idea would be to buy a cold sore cream with a long shelf life to keep in the home for use when next the virus is about to erupt (tingling stage) or is still in the process of blistering.

As with any other professional, I would like to offer a therapeutic intervention only when it is warranted. It’s the professional and moral thing to do. The drawback that befalls community pharmacists is that we directly handle cash and when I am offering an alternative or a supplementary therapy I get a lingering trepidation that the patient might think that I just want the cash off them: A syndrome that is not associated with a doctor or nurse yet these other health professionals also make a living from what they do. So I might have offered to sell a lip anti-sceptic cream if only as a placebo but I obviously didn’t. Don’t get me wrong, I make a good living from my calling, but if I could help it I wouldn’t touch a till or conduct my profession near it! Honestly, the tuck-shop man was my father, not me.

Yours Medicinally, Abel Kubare,

Superintendent Pharmacist Day & Night Pharmacy

Opening Hours

Monday – Saturday 8.00 am -10.30 pm

Sunday: 9.30am – 10.30pm

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