How People in the Public Eye Deal With Cold Sores

Herpes simplex virus type 1 (HSV-1) causes most cold sores, and about 64% of people under 50 carry it. It doesn't discriminate between the famous and the ordinary','blog','celebrities-with-herpes'). Actors, presenters, singers and models get cold sores at the same rate as everyone else.

What is different is the cost of a badly timed outbreak. A cold sore on the morning of a shoot, a red carpet or a kissing scene can delay production or end up in a thousand photos. So people who work on camera tend to handle cold sores with more planning than most of us.

Online lists claiming that specific celebrities use specific cold sore remedies are almost never sourced, and we no longer repeat them. What follows is how dermatologists, makeup artists and productions handle cold sores, which you can use too.

They take antivirals before high-risk events

The most effective trick is one any doctor can prescribe. Short-term preventive antivirals, usually valacyclovir, can be taken before a known trigger, such as a long shoot under hot lights, a ski trip, intense sun exposure or a dental or cosmetic procedure.

Dermatologists often prescribe valacyclovir for people who get cold sores after laser treatments or lip fillers, starting a day or two before the procedure. The same approach works before any event where you know your risk is high.

For people with frequent outbreaks, daily suppressive therapy is another option. It reduces how often cold sores appear and lowers the chance of passing HSV-1 to others.

Ask your doctor for a prescription you can keep on hand. Having it ready means you can start within hours of the first tingle rather than waiting for an appointment.

They treat at the first tingle

Most people feel a cold sore coming before they see it. Tingling, burning, itching or a tight feeling on the lip can start several hours to a day before the blister appears.

Antivirals work best in this window. A single-day, high-dose course of valacyclovir taken at the first sign can shorten an outbreak and sometimes stop a blister from forming at all.

Over-the-counter docosanol cream (Abreva) is a milder option. It shortens healing by about half a day on average in clinical trials and works best when applied at the tingle stage.

Some people also add lysine, an amino acid that may help limit how quickly HSV replicates by competing with arginine. The evidence is mixed, but it is cheap and low-risk. See our guide to lysine dosage for cold sores.

They protect their lips from known triggers

Sun is one of the most common cold sore triggers, and outdoor shoots, beach events and stage lighting all add up. A lip balm with SPF 30 or higher, reapplied often, is standard advice from dermatologists.

Other common triggers include stress, poor sleep, illness, cold wind, dry lips and lip injuries from dental work or cosmetic procedures. Busy schedules, travel and performance nerves hit several of these at once, which is why people in demanding public jobs often notice outbreaks before big events.

Keeping lips moisturized, sleeping as much as a schedule allows and avoiding lip procedures right before an important day all help. Our full list of cold sore triggers covers the rest.

Makeup artists can hide a healing cold sore

Professional makeup artists have a standard approach to cold sores, and it is different from covering a pimple.

• Wait until it crusts. Makeup on an open, weeping blister can irritate it and spread the virus. Concealing works best once the sore has scabbed.
• Use disposable tools. Apply concealer with a single-use applicator or clean fingertip, never a brush or sponge you'll use again, and never dip back into the pot.
• Choose a thick, creamy, full-coverage concealer in your skin tone, and set it with powder.
• Go for a neutral lip. Bright lipstick draws the eye to the mouth. A muted shade or a hydrocolloid patch under makeup is less noticeable.

Our guide to wearing makeup over a cold sore goes into product choices.

Productions plan around kissing scenes

HSV-1 spreads easily through kissing, especially when a sore is visible. On film and TV sets, an actor with an active cold sore will usually have a kissing scene rescheduled, shot from an angle that avoids contact, or covered with a body double.

Intimacy coordinators, now common on many productions, discuss health and boundaries with actors before intimate scenes. A visible cold sore is a normal, non-judgmental reason to adjust the plan.

The same rule applies off camera. Avoid kissing and sharing lip products, cups or utensils from the first tingle until the scab has fallen off and the skin has healed. See kissing with cold sores for details.

Cold sores are nothing to be ashamed of

Cold sores carry far more stigma than they deserve. Most adults have the virus, and most caught it in childhood from a kiss or a shared cup, not from anything sexual. A cold sore says nothing about who you are or how clean you are.

Dealing with the embarrassment gets easier with information and a plan. Talking about it with friends, family or a support group also helps, and you will find that many of them get cold sores too.

Here is a simple plan to minimize a cold sore:

• Know the early signs. Tingling, burning or itching around the lips for several hours or a day before the sore shows up.
• Keep antiviral medication on hand. Start it at the first sign. Antivirals stop the herpes virus from replicating.
• Use an over-the-counter cream if you can't get a prescription quickly.
• Numb the pain. Lidocaine or benzocaine creams ease burning and discomfort.
• Moisturize. Keep the area moist to prevent painful cracking as it heals.

Millions of people deal with the same thing every year, famous or not.