Like teeth, gums have to be well taking care of in order to prevent disease and infection.

One of the most common gum diseases is gingivitis. This is an inflammation of the gums usually cause by poor oral hygiene and smoking. However, it can also be caused by a blood disorder or vitamin deficiency. The plaque between the teeth and the gums inflames the gums causing them to swell and bleed and leaving tiny pockets where food particles get trapped, causing more plaque build-up and infection. The area must be cleaned and the infection must be treated at once or else the condition may spread and become chronic. If the condition spreads, it is called periodontitis and this causes loss of fibers and ligaments which attach the teeth to the bone, then loss of bone which causes the teeth to become loose and eventually fall out.

Evidence shows that there is a genetic disposition to gum disease so although everyone must take proper dental care, those who have gum disease in their genes must be especially careful. Smoking is a great risk factor and should be avoided.

Efficient teeth cleaning and flossing temporarily gets rid of the acids that attack tooth enamel and will help prevent dental caries and the build-up of plaque that can lead to gingivitis. However, if you are vulnerable to disease of the periodontal tissues, it won’t necessarily prevent you from developing it. Poor oral hygene and continuing to smoke will make any effective treatment virutally redundant. It is a good idea to have regular check-ups with your dentist and to follow a nutritious, balanced diet.

Flu or influenza is a highly contagious disease. The virus is airborne. Hence its dubbed a bug. It also bugs you by its unwelcome house calls and persists in being an unwanted house guest. Usually it makes the rounds of all the family. If you share the same air, you share the same bug.

The flu isn’t just the common cold. It can be accompanied by high fever, chills, aches, headaches, sore throat, cough, watery eyes, sniffles and general weakness overall. The long and short of it is that you feel lousy. Flu has serious fatalities in the very young and the aged.

Preventive medicine is the best protection. Here are some warring strategies to fend off the flu bug.

1) Rest in warm, airy rooms.

2) Stay home whenever possible if you are struck by the bug. This contains the bug and prevents an epidemic.

3) Drink plenty of fluids to replenish your losses.

4) Take Panadol/paracetamol and cough mixture to ease your misery. Since the doctor doesn’t recommend prescribing antibiotics, you may as well save some money by just buying off-the-counter drugs. Read labels carefully to self-administer dosages.

5) If you fall into one of the high-risk categories like heart disease, diabetes, kidney failure, asthma or chronic lung disorder, then you need to get your antibiotics.

6) Be prepared to cope with the side-effects of flu medication like nausea, drowsiness and impaired vision. Driving and operation of machinery are out.

7) If you have reason to believe that you may contract flu but would like to prevent it, get a flu shot. This is off-limits to those with egg allergies and women within the first three months of pregnancy.

Maintain a balanced diet. Fresh vegetables and fruits provide vitamins and minerals to boost your immunity system.

9) Exercise regularly to improve your blood circulation.

10) Avoid smoking and smoke pollution. The haze also carries flu bugs.

11) Wash hands thoroughly before handling food. Flu bugs are unsavory on the aftermath.

14) Same goes for you. If you are down with flu, stay away from the crowd. You don’t want to be remembered for causing a flu epidemic.

15) Relaxation is an alternative remedy. If you are stressed out, your body’s defense is also out and this gives the flu bug easier access.

16) A warm bath soothes bad aches and clears sniffles. If you are afraid of getting the shivers, soak your feet in a pail of hot water. Add a few drops of rosemary or sage essential oil and soak your nose too.

17) Endorphins are natural boosters in our immune system. Practice music therapy. Listening to your favorite tunes alleviates your mood and encourages the production of more endorphins.

Fifth’s Disease is a virus caused by human parvovirus. Often presenting itself with a facial rash that looks like ‘slapped face or slapped cheek’ rash. It may or may not be accompanied by a temperature from 99- 102 degrees. The most common ages to have the disease are school age children.

Symptoms of Fifth’s often happen in three stages:

1. Flu and cold type symptoms- cough, running nose, generalized aches and pains in joints and muscles, loss of appetite and irritability.

2. Rash on a cheek that appears to look like ‘slapped face or cheeked’ and it is warm to touch, but not painful.

3. The rash then spreads to the thighs and arms in a lacelike pattern.

How contagious is Fifth’s Disease?

Fifth’s Disease is highly contagious, but very difficult to control. It is a harmless virus that leaves no lasting effects. And it affects the red blood cells of the body, and increasing the white blood cell count. It is transmitted by airborne pathogens such as sneezing or coughing. The incubation period is four days to two weeks after exposure to someone infected with it. The child is usually feeling ill three to seven days. It may manifest itself with only a few of the above named symptoms, which would lead only to a mild case of the disease. It has been reported children who suffer from measles or mumps may have Fifth’s Disease right after infected with the measles and mumps viruses. Unfortunately, you are only infective before the rash appears. So there is no need to keep the child home from school to prevent the spreading of the disease, because they have already infected most people they have come in contact with. The school should be told if your child does have Fifth’s Disease, as well as family and friends.

This can cause complications only with those women in their first trimester of pregnancy. If a pregnant woman is infected she can go to her physician and have blood tests to determine if she is immune or her status with the disease. As the first trimester of pregnancy is the most important it is pertinent to know if the possibility the child will have birth defects. After the blood work is finished and the results are in an ultrasound or amniocentesis can be done to determine the exact effects

What is the treatment?

Make sure you use good hand washing techniques. No sharing of glasses, plates or other eating utensils.

There is no treatment or antibiotic to be given. Fifth’s Disease is a virus, viruses are not treated with antibiotics. Comfort therapy is used, most physicians recommend Tylenol, Advil and plenty of fluids to prevent dehydration.

Fibromyalgia is a chronic disorder characterized by widespread musculoskeletal pain, fatigue, and multiple tender points. “Tender points” refers to tenderness that occurs in precise, localized areas, particularly in the neck, spine, shoulders, and hips. People with this syndrome may also experience sleep disturbances, morning stiffness, irritable bowel syndrome, anxiety, and other symptoms.

Unfortunately, at this time, no single medication alleviates all of a fibromyalgia patient’s pain and accompanying symptoms. This makes it very important for physicians to keep updated regarding results of ongoing FMS research and current changes in recommended fibromyalgia treatments.

Because different symptoms accompany each FMS patient, the doctor needs to know what problems are specific to each individual. For instance, non-restful sleep is almost always a major concern for fibromyalgia sufferers. Small doses of antidepressant medication seem to help many FMS people. However, other sufferers with restless legs syndrome may need a different approach to settle themselves into a good night’s rest. Always check with your doctor to find a treatment that is right for you.

Prescription Medications

You may also be put on prescription medication to help you cope with insomnia. Antidepressants are commonly prescribed for fibromyalgia patients primarily to reduce sleeplessness and muscle pain; treating depression is a secondary benefit for those suffering from both depression disorder and fibromyalgia. The tricyclic drug most commonly used for fibromyalgia is amitriptyline (Elavil, Endep). Other tricyclics include desipramine (Norpramin), doxepin (Sinequan), imipramine (Tofranil), amoxapine (Asendin), trazodone (Desyrel), and nortriptyline (Pamelor, Aventyl). Side effects are fairly common with these medications, although generally only small doses are necessary for relief of fibromyalgia. Side effects most often reported include dry mouth, blurred vision, sexual dysfunction, weight gain, difficulty in urinating, disturbances in heart rhythm, drowsiness, and dizziness. Blood pressure may drop suddenly when sitting up or standing. Like all medications, tricyclics must be taken as directed; overdose can be life threatening.

Estrogen Therapy

Because fibromyalgia often develops when a woman reaches menopause, some experts believe that estrogen replacement therapy may have special benefits for fibromyalgia patients, in addition to protection against heart disease, osteoporosis, and, possibly, Alzheimer’s disease. Women who take estrogen therapy seem to fall asleep faster, have longer periods of REM sleep, have fewer wakeful periods, and sleep longer than those not taking estrogen. Taking estrogen shortly before going to bed is most helpful.

Pain Relievers

For relief of pain, acetaminophen (Tylenol) is recommended. Anti-inflammatory drugs, such as corticosteroids and nonsteroidal anti-inflammatory drugs, which include aspirin ibuprofen (Advil), and others, are less useful for the pain of fibromyalgia, because the pain is not caused by muscle inflammation. A number of patients are prescribed opioids such as codeine or codeine combinations for pain relief. One study indicated that many doctors prescribe opioids primarily because of the patients’ expressions of pain not from any objective criteria, such as cause, duration, pain severity, and physical findings. Physicians are urged to take a careful medical and psychological profile of the patient before prescribing them and periodically evaluate the patient for continuing pain relief, side effects, and indications of abuse.

Diet and Lifestyle Changes

One of the easiest and most helpful self-care techniques is the monitoring of food and diet. Identify food allergies, such as dairy, wheat, eggs, chocolate, citrus fruits, corn, and MSG. These are all common food allergens, and have been found to intensify with fibromyalgia. By following elimination diet (eliminating one possible food allergen for 2 weeks), problem foods can be identified and subsequently avoided. It is advisable to avoid sugar as much as possible.

Evaluate the acid/alkaline content of your diet. High acid foods consumed over time can lead to a weakened immune system. Eat more vegetables; it appears that a vegetable-based diet offers relief to fibromyalgia patients.

Add more fish to your diet as a great source of protein and nutrients. Fish also contains anti-inflammatory essential fatty acids.

Exercise to tolerance. Exercise cannot be overestimated in improving FMS symptoms. Extreme exercise, however, may cause muscle pain. Make sure that you also get enough rest and relaxation. Stress reduction may be the most important factor in improving the overall well being of fibromyalgia patients. Meditation and massage may also help.

Nutritional Supplements

Always check with your doctor before taking any nutritional supplements. Magnesium and Malic Acid. Magnesium relaxes the muscles. It can help alleviate muscle pain, strain, rigidity, and spasms. Most people with fibromyalgia are deficient in magnesium. Malic acid is important in the citric acid cycle, which helps with the overall transport of magnesium through cell membranes. Recommeded Dose: Magnesium, 400 to 600 mg/day; malic acid, 600 to 1200 mg/day.

B-Vitamin Complex. All of the B vitamins can play a leading role in energy production, rejuvenating nerve cells, protecting nerve coverings, and metabolizing proteins, carbohydrates, and essential fatty acids. Dose: 25 mg of vitamins B1 and B2, 50 mg of vitamin B6 and inositol, and 100 to 200 mcg of vitamin B12 b.i.d.

Calcium. It should be given in conjunction with magnesium (approximately a 2:1 ratio). Calcium deficiency can cause muscle cramps. Recommended Dose: 1,000 to 1,500 mg elemental calcium/day.

Vitamin C (ascorbic acid) and Quercetin. Vitamin C is an antioxidant, an anti-inflammatory, and an anti-allergic. Vitamin C and quercetin can decrease histamine levels. Recommended Dose: vitamin C, 1 to 3 g/day; quercetin, 400 mg t.i.d.

EFAs (Essential Fatty Acids) - fish oil and evening primrose oil. EFAs are natural anti-inflammatories that can help with muscle and bone inflammation. Recommended Dose: 1 to 3 g/day. Evening primrose oil should be standardized to contain 8 percent gamma linolenic acid.

Proanthocyanidins (grape seed, Pycnogenal). Proanthocyanidins act as antioxidants, protecting against degenerative diseases. They also have anti-inflammatory and circulatory benefits. (Maffei Facino et al) Recommended Dose: 100 mg/day.

St John’s Wort (Hypericum perforatum). If depression and anxiety accompany or trigger fibromyalgia episodes, St. John’s Wort may be helpful. It is not to be used in conjunction with antidepressant drug therapy. Recommended Dose: 300 to 900 mg standardized to 0.3 percent hypericin.

Conclusion

Fibromyalgia, although painful, is not untreatable. Because symptoms vary from patient to patient, it is important to not give up hope for relief. FMS research reveals something new every year, and there are millions of people living functional lives with FMS. Don’t give up hope. Contact the Arthritis Foundation for more self-care measures by looking them up in your local phone book.

FMS is a complex, chronic condition that causes widespread pain and fatigue. The condition causes pain and/or swelling in the soft tissues located around joints, skin, and organs throughout the body. Unlike arthritis, FMS does not cause swelling in the joints themselves.

Up to 10 million Americans have been estimated to have Fibromyalgia and the condition is known and recognized around the world. Although it is most common in women of childbearing age, it effects people of all ages, sexes, and races. Men, women, and children have been diagnosed with the syndrome. The typical age range is between 30 and 50, but many relate that they had problems physically as far back as their childhood, which were then attributed to “growing pains”.

Fibromyalgia is a tricky, frustrating condition. It claims victims through a variety of symptoms. The one prevalent symptom is chronic, widespread pain. Fibromyalgia is not a benign disease; although the symptoms are not life threatening, they are often life altering. Pain and exhaustion may cause a person with FMS to become isolated and incapacitated for days at a time. Because of the invisible nature of this condition, families and friends of people with Fibromyalgia sometimes believe it’s “All in their head” and even doctors at one time considered the disease a psychosomatic or “made-up” illness. However, the American College of Rheumatology, the American Medical Association, and the Arthritis Foundation have all recognized Fibromyalgia as a serious, but treatable disease.

To accurately diagnose Fibromyalgia, a rheumatologist or other doctor familiar with Fibromyalgia will perform a tender point test. (If you can’t find a doctor near you, contact the Arthritis Foundation and they can refer you.) These 18 trigger points are shown in the graphic below. The doctor will apply pressure with an approximate force of 4kg. If the patient has pain in 11 of these 18 tender points in combination with meeting other diagnose criteria, and then the doctor may diagnose Fibromyalgia.

Pain levels have been found to vary among individuals, from low to high levels, along with a variety of symptoms. To be diagnosed with Fibromyalgia, a sufferer must have pain in 11 of 18 tender points. However, widespread pain can be anything from achiness and stiffness in the morning to sharp, shooting pain that lasts all day long. No two FMS patients have symptoms that are identical. FMS is also known to aggravate other illnesses, and it is common for FMS sufferers to have other conditions as well. A person diagnosed with Fibromyalgia may have all or just a few of the following symptoms:

Back Pain, Knee Pain, and Muscle Pain: Pain that is located near the joints. Joints that are achy, swollen or stiff. There may be sharp, shooting pains through the muscles, especially where the tendons meet the bones.

Trigger Point Inflammation: Trigger points (used to diagnose FMS) often become inflamed and painfully tender.

Overall Stiffness: Stiffness effects multiple parts of the body, especially in the morning or after sitting or standing in one position. May be aggravated with changes in the weather.

Fatigue and Sleep Problems: Many people with Fibromyalgia wake up in the morning feeling exhausted, even after a good amount of sleep. They may have problems falling asleep or staying asleep. FMS patients have difficulty achieving phase 4 sleep and sometimes toss and turn, awaking throughout the night.

Weight Gain: The average person diagnosed with FMS gains up to 50 pounds within 5 years of diagnosis. Factors contributing to this gain are a lack of exercise, cravings for sweets and carbohydrates, and medication. It is unknown whether FMS directly contributes to this weight gain. Depending on the level of pain experienced, exercising may be nearly impossible during times of acute pain. However, many sufferers claim exercising has helped alleviate some of their symptoms.

Skin Problems: Itchy, dry or blotchy skin is common for FMS sufferers.

Allergies: Patients with allergies may experience an increase in symptoms, such as sinusitis or allergic rhinitis. Patients who are NOT allergic may experience symptoms closely akin to allergic reactions. This can happen in reaction to a number of substances, such as medication, food additives, chemicals, etc. They may have unexplained nasal congestion and sinus pain in the absence of allergic reactions.

Sensitivity: 50% of patients may be particularly sensitive to environmental factors. They may feel abnormally hot or cool. Some patients become hypersensitive to light, noise, odors, and changes in the weather. (Rain, etc.) This sensitivity is attributed to hyper vigilance in the nervous system.

Dizziness: Some patients may experience periodic dizziness or a sense of lost equilibrium. Other patients may get dizzy then disoriented, bumping into things, dropping things, and doing other things observers may consider “clumsy”.

Cognitive Disorders (also called “Fibrofog”): Patients with FMS report cognitive disorders that can vary on a daily basis. These include difficulty concentrating, forgetfulness, memory lapses, and becoming overwhelmed easily.

Depression and Anxiety: Sufferers sometimes experience anxiety and/or depression at a high rate. Although there is no way yet to determine which comes first, doctors believe that FMS is contributing factor to depression, not the other way around.

Chest Pain: Patients are more likely to have chest pain when they engage in activity that requires forward motion, such as sitting at a desk. Many patients experience shallow breathing and upper body discomfort. Often, patients with FMS have been misdiagnosed with heart disease in the past.

Ears Ringing/Itching: FMS sufferers may have ringing or itchy ears, or hear “strange” sounds inside their ears, especially at night or when laying down.

Headaches/Migraines: Patients may experience migraines, tension, or vascular headaches.

TMJ : Many sufferers develop an arthritic condition of the temporomandibular joint in the jaw. (TMJ) Common symptoms include facial pain, joint popping or locking, pain with chewing and inability to completely open or close the mouth. 1/3 of patients experience TMJ pain.

Sinus Problems: Sufferers may have an increased occurrence of sinusitis and sinus pain, even if there is no infection or allergy present.

Gastrointestinal Disorders: Many patients experience digestive problems, abdominal pain, and diarrhea. Many suffer from IBS (irritable bowel syndrome) in addition to FMS.

Urinary Problems: FMS sufferers may experience increased urination or more frequent urination, without having a bladder infection. Some may develop a chronic, inflammatory condition of the bladder.

Menstruation Problems: A woman’s menstrual period may become more painful. She may also experience pain during sex, or pain in the vulva region during menstruation.

Swelling in Extremities :Some patients may find that they have a sensation of swelling in their fingers and toes, even if no swelling is present.

Tingling and Burning Sensations :Some patients may experience tingling or burning sensations in their feet and hands.

Restless Leg Syndrome :31% of patients have a disorder called RLS. This syndrome involves the compulsive urge to move the legs when at rest or lying down.

Other symptoms may be attributable to Fibromyalgia that are not on this list. If you have been diagnosed with Fibromyalgia, it is important to remember that you are not alone, and that you are not “crazy”, even when your symptoms make no sense. If the medical community understood Fibromyalgia completely, there would be a cure for it. Self-care, along with the treatment of a knowledgeable doctor or rheumatologist can help you cope with your symptoms drastically to enhance your quality of life.

One of the latest buzz words in the health world is fibromyalgia. The term simply means pain in the body’s fibrous tissues. It’s an ailment known worldwide and has been studied in such other diverse nations such as India, Japan, Germany, Norway and South Africa. Between 70 to 90 percent of fibromyalgia sufferers are women between the ages of thirty-five and sixty. It’s an illness that even medical professionals have labeled “slippery” or “mysterious” and the condition bears a striking resemblance to chronic fatigue syndrome.

So, what makes fibromyalgia unique? It has no known cause, no simple diagnostic test and no easy treatment or cure. Fibromyalgia is a syndrome, marked by chronic pain in the muscles, ligaments, tendons or bursae around joints. Individuals with fibromyalgia report they feel completely drained of energy for no apparent reason. “I hurt all over,” is another common refrain. It’s gets the title “syndrome” because it includes a set of conditions which always occur together. Patients are plagued with other signs including chronic headaches, stiffness, irritable bowels, disturbed sleep, and depression.

One key to diagnosing fibromyalgia are spots on the body called “tender points.” Research has found 18 specific points, which are tender and painful to the touch. Further studies have shown these tender points can be used to distinguish fibromyalgia from other painful joint and muscle conditions. The criteria for diagnosing the ailment is pain or tenderness in at least 11 of the 18 points. Tender points hurt only when pressed. Individuals may not realize they have these spots until a doctor presses on them during examination. But, if tender points are found on less than 11 of 18 points, for example, doctors will usually diagnose the ailment as fibromyalgia, provided other diseases are first excluded.

Sleep disorders occur in about 90 percent of persons with fibromyalgia. In a sleep lab, researchers found fibromyalgia syndrome patients could fall asleep without much trouble, but their deep level (or stage 4) sleep was constantly interrupted by bursts of awake-like brain activity. The fourth state of sleep, deep sleep, is necessary for muscles and other body tissues to regenerate adequately. Muscle pain occurs, it’s believed, because muscles are deprived of proper rest in persons with the ailment. However the pattern of insomnia varies. Although some may have trouble initially falling asleep, others may wake up often during the night and be unable to fall back asleep. Doctors often refer to this as unrefreshed sleep.

As sufferers can tell you, some in the medical establishment have been skeptical regarding this disorder. As pain has always been an elusive phenomenon, fibromyalgia can be misdiagnosed as arthritis or chronic fatigue syndrome. One women in her late forties visited ten doctors before finding one that could put a name to her ailment. Because females are the primary sufferers, less than open-minded physicians have been dismissive. Some have termed the illness the “tender lady syndrome,” and don’t seem to take the ailment seriously. Making matters worse, family and friends may

find the malady difficult to understand. On a more positive note, over the last five to ten years, attitudes among the medical profession have been changing. This is partly due to reputable studies conducted by physician specialists such as neurologists and rheumatologists.

Exactly what causes this disorder is still not clear. One theory suggests in persons with fibromyalgia, the body breaks down muscle protein at an unusually high rate and converts it to glucose for energy. This increased level of tissue breakdown has been interpreted as one of the reasons for the pain, aching and fatigue.

Possible deficiencies in the diet are another theory. For the body to manufacture energy, it requires the presence of certain compounds, including magnesium. Some studies have indicated patients with fibromyalgia tend to be deficient in magnesium, which is crucial for maintaining normal energy levels.

Because the cause is currently unknown, treatments are geared primarily to easing the painful symptoms of the disorder, rather than curing it. An antidepressant drug called amitriptyline has been shown to provide some short-term relief, however, it has numerous side effects.

People with fibromyalgia do not generally have serious long-term arthritis or crippling ailments. In other words, the disorder is not the beginning of a serious rheumatic disease. Although there will be pain, studies have shown sufferers will not have to cope with damaged joints later. Generally, the ailment waxes and wanes with the years, but it is considered a chronic ailment. The impact of fibromyalgia can have on daily living activities, including the ability to work a full-time job, differs among individuals. If the symptoms escalate, patients may become unable to work, which can lead to depression, anxiety and anger.

Lifestyle modifications can help conserve your energy and minimize pain. Some coping strategies are: gentle exercise, relaxation techniques and therapeutic massage. Mild exercise has also been shown to help.

Fever blisters and canker sores are two of the most common disorders of the mouth, causing discomfort and annoyance to millions of Americans. Both cause small sores to develop in or around the mouth, and often are confused with each other. Canker sores, however, occur only inside the mouth- on the tongue and the inside linings of the cheeks, lips and throat. Fever blisters, also called cold sores, usually occur outside the mouth-on the lips, chin, cheeks or in the nostrils. When fever blisters do occur inside the mouth, it is usually on the gums or the roof of the mouth. Inside the mouth, fever blisters are smaller than canker sores, heal more quickly, and often begin as blisters. Both canker sores and fever blisters have plagued man- kind for thousands of years. Scientists at the National Institute of Dental Research, one of the federal government’s National Institutes of Health, are seeking ways to better control and ultimately prevent these and other oral disorders.

Fever Blisters

In ancient Rome, an epidemic of fever blisters prompted Emperor Tiberius to ban kissing in public ceremonies. Today fever blisters still occur in epidemic proportions. About 100 million episodes of recurrent fever blisters occur yearly in the United States alone. An estimated 45 to 80 percent of adults and children in this country have had at least one bout with the blisters.

What causes fever blisters?

Fever blisters are caused by a contagious virus called herpes simplex. There are two types of herpes simplex virus. Type 1 usually causes oral herpes, or fever blisters. Type ‘ usually causes genital herpes. Although both type I and typ4 2 viruses can infect oral tissues, more than 95 percent of recurrent fever blister outbreaks are caused by the type 1 virus.

Herpes simplex virus is highly contagious when fever blisters are present, and the virus frequently is spread by kissing. Children often become infected by contact with parents, siblings or other close relatives who have fever blisters. A child can spread the virus by rubbing his or her cold sore and then touching other children. About 10 percent of oral herpes infections in adults result from oral-genital sex with a person who has active genital herpes (type 2). These infections, however, usually do not result in repeat bouts of fever blisters.

Most people infected with the type I herpes simplex virus became infected before they were 10 years old. The virus usually invades the moist membrane cells of the lips, throat or mouth. In most people, the initial infection causes no symptoms. About 15 percent of patients, however, develop many fluid-filled blisters inside and outside the mouth 3 to 5 days after they are infected with the virus. These may be accompanied by fever, swollen neck glands and general aches. The blisters tend to merge and then collapse. Often a yellowish crust forms over the sores, which usually heal without scarring within 2 weeks.

The herpes virus, however, stays in the body. Once a person is infected with oral herpes, the virus remains in a nerve located near the cheekbone. It may stay permanently inactive in this site, or it may occasionally travel down the nerve to the skin surface, causing a recurrence of fever blisters. Recurring blisters usually erupt at the outside edge of the lip or the edge of the nostril, but can also occur on the chin, cheeks, or inside the mouth. The symptoms of recurrent fever blister attacks usually are less severe than those experienced by some people after an initial infection. Recurrences appear to be less frequent after age 35. Many people who have recurring fever blisters feel itching, tingling or burning in the lip I to 3 days before the blister appears.

What causes a recurrence of Fever Blisters?

Several factors weaken the body’s defenses and trigger an outbreak of herpes. These include emotional stress, fever illness, injury and exposure to sunlight. Many women have recurrences only during menstruation. One study indicates, that susceptibility to herpes recurrences is inherited. Re search is under way to discover exactly how the triggering factors interact with the immune system and the virus to prompt a recurrence of fever blisters.

What are the treatments for fever blisters?

Currently there is no cure for fever blisters. Some medications can relieve some of the pain and discomfort associated with the, sores, however. These include ointments that numb the blisters, antibiotics that control secondary bacterial infections, and ointments that soften the crusts of the sores.

Currently there is no vaccine for herpes simplex virus available to the public. Many research laboratories, however, are working on this approach to preventing fever blisters. For example, scientists at the National Institute of Dental Research and the National Institute of Allergy and Infectious Diseases have developed a promising experimental herpes vaccine. In tests on laboratory mice, the vaccine has prevented the herpes simplex virus from infecting the animals and establishing itself in the nerves.

Although these findings are encouraging, the scientists must complete more animal studies on the safety and effectiveness of the vaccine before a decision can be made whether to test it in humans. The vaccine would be useful only for those not already infected with herpes simplex virus.

What can the patient do?

If fever blisters erupt, keep them clean and dry to prevent bacterial infections. Eat a soft, bland diet to avoid irritating the sores and surrounding sensitive areas.

Be careful not to touch the sores and spread the virus to new sites, such as the eyes or genitals. To make sure you do not infect others, avoid kissing them or touching the sores and then touching another person.

There is good news for people whose fever blister out- breaks are triggered by sunlight. Scientists at the National Institute of Dental Research have confirmed that sunscreen on the lips can prevent sun-induced recurrences of herpes. They recommend applying the sunscreen before going out- side and reapplying it frequently during sun exposure. The researchers used a sun block with a protection factor of 15 in their studies. Little is known about how to prevent recurrences of fever blisters triggered by factors other than sunlight.

People whose cold sores appear in response to stress should try to avoid stressful situations. Some investigators have suggested adding lysine to the diet or eliminating foods such as nuts, chocolate, seeds or gelatin. These measures have not, how- ever, been proven effective in controlled studies.