Herpes labialis (lip sores)

Cold sores are an indisposition which all players of cup-mouthpiece instruments fear greatly. The medical name for this illness is Herpes labialis. It is caused by viruses — microorganisms similar to bacteria. The group of the Herpes viruses alone contain over 25 known types and they are so widespread that over 90% of people are infected with them.

It is thought that these viruses settle in the trigeminal nerve and then become active at irregular intervals. Herpes labialis viruses operate in such a way that, out of several human cells on the lips, an enlarged cell is formed which fills with fluid, thus forming a painful swelling. After a few days this blister dries up and heals, leaving no scar.

A herpes on the lip makes playing impossible, however, as it is much too painful and prevents a relaxed embouchure. Until now there has been little that one could do about infection by these viruses with any hope of success. In many countries preventive vaccines made from dead herpes viruses are available. They are supposed to help build up the body's own defensive reaction. They require first weekly injections for ten weeks, then monthly injections for six months, and then six-monthly booster injections. The whole thing is thus a very expensive therapy and, even though some people believe firmly in its effects, it shows a very high failure rate.

Now there is a simpler method. This one uses tablets which are supposed to prevent the viruses from multiplying, and also to make the body develop its own resistance to them. Until we have some experience of these we must continue to try and hinder the activity of the viruses already present in the body. But that is not easy, either, since viruses, unlike bacteria, have no metabolism of their own in which one might try to intervene by medication.

Finally we are left with no alternative but to avoid everything that could stimulate the activity of the viruses, and we do know something about this. Thus feverish infections and sunburn cause herpes labialis in an almost regular way. These lip sores often occur in women in association with menstruation. Nervous stomach complaints and gastritis likewise exert a great influence over the occurrence of herpes labialis.

It is therefore quite in order for a brass player to avoid cold drinks and spicy foods. Smoking and strongly alcoholic drink also make for a sick stomach. Stress and nervous strain also lead to stomach irritation, of course, and so may also cause lip sores.