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The Trombone ForumCreation and PerformanceThe Healthy Trombonist(Moderator: tbone62) Lip herpes, Do you know how to avoid it?
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PacoBone
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« on: Nov 07, 2006, 08:23AM »

I´ve got lip herpes (also known as cold sore) so often, (almost once per month). It is becoming a nightmare as far as when it appears it is impossible to play the trombone for around 10 days. I wonder if you know a remedy, or a way to prevent it. (please be serious, this is not a joke).
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« Reply #1 on: Nov 07, 2006, 08:43AM »

This topic (also called cold sores) comes up fairly often here. The usual remedies include creams like Carmex and Blistex and things like icing the sore etc. My personal solution has been to carefully apply rubbing alcohol to the sore. Do not swallow any, use a cue tip for accuracy and use a nice lip cream for areas around the sore. Generally the problem is reduced to inconsequential in one night and dissapears in two to five days. (I had one that flared up on Friday and I had to do a night of cocktail jazz on Saturday-I had no problems for the gig.)

As for prevention these things usually work for me to stay healthy:

-get lots of rest
-keep your mouthpiece clean
-try not to over practice or over extend yourself during a gig
-use a lip cream that feels soothing to you after practice.
-wash your hands regularly


Also check you rmouthpiece to make sure  the plateing is in good shape.

Good luck!
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« Reply #2 on: Nov 07, 2006, 09:07AM »

Good suggestions so far.

Make sure that you are not using anything in or around your mouth that you are allergic to.  Some people are allergic to silver and have to use gold mouthpieces.  I had an allergic reaction to a very common toothpaste once and had sores all over my mouth.  Anything that comes in contact with your mouth could be the culprit.  

If it always happens where the rim hits your face it's could be one of two things.  You could be allergic to the metal on the mouthpiece or there is something else on the mouthpiece that you are allregic to.  That something else could be anything that was on your hands or face that got onto the mouthpiece, which in turn gets rubbed into your face everytime you play.  That might be why the problem lasts so long.  A good mouthpiece cleaning seems to be in order.

I've never tried the rubbing alchohol thing before.  I might give it a shot myself.
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« Reply #3 on: Nov 07, 2006, 10:12AM »

For true cold sores, forget Carmex and Blistex. Look into Abreva for an over-the-counter medication or ask your doctor for a prescription medication. Nothing cures herpes or cold sores, but Abreva and some similar prescription medications shorten the duration and lessen the severity of an outbreak if applied early enough. I'm not a sufferer, but I know folks who are.

Oh yeah, to avoid outbreaks: lower your stress levels, eat healthy, get lots of sleep, drink enough water to not get dehydrated, mellow out. It works.
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« Reply #4 on: Nov 07, 2006, 04:13PM »

Carmex, and maybe Blistex both contain menthol

I find that products with menthol numb where it is applied

would not reccomend putting it on ur lips if ur a brass musician! Bad dog.  No Biscuits.



A lot of people experience this also.  Menthol is a pain reducer, so numbing is to be expected...
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Frank B
« Reply #5 on: Nov 08, 2006, 06:57AM »

Quote from: "PacoBone"
I´ve got lip herpes (also known as cold sore) so often, (almost once per month). It is becoming a nightmare as far as when it appears it is impossible to play the trombone for around 10 days. I wonder if you know a remedy, or a way to prevent it. (please be serious, this is not a joke).


Herpes is with you now for the rest of your life. To avoid outbreaks, stay healthy and avoid excess stress as much as possible.
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Donn Schaefer
« Reply #6 on: Nov 08, 2006, 10:29AM »

Valtrex or Zovirax are two prescription medications that work for cold sores on the face. On the first sign of the tingling feeling that comes before a cold sore, take a preventative dose of one of the above medications. You may be able to go years without another outbreak of cold sores.

From what I have read, 80% of the population carries the virus that can cause cold sores, it is related to the virus that causes chicken pox. Some people are lucky in that they don't ever get cold sores. Other people have frequent outbreaks, often made worse by the physical stress of playing a brass instrument.

Some people are sensitive to citric acid, wine or chocolate, any of which may trigger an outbreak. Irritants on the chops such as a scratched mouthpiece rim may also make symptoms worse.

For an over-the-counter medication, Abreva is the only one that has been scientifically tested and proven to have some effect. Unfortunately, it does not work very well as a preventative medication. Abreva only serves to shorten the length of cold-sore outbreaks.

See a doctor to discuss Valtrex or Zovirax. I know many brass players who use these medications.
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« Reply #7 on: Nov 08, 2006, 11:04AM »

I second Abreva shortening symptoms, it works.  Consider a gold plated or lexan rim.  Sunlight also is a trigger besides stress.

If menthol reduces pain (which can be considerable) what's the problem?  It doesn't affect the muscle control, just the surface nerve sensations.  Carmex  and Savex work well in my opinion...

Just thought of this.  When I've laid off the horn because of a cold sore, they seem to last forever.  When I have engagements that I can't get out of, there is discomfort, but the sores go away much faster.  I'm not sure if the vibrations affect it, the increased blood flow, or if I'm just weird.  Could be D, all of the above Grin
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« Reply #8 on: Nov 08, 2006, 11:13AM »

Quote from: "john sandhagen"
I second Abreva shortening symptoms, it works.  Consider a gold plated or lexan rim.  Sunlight also is a trigger besides stress.

If menthol reduces pain (which can be considerable) what's the problem?  It doesn't affect the muscle control, just the surface nerve sensations.  Carmex  and Savex work well in my opinion...

Yes on Abreva from those I know that have tried it. Much smaller sores and somewhat shorter duration. Re: Carmex & so on, some people report that it seems that makes the sores spread more or appear larger. The latter certainly was the case in my source's experience. It's all very anticdotal: some insist it is great, others insist it is terrible.

That's why sticking to the clinically tested stuff like Abreva and the two previously mentioned prescription medications is the best plan right now to control an outbreak, and staying relaxed and eating and drinking properly is the best plan to avoid them.

Side note, I regularly used the blue extra-medicated Carmex years ago to play in marching band with just normally chapped (or split) (or blown-out) lips. It's very numbing and greasy and I could usually play just fine with it.
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« Reply #9 on: Nov 08, 2006, 11:21AM »

I get these, somethimes monthly...

Agreed, take Zovirax at first tingle...it seems to stop it at the size you first apply it at...Have to go through the whole cycle, but if you stop it small it helps.

Agreed with sunlight and stress being triggers...

Last one I got...someone told me that...it can be triggered by...

Rancid Walnut Oil!...He said walnuts go bad rather quickly...

A few days before the outbreak...I had eaten some walnuts...still in the shell..
No clue how long they'd been in the pantry...(Tasted fine) and no I didn't eat the shells...

Don't know if that's it...but I'm giving up walnuts for now...
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« Reply #10 on: Nov 08, 2006, 12:25PM »

I have to say that these pests plague me once in awhile, usually only once every 12-18 months.  I have learned that taking massive doses of lysine will shorten the duration of the "attack".  I start with 6-8g (6000-8000 mg) at the first sign and dose up every couple hours with another 2-4g.  I also use pharmaceutical grade colloidal silver right on the sore.  This helps to dry and shrink it.  I find that if I leave off the carmex etc., they dry up and vanish more quickly.

They're such a hassle and I sympathize with you.  Good luck with your experiments, courtesy of your favorite boneheads. . . . . . . . . .
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« Reply #11 on: Nov 08, 2006, 12:28PM »

PS------I don't think one can avoid an outbreak.  If the virus is in your system, it will remain dormant until some stressor or other stimulus activates the darn thing.   Some of the items mentioned above can and do contribute to an outbreak.  Geez,  who wants to give up sun or chocolate or coffee?
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« Reply #12 on: Nov 08, 2006, 12:40PM »

Just something to consider:  Carmex is formulated for cold sores, that is to dry them up and condition your lips.  However the "drying up" part is what you need to look out for.  If you look at the ingredients, Carmex (and maybe some other lip medications) contain salicylic acid, which is an astringent; the same kind of medication you might use for acne.  This works well for cold sores, but I would be weary of using this as your regular lip balm, because it may dry your lips out quicker, causing you to apply more, drying you out more, etc.

I agree with everything that's been said here: sleep, relax, hydrate, clean your mouthpiece, etc.  Just be careful not to OVERuse the hard stuff like Carmex, because it may be detrimental to the chops.  As a regular lip balm, I use Blistex DCT, that has softer ingredients like aloe, cocoa butter, and vitamins A and E.

Good luck!
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« Reply #13 on: Nov 08, 2006, 01:37PM »

Quote from: "PacoBone"
I´ve got lip herpes (also known as cold sore) so often, (almost once per month). It is becoming a nightmare as far as when it appears it is impossible to play the trombone for around 10 days. I wonder if you know a remedy, or a way to prevent it. (please be serious, this is not a joke).


Maybe if you got another mouthpiece (like the exact same make and model, or if you want to change it, then do so), maybe you got some kind of infection on the mouthpiece.

Something similar happened to a girl in England I think, except she kept getting pneumonia.
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« Reply #14 on: Nov 08, 2006, 01:44PM »

When you've got it, the herpes virus is in you... forever. It can be passed to new people through open cuts and dirty mouthpieces. But an outbreak of sores in someone who has it comes from the inside.
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« Reply #15 on: Nov 08, 2006, 06:25PM »

I get cold sores too Frown I think they’re EXTREEMLY painful to play with :cry: especially since I always play with allot of pressure agent my mouth piece; But I usually tuff it out and play any way Grin

Since I did a report on cold sores back in7th grade for health class( yes I still remember the info in the report) I know alout of the technical stuff about cold sores

 Clever Technical stuff:
Herpes’s simplex(cold sores) is a chronic viral infection on the skin.
-that means that once you get them you have them for the rest of your life.
Cold sores usually remain dormant, but reaper when the body's defenses are weakened.
-so you get them when your sick(like getting colds), or really stressed out.
Although this varies from person to person, cold sores generally last around a week.
This virus is highly contagise , and is spread threw close personal contact, threw touch.
-It's spread by contact with the virus; Such as kissing, sharing a drink, sharing a mouth piece, ect.
  -So if you do get cold sores make sure you don't ever share your mouth piece with any body else Bad dog.  No Biscuits. and wash your mouth piece allot. Keep it clean :)

I don't know if this is the best medicine/remedy for cold sores but I usually use Carmex
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« Reply #16 on: Nov 09, 2006, 10:34AM »

I've been using some stuff called"Zilactin-L"
Says the active ingredient is 2.5% Lidocaine along with some other crap and alcohol.
I start putting a drop on the area as soon as it starts to itch.
It still takes a couple of days to heal,  but with less pain & itch.
I don't get them too often anymore.
I did get them quite often when I played a lot in college.
Lots of face time in addition to the stress of school.

Definitely keep the mpce clean,  hot soapy water, disinfectant spray or Listerene.
Also,  keep your fingers away from the sores, and NEVER touch your genital area if you have touched a sore,  you can infect yourself and/or someone else even worse!!!!!!!

Thanks
Eric
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« Reply #17 on: Nov 13, 2006, 07:02AM »

and dont forget to get a new tooth brush!   everytime you get a sore, buy a new toothbrush.   open it when the blister and the discharge have gone and the scab is there.    its the liquid from the blister that is contagious.   make sure your mouthpiece is new and completely plated, you might even try one of the pretty lexan mouthpieces.  (they come in a  rainbow of colors, but not much size variety)
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« Reply #18 on: Nov 14, 2006, 07:08AM »

Often, this may come from diet. Avoid nightshade vegetables like tomatoes, avoid processed foods. eat whole grains, vegetables...low fat. Avoid meat, dairy products....beans are good, some nuts....simple diet, whoe foods. Check out Macrobiotics on the Internet.

Treating it is one thing; not getting it is better!
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« Reply #19 on: Nov 27, 2006, 02:49AM »

Hi I found that Shaving caused me some problems, so I grew a beard and tash. No more problems. I might be extra fussy, but I clean my equipment on most days I have 2 Yamaha horns and they are just as clean as when they were new. My solution to herpes, be extra fussy don't shave and grow a beard. Regards Max Croot
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« Reply #20 on: Nov 27, 2006, 06:20AM »

and what about Aloe Vera and Siberian Ginseng or Tea Tree oil?
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« Reply #21 on: Nov 27, 2006, 07:17AM »

Ok,  this is a simple answer to give since I have had the same thing for 35 years.  Herpes simplex is a virus that lives in the body and is incurable, but there are things to make it go away FAST!  I've tried them all but there is only one thing that kills the virus:  Acyclovir!  It's a prescription drug under the name: Zovirax. Anything else is merely topical treatment and does nothing to kill the herpes simplex virus.  Unfortunately, the virus lies dormant in the body and cannot be killed while in this state, only when its active.  There are some creams that have acyclovir in them and they work as well.

I have a perscription for 800mg tablets and keep a supply around at all tims.  This is NOT medical advice, merely what I do so make your own decisions.  At the first sign of an outbreak, I take 2 tablets immediately which seems to kill the viral action within about an hour or two and keeps the eruptions from starting. Then, I follow the directions from there on out until it's gone.  If caught early, I can stop a herp from even showing up on my lip.  Nobody even notices it and you can keep right on playing. It's the only way to go in my opinion.

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« Reply #22 on: Aug 15, 2017, 11:44PM »

At the first tingle tI take one Zostex 125mg. Prescription and pricey but works 9 out of 10 times. No outbreak except if you take iot too late...
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« Reply #23 on: Aug 16, 2017, 03:34AM »

Take a Lysine supplement.   Avoid foods with arginine such as peanuts, chocolate, citrus fruits, etc. 
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« Reply #24 on: Aug 16, 2017, 05:48AM »

I know a player who found help in switching from a metal rim mouthpiece to a lexan rim one.
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« Reply #25 on: Aug 16, 2017, 08:39AM »


Interesting. A while back I posted a topic about using coins and pencils to get an impression of m/p dimensions without having to put them to your face. This situation is a perfect example of what I've been keen to avoid. Trying other peoples m/ps is always going to be risky.
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« Reply #26 on: Aug 17, 2017, 07:29AM »

Digging up an 11-year-old topic, are we?
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« Reply #27 on: Aug 17, 2017, 03:02PM »

I  stopped getting them when I quit using $8.00 hookers!
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« Reply #28 on: Aug 17, 2017, 03:15PM »

Digging up an 11-year-old topic, are we?

For some it's a recurring problem, unfortunately.
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« Reply #29 on: Aug 17, 2017, 03:59PM »

My college instrumental pedagogy teacher claimed that if you traded enough mouthpieces around you'd eventually be inoculated against everything.
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« Reply #30 on: Aug 17, 2017, 05:52PM »

For some it's a recurring problem, unfortunately.


All in jest :) I have strong case pretty often myself every couple of months. Best help for me has been to just wash the mouthpieces and avoid hand-to-mouthpiece and hand-to-mouth contact mostly.
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« Reply #31 on: Sep 11, 2017, 02:27AM »

Like a lot of people that have posted already, I suffered from this for years:  all the way through junior high, high school, and through my performance degree.  I cut down on my playing dramatically after that (I went to medical school) and they stopped.  Now I am 43 and getting back into it again. The stress/trauma of the MPC is enough to cause an outbreak.  And unfortunately, if the virus has taken up residence in one of the nerve roots that supplies your face, then they will occur there.

To prevent any HSV outbreaks I actually use acyclovir prophylactically, 400mg daily now.  This is a serious problem for brass players.  If you are really getting one monthly, and yes they last 10d, you should consider preventing with acyclovir.  Of course you should try to avoid any other stressors as well.

Good luck with it and I feel for you.
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« Reply #32 on: Sep 11, 2017, 04:29AM »

Research Argenine and Lysine.  The virus feeds on Argenine, which is found in chocolate, peanuts, citrus fruits and many other foods.  Lysine supplements will slow down the virus.   I take a small dose of Lysine every day and when a cold sore comes on I take megadoses. 
I also take Valtrex- 2 grams at the very first sensation of an out break and 2 grams exactly 12 hours later.  Even with this, one will occasionally slip past my defenses.  I will add Abreva to the menu and I can usually zap a cold sore within one day.   However, if a cold sore breaks through the skin before I start any treatment I have it for a week or more.  Gotta hit it early. 
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« Reply #33 on: Sep 11, 2017, 08:21AM »

This thread started before we had the Healthy Trombonist board.  I'm moving it there.
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« Reply #34 on: Sep 11, 2017, 08:41AM »

Acyclovir and Valtrex definitely work, but for some people like me, it can wreak havoc on the digestive system over time; it's an antibiotic, so it can have negative effects on intestinal flora.

I've found that regulating the lysine/arginine ratio in my diet has been extremely effective in eliminating recurrences of cold sores. Here's a chart of lysine/arginine ratios in a wide range of foods:

https://hsvblog.org/herpes-blog/diet-lifestyle-tips/chart-of-lysine-vs-arginine-in-common-foods/

Foods at the top of the chart have the highest lysine/arginine ratios; those at the bottom have the lowest, and are to be avoided.

For me, nuts, nut butters, and orange juice are definite triggers. Taking L-lysine supplements on an empty stomach reduces the chance of an outbreak when I occasionally indulge in high arginine foods.



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« Reply #35 on: Sep 11, 2017, 10:18AM »

Acyclovir and Valtrex definitely work, but for some people like me, it can wreak havoc on the digestive system over time; it's an antibiotic, so it can have negative effects on intestinal flora.

I've found that regulating the lysine/arginine ratio in my diet has been extremely effective in eliminating recurrences of cold sores. Here's a chart of lysine/arginine ratios in a wide range of foods:

https://hsvblog.org/herpes-blog/diet-lifestyle-tips/chart-of-lysine-vs-arginine-in-common-foods/

Foods at the top of the chart have the highest lysine/arginine ratios; those at the bottom have the lowest, and are to be avoided.

For me, nuts, nut butters, and orange juice are definite triggers. Taking L-lysine supplements on an empty stomach reduces the chance of an outbreak when I occasionally indulge in high arginine foods.




There is an antiviral cream that I have prescribed called Denavir.
I also use a laser Diode or Nd:YAG to lessen the symptoms and shorten the duration of an outbreak as long as its done when the littlest symptoms start.
Also Acyclovir and Valtrex are not antibiotics (antibacterials).  They are antivirals and don't affect the intestinal flora (bacteria).
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« Reply #36 on: Sep 11, 2017, 11:40AM »


Also Acyclovir and Valtrex are not antibiotics (antibacterials).  They are antivirals and don't affect the intestinal flora (bacteria).


Thanks for the correction. When I took acyclovir regularly, my digestion to slow down significantly. Not sure why exactly, but that was a side effect for me.
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« Reply #37 on: Sep 11, 2017, 11:43AM »

Thanks for the correction. I'm not sure why, but when I took acyclovir regularly, my digestion seemed to slow down significantly.
It can monkey with your intestines. Not sure what the pathway is though.
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« Reply #38 on: Sep 11, 2017, 12:36PM »

Don't let dirty grammas kiss babies. Problem solved.
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