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Cold Sores and Skincare

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In my daily practice as an esthetician, I am confronted with a myriad of questions. The vast majority of individuals who approach me generally believe that their concerns are purely cosmetic in nature. In some instances, that is true; however, in many instances, the problem appears cosmetic, but has internal causes. For example, did you know that an early sign of lupus is hair loss (When clients discuss unexplained hair loss and dismiss it as merely stress, I always refer them to a doctor because estheticians aren’t qualified to diagnose lupus)? Likewise, did you know that recurring boils may need to be surgically removed rather than being repeatedly extracted? What’s more is that the need to take these steps can often be identified through full disclosure of one’s current and past medical history.

Full disclosure is important; however, it can be hampered by clients’ perception of stigma. To this end, I am talking about cold sores. People squirm and hesitate when I ask, “Do you have herpes?” They react slightly better to “Do you get or have you ever gotten a cold sore?” I’ve even had people lie to me only to send me emails later disclosing their shame and the truth. Plain and simple, people are embarrassed about it; however, it is important know why the full truth matters.

The stigma that often accompanies the virus because many people associate it with herpes simplex 2 which affects the genitals and is a sexually transmitted disease. Let’s be crystal clear: cold sores are, in fact, a symptom of Herpes Simplex Virus 1 (HSV), which is an incurable contagious virus. Let’s be even clearer: medical professionals believe that somewhere around 50% - 80% of the US adult population has been exposed to the virus, and by age 50, 90% of the US population has been exposed. While exposure doesn’t translate into automatic contraction of a disease, such a high exposure rate does translate into herpes being more common than most people probably think it is. The disease is easily transmitted from person to person and can be transmitted through non-sexual contact as well. Furthermore, the diminished stigma surrounding cold sores as opposed to HSV is irrational because the virus that causes the genital sores and lesions is the same as the virus that causes sores on the mouth. The primary purpose for distinguishing the two is so that professionals know the location of an outbreak when speaking with a client or patient.

Estheticians are concerned about HSV for three reasons. First, it is communicable and easily passed between people. While estheticians should ALWAYS take the proper steps to protect themselves and their clients, full disclosure can and should increase diligence. Second, if he or she is providing clients with certain treatments and services, clients should be made aware of the increased risk of outbreaks and steps to minimize this likelihood. HSV lives within the body’s nerve endings and has both active and dormant phases. Unfortunately, certain skincare treatments can irritate the skin and nerves; thereby triggering an active phase also referred to as an outbreak. Finally, it is important to prevent outbreaks because they can complicate recovery, increase the risk of infection, decrease quality of life and compromise the immune system as a whole. Common symptoms include lesions (which can look like infected bumps), pain, burning, tingling, swelling, crusting, and weeping (the lesions excrete a fluid as they drain and heal).

Overall, estheticians are professionals and are expected to keep your health information private and have no interest in judging you. Further, it is not worth the pain and potential health risk to hide this important information.

References: http://www.hopkinsmedicine.org/healthlibrary/conditions/oral_health/mouth_infections_85,P00888/.

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