Cold Sores, which occur as blisters followed by open sores usually around the mouth, are caused by a herpes virus (herpes simplex type 1). Similar sores around the genital area, especially those caused by a different herpes virus (herpes simplex type 2), are of great concern for pregnant women. An active herpes outbreak in the genital area at the time of delivery is an extreme danger to the baby and requires a caesarean section delivery.

A natural delivery with a herpes outbreak risks transmitting the disease to the baby. Infant herpes is a far more serious disease than it is in adults, and can cause blindness, brain damage, or death.

Cold sores are different from genital herpes, even when they are caused by the same virus. (That is sometimes the case. It’s possible to have genital sores that are caused by herpes simplex type 1, or facial sores caused by herpes simplex type 2. The other way around, however, is much more common.) However, there are some concerns for both mother and baby when the mother suffers from cold sores.

Facts About Herpes And Cold Sores

Cold sores are caused by an infection with a herpes virus. The disease causes symptoms in outbreaks that usually last seven to ten days. An outbreak often begins with an itching, tingling sensation in an area of skin normally near the mouth. Swelling and discoloration are followed by an eruption of small blisters in a cluster. The blisters break open, resulting in an open sore that forms a scab-like crust. Over several days, the sore heals and symptoms disappear. The virus enters a dormant stage, but the victim is not “cured.” New outbreaks can happen at any time, especially when the immune system is compromised (this is why the disease is associated with colds, hence the common name). There is no cure for herpes. Once contracted, the disease is present all one’s life.

Herpes is highly contagious, especially during an active outbreak. The disease may also be transmitted while it is in its dormant phase, but
transmission is much less likely when there are no symptoms present.

Risks For The Mother

The main risk for a mother who has herpes is increased likelihood of an outbreak. Pregnancy results in a weakened immune system. Pregnant women are at greater risk for all kinds of minor infectious diseases. Those who are already suffering from either cold sores or genital herpes are likely to experience increased frequency of outbreaks over the course of pregnancy. Pregnancy also causes increased stress
and worry, which also increases the risk of an outbreak. All in all, what this means is that if you have herpes, at least once and probably more than once during gestation you will have an outbreak of the illness.

There is no evidence that cold sores are worse or outbreaks longer-lasting during pregnancy than otherwise. The illness, although aggravating and unsightly, is normally not dangerous. It does not become dangerous for the mother during pregnancy, either. The standard description of herpes, either oral or genital, is “It won’t kill you, but you won’t kill it, either.”

Risks For The Baby

Genital herpes is very dangerous for babies, but only if an active outbreak is occurring at the time of delivery. Oral herpes (cold sores) carry a much lower risk of transmission during gestation and delivery than genital herpes. However, although very rare, it does happen and can result in serious injury or death of the infant. If you have cold sores and are pregnant, consult with your doctor about the possible risk of
infection.

Risk of infection from cold sores increases dramatically after the baby is born. This is not something that is specific to pregnancy, but simply the fact that herpes is an extremely contagious infection. If you have a cold sore outbreak –– in fact, if anyone around the baby has a cold sore outbreak –– the baby is at risk to contract the disease, just as anyone else would be who comes into contact with a sufferer. Caring for a baby normally involves a great deal of personal contact, which carries a significant risk of infection during an active outbreak. Once the baby is past the initial newborn stage, the complications of being infected with herpes become much less and the disease behaves much as it does for any adult sufferer. Of course, that is still something to avoid. You can reduce the risk of infection by frequent washing of the hands especially before touching the baby, and by keeping cold sores covered either by bandages or by creams that prevent discharge of fluids from the sores into the environment.

Treatment Options During Pregnancy

Topical and symptomatic treatments (analgesics and so on) are generally safe to use during pregnancy. The big question mark surrounds acyclovir and other prescription or non-prescription antiviral treatments for cold sores. Either taken orally or used topically, antiviral treatments can often reduce the duration of cold sores. There is no strong evidence that these drugs are dangerous either to pregnant women or to their fetuses. However, there is not enough evidence to conclude that they are safe, either. Common sense suggests that the topical version of the drugs is less likely to pose any problem than the oral version. As a general rule, anything that might be dangerous for the fetus should be avoided during pregnancy. Cold sores, although annoying, are not a serious illness in adults, and a treatment that, at best, reduces a period of mild discomfort by a few days is not a great benefit to weigh off against a possible risk.

A number of other treatments may be considered. Topical analgesics to reduce the discomfort of cold sores are safe to use while pregnant.
Good nutrition and reducing stress are likely to improve immune responses and so reduce the risk of an outbreak. As these are good ideas during pregnancy in any case, quite aside from any benefits they may carry in regard to cold sores, clearly they’re a good idea for that reason as well.

Caution is advisable with regard to herbal treatments and other home remedies, and any such treatments should be explored with a view to
finding out any possible pregnancy complications first.