Q. My daughter has had five cold sores in the past two months, often at times of stress. She is getting married soon and is terrified one will surface just before the big day. A. The small, fluid-filled sores, which appear on the lips or around the mouth, are caused by the herpes simplex virus. Most of us contract the virus in our childhood but it normally remains dormant in the sensory nerve cells near the mouth. There is seldom any sign of the virus until you have an outbreak of cold sores, which may happen much later.

Often there is no obvious trigger for an outbreak but, according to NHS Choices, possible factors include a high temperature, another infection, emotional upset, stress, tiredness, menstruation, strong sunlight or an injury to the affected area.

Initial signs are usually a tingling, itchy or burning sensation around your mouth. This is the time to use a non-prescription antiviral cream (ask your pharmacist). Applying it later has little effect. Cold sores usually clear in seven to ten days.

The best way to prevent and treat a cold sore is to take the L-Lysine supplement, says pharmacist Shabir Daya: ‘Numerous studies indicate that lysine supplementation can help speed the recovery from and prevent recurrences of cold sores. Lysine has antiviral properties and blocks the uptake of arginine, an amino acid that promotes viral growth.’

Try a product with the herb lemon balm in it as it contains tannins, which have potent antiviral and antimicrobial properties, plus terpenes, which numb the pain. Apply Organic Lemon Balm Cream often, from the first sign of tingling. Alternatively, Lysine Lip Therape contains lysine plus monolaurin (from coconut oil), both powerful antivirals. Wash your hands thoroughly with soap before and after touching the sore.

Recurrences often indicate a weakened immune system and nutritional deficiencies. ‘A stronger immune system may help prevent the virus replicating and return it to a dormant state,’ says Daya. He recommends Daily Immunity, a blend of nutrients, probiotics and herbs to help support the immune system.

To help your daughter manage her anxiety about getting a cold sore, I suggest she practises camouflaging along her lip line with a matt concealer in the same shade as her skin. Apply with a new cotton bud each time. Then fix with sheer powder and finish with a glossy lip colour, the same colour as the sore. WebMD (www.webmd.com) has a useful film How to Hide Cold Sores.

Product details: L-Lysine by Lamberts, £6.25 for 90 tablets; Lysine Lip Therape with Monolaurin by Life-Flo, £7.95; Organic Lemon Balm Cream by Granary Herbs, £8.50 for 60ml; Daily Immunity by Food Science of Vermont, £25 for 60 capsules, all from Victoria Health, www.victoriahealth.com.

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ENERGY-BOOSTER UPDATE

I recently wrote about takin a daily supplement of ubiquinol, the antioxidant version of co-enzyme Q10 that helps boost energy and fight fatigue. A 65-year-old reader sent me this email: ‘Although retired, I have a very busy and active life, which includes looking after horses and a guide dog puppy-in-training. I put my recent lack of energy down to being always on the go. I was also troubled by my inability to sleep for more than a couple of consecutive hours each night, despite often feeling exhausted. The fatigue was becoming very debilitating so a friend recommended VESIsorb Ubiquinol. I was amazed at the immediate improvements, both in my energy levels and sleeping patterns. When I ran out I really noticed the difference. It’s not cheap but it is worth the money.’ Igennus VESIsorb Ubiquinol-QH, £33.98 for 30 capsules, Victoria Health, www.victoriahealth.com.