The information provided here is meant to give you a general idea about each of the medications listed below. Only the most general side effects are included. Ask your doctor if you need to take any special precautions. Use each of these medications as recommended by your doctor, or according to the instructions provided. If you have further questions about usage or side effects, contact your doctor.
Cold sores usually heal on their own within 7-20 days. Medications for the treatment of cold sores do not cure or rid the body of the virus. They may help to reduce the number of days an outbreak may last and may reduce discomfort.
Common names include:
Antivirals slow the growth and spread of the virus. It helps the body fight the virus more effectively. Antivirals work best if started before the sores breaks out. The first sign that a breakout is coming may be a tingling or burning sensation in the skin.
Oral antivirals include acylovir, valacyclovir, and famciclovir. They are used to shorten the length of the outbreak. Acyclovir may be given for the first or later outbreak of cold sores.
Topical prescription antivirals include acyclovir cream, and penciclovir cream. These creams help reduce the discomfort and may slightly shorten the length of an outbreak. The cream is applied to the area as soon as the first sign of an outbreak appears. It is used only on the face and lips—not the inside of the mouth and nose or around the eyes.
Side effects are rare, but may include:
Common names include:
Docosanol is an ointment that helps reduce the discomfort and length of an outbreak. It is similar in its action to the prescription antiviral cream, but it is sold over-the-counter. The cream is applied to the area as soon as the first sign of an outbreak appears. It is used only on the face and lips—not the inside of the mouth and nose or around the eyes.
Possible side effects include:
Common names include:
Pain relievers will help relieve the pain that accompanies a cold sore outbreak. They are taken on an as-needed basis. The dose depends on the amount of pain you are having. For severe pain and inflammation, ibuprofen is available in higher doses by prescription. Ibuprofen should be taken with food or a full glass of water.
Possible side effects include:
There are many cold sore creams and ointments available at drug stores that can help protect the lips and reduce the discomfort of a cold sore outbreak. These medications usually contain sunscreen and medicine to help relieve pain.
Common brand names include:
Antibiotic ointments contain one or a combination of antibiotics that are sometimes effective in fighting bacterial skin infections. Cold sores are caused by a virus, not a bacteria, but these ointments may be used to help treat a secondary bacterial infection. They are applied, with clean hands, directly to the cold sore. They should not be used inside the mouth or too near the eyes. Use only as directed. Possible side effects include skin irritation or allergy.
Common names include:
Anesthetic ointments work by numbing the area of the cold sore. This helps relieve the pain. Dry the area well before applying the ointment, and apply no more than 4 times per day. Side effects rarely occur.
If you are taking medications, follow these general guidelines:
Herpes simplex. DermNet NZ website. Available at: http://dermnetnz.org/viral/herpes-simplex.html. Updated February 6, 2013. Accessed February 17, 2014.
Herpes treatment. American Academy of Family Physicians Family Doctor website. Available at: http://familydoctor.org/familydoctor/en/diseases-conditions/herpes/treatment.html. Updated December 2010. Accessed February 17, 2014.
Kuehl B. Cold sores: how to prevent and treat them. Skin Care Guide website. Available at: http://www.skincareguide.ca/articles/herpes/to_prevent_cold_sores.html. Accessed February 17, 2014.
Oral herpes. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T115104/Oral-herpes. Updated October 5, 2015. Accessed October 4, 2016.
Last reviewed March 2017 by EBSCO Medical Review Board David L. Horn, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
