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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.

Prescription Medications

Antiviral Agents

  • Acyclovir (Zovirax)
  • Famciclovir (Famvir)
  • Penciclovir (Denavir)
  • Valacyclovir (Valtrex)
Over-the-Counter Medications

Antiviral Agents

  • Docosanol cream (Abreva)

Pain Relievers

  • Acetaminophen (Aceta, Apacet, Feverall, Panadol, Tylenol)
  • Ibuprofen (Advil, Dolgesic, Genpril, Ibuprin, Motrin, Nuprin, Rufen)

Cold Sore Creams

Antibiotic Ointments

  • Neosporin
  • Polysporin

Anesthetic Ointments

  • Benzocaine (Americaine Topical Anesthetic, Lagol)
Prescription Medications
Antiviral Agents

Common names include:

  • Acyclovir (Zovirax)
  • Famciclovir (Famvir)
  • Penciclovir (Denavir)
  • Valacyclovir (Valtrex)

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:

  • Allergic reaction, which may include rash, swelling of the face, or difficulty breathing
  • Upset stomach, decreased appetite
  • Headache
  • Local numbness or tingling in area of application
Over-the-Counter Medications
Antiviral Agents

Common names include:

  • Docosanol (Abreva)

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:

  • Headaches
  • Allergic reaction, which may include rash, swelling of the face, or difficulty breathing
Pain Relievers

Common names include:

  • Acetaminophen (Aceta, Apacet, Feverall, Panadol, Tylenol)
  • Ibuprofen (Advil, Dolgesic, Genpril, Ibuprin, Motrin, Nuprin, Rufen)

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:

  • Headache
  • Upset stomach
Cold Sore Creams

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.

Antibiotic Ointments

Common brand names include:

  • Neosporin
  • Polysporin

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.

Anesthetic Ointments

Common names include:

  • Benzocaine (Americaine Topical Anesthetic, Lagol)

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 four times per day. Side effects rarely occur.

Special Considerations

If you are taking medications, follow these general guidelines:

  • Take your medication as directed. Do not change the amount or the schedule.
  • Know what side effects could occur. Discuss them with your doctor.
  • Talk to your doctor before you stop taking the medication.
  • Plan ahead for refills if you need them.
  • Do not share your medication with anyone.
  • Drugs can be dangerous when mixed. Talk to your doctor if you are taking more than one drug, including over-the-counter products and supplements.

References:

Herpes labialis. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated May 27, 2011. Accessed March 20, 2013.

Herpes simplex. DermNet NZ website. Available at: http://dermnetnz.org/viral/herpes-simplex.html. Updated February 6, 2013. Accessed March 20, 2013.

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 March 20, 2013.

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 March 20, 2013.



Last reviewed March 2014 by 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.

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