In the majority of cases, cold sores will heal on their own in 7 to 10 days. In the meantime, though, the sores may cause unbearable discomfort, intense embarrassment, or serious complications. Luckily, there are a number or over-the-counter and prescription medications you can use to get relief from the pain, itching, and burning caused by the cold sores and reduce the amount of time you have to suffer from them.
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Cold sores are caused by the herpes simplex virus type 1 or HSV-1. Though there isn’t a cure for this disease or a vaccine to stop you from getting it, it can be combated with the use of antiviral medications. These medications may come in cream or tablet form and must either be applied to the affected site or taken several times a day. For example, antiviral creams usually need to be applied to the cold sore four to five times per day.
You can purchase cold sore creams over-the-counter and without a prescription from a variety of retailers. However, to be effective, you must apply them as soon as you begin experiencing the signs of cold sore eruption such as tingling and burning along the lips. This indicates the herpes simplex virus is replicating and spreading. Antiviral medications works best when the virus is in this stage.
This also holds true if you have frequent outbreaks. As soon as you feel one coming on, start using an antiviral medication to minimize symptoms and speed up the healing process.
Another popular antiviral agent is Abreva (docosanol). It works by preventing the herpes virus from fusing with its cell host, thus stopping it from replicating and decreasing the duration of the outbreak. One of the best things about using Abreva is it can be worn under makeup, so you can conceal the cold sore as it heals. It is also available over-the-counter, so you don’t need to make an appointment with your doctor to get it.
A few of the most popular medications are acyclovir (Xerese, Zovirax), famciclovir (Famvir), valacyclovir (Valtrex), and penciclovir (Denavir). These medications work by preventing the virus from replication and spreading.
While antiviral pills are generally more effective than antiviral creams, these medications are usually only prescribed to treat severe outbreaks. In some cases, the medication may be given by injection.
It’s important to note that these medications do not prevent outbreaks. Though they may shorten your suffering by a few days, you may still get cold sores in the future.
The general purpose of the medications in this category is not to combat or remove the virus but to alleviate the mild to moderate symptoms caused by the cold sores. For example, some creams can reduce itching and inflammation. If your cold sores are particularly painful, your doctor may recommend that you take pain relievers such as ibuprofen or Tylenol.
Medications in this category are generally available over-the-counter, and the most popular ones are Blistex, Cymex, Bonjela, Zilactin, Zilactin-L, and Viractin. They are easy to apply, usually only requiring you to put the medication on the cold sore using your finger or an applicator. It’s essential that you wash your hands before and after application to avoid passing harmful bacteria into the cold sore or spreading the disease to other people.
Some OTC products may also be used off-label to treat cold sore symptoms. For instance, Visine is an eye medication designed to alleviate red, dry eyes. However, applying it to a cold sore will also get rid of redness and inflammation.
Hand Held Devices
Two new hand held devices that claim to help reduce or prevent cold sore outbreaks are Intercept CS Cold Sore Prevention System and Zeno CS. These devices deliver a 30-second heated treatment directly to the cold sore that lasts for about four minutes. When used at the first signs of a cold sore, these treatments can prevent the cold sore from forming at all. However, you must apply it every four to five minutes for several hours to get the benefit.
Prior to purchasing these devices, be certain to consult with your doctor to ensure they are safe for you to use.
Cortisone is a medication made from the steroid hormone that is effective at quickly eliminating inflammation. Treatment with this medication consists of the doctor injecting the cortisone directly into the cold sore, which may be painful. The outcome, though, is the medication will shrink swollen cold sores within a very short period of time. Cortisone can reduce your ability to fight off infections, though, so it should not be used for long stretches of time.
Cold sore patches offer both the benefits of an antiviral medication and a concealer in one product. The patch contains a substance called hydrocolloid that treats the cold sore. However, the patch is designed to cover the sore and hide it from view during the healing process. It’s not as subtle as Abreva, but it can help minimize the humiliation related to having a cold sore.
Coldness restricts blood vessels and can reduce pain and inflammation. Therefore, applying a cold compress (or cold tea bags) to a cold sore for 20 minutes can provide relief from some symptoms such as swelling and redness. Take an over-the-counter pain reliever such as Tylenol or ibuprofen to further alleviate pain.
Medications for Gingivostomatitis
One symptom that affects adults and children (but children primarily) is gingivostomatitis. The disease develops when the herpes simplex virus invades the gums, causing them to become painful and swollen. The condition may be accompanied by a high fever and feelings of general malaise. It can make it difficult to brush the teeth properly, which may lead to the onset of other oral infections such as periodontal disease. If the infection is severe enough, your lips may partially or fully stick together.
There are a couple of different treatments available to treat the symptoms of this disease:
- Oral rinses such as antiseptic mouthwash
- Benzydamine, which is available as an oral rinse and spray. The medication decreases mouth and throat pain
- Over-the-counter pain killers such as aspirin or ibuprofen
- Lip barrier creams to prevent the lips from sticking together
Typically, gingivostomatitis will go away within 7 to 14 days. However, it may take 21 days for the sores caused by the disease to heal.
There are a few complications that can develop as the result of cold sores and the herpes virus. A common one is dehydration. This is typically associated with gingivostomatitis because mouth and throat pain may make it difficult to eat food or drink fluids. If the dehydration gets severe enough, hospitalization may be required so the person can have fluids administered intravenously.
Signs of dehydration include:
- Little urine output
Another possible complication is the herpes infection can spread to other parts of the body, causing the affected person to develop blisters in those areas. This typically occurs because the person had an open wound (e.g. cut) that came in contact with fluids from the cold sore. The virus can also spread to the eyes via similar contact, leading to swelling and redness as well as sores developing on the eyelids. However, these secondary infections respond well to antiviral medications.
Lastly, the affected person may develop encephalitis. This is swelling in the brain. It is a life-threatening condition that must be treated right away to avoid causing brain damage. However, injections of antiviral medication such as aciclovir are usually effective at treating this condition as well.
Here are a few things you can do to deal with or minimize some of the side effects associated with having a cold sore:
- Drink at least 6 to 8 glasses of water a day to avoid becoming dehydrated. If you get bored with water, drink tea or eat foods with high water content such as watermelon.
- Adjust your diet to include soft, cool foods such as bananas and cold boiled eggs. Avoid eating foods that are acidic or salty as this can irritate the cold sore and inflamed gum tissues.
- If you can’t brush your teeth because it hurts too much, eliminate oral bacteria by using an antiseptic mouthwash.
- Gently dab creams onto the cold sore. Rubbing into the sore may irritate it.
- Use soap and warm water to thoroughly wash your hands before and after touching your cold sore. You can easily pass bacteria into the cold sore or spread viral organisms to other people if you fail to do this.
- Other than applying medication, do not touch your cold sore or you may aggravate it and make your symptoms worse. Do not share your cold sore medication with others as you may inadvertently pass the virus to them.
Prevention and Tips to Avoid Spreading
The herpes simplex virus is highly contagious, and you’re even more contagious when you have a cold sore. Here are a few things you can do to avoid spreading the disease to others:
- Avoid kissing or participating in oral sex with other people.
- Do not share personal items such as towels, lip balm or lipstick, or silverware that’s been in your mouth.
- Minimize bare skin contact with others.
- Wash your hand frequently.
- Do not touch the cold sore unless you are applying medication. Wash your hands using soap and water before touching another person or other parts of your body.
- Keep your hands away from other vulnerable parts of your body such as the eyes and genitals. You could spread the disease to these areas.
Although the herpes simplex virus causes cold sores, outbreaks can be triggered by internal and external factors such as stress, the onset of other infections or viruses such as the flu, exposure to bright sunlight, and too little sleep. It’s a good idea to track your outbreaks to pin down your triggers and minimize your exposure to them. For example, following a healthy diet and exercising can aid in stress management and reduce your risk of getting a cold or the flu. Put sun block on the cold sore or use a lip balm that contains sun protection to reduce the amount of UV light the cold sore is exposed to when you go outside.