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Medications for Cold Sores (Herpes Simplex Type 1)

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
  • Famciclovir
  • Penciclovir
  • Valacyclovir

Over-the-Counter Medications

Antiviral Agents

  • Docosanol cream

Pain Relievers

  • Acetaminophen
  • Ibuprofen

Cold Sore Creams

Antibiotic Ointments

  • Neosporin
  • Polysporin

Anesthetic Ointments

  • Benzocaine

Prescription Medications

Antiviral Agents

Common names include:

  • Acyclovir
  • Famciclovir
  • Penciclovir
  • Valacyclovir

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

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
  • Ibuprofen

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

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.

Special Considerations

If you are taking medications, follow these general guidelines:

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

Revision Information

  • 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%5Fprevent%5Fcold%5Fsores.html. Accessed February 17, 2014.

  • Oral herpes. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated January 30, 2014. Accessed February 17, 2014.