Topical products, such as creams or gels, are sometimes used to treat
cold sores. Many are prescription medicines that may
slightly shorten the duration of cold sores, usually by just 1 to 2 days.1
Some experts find that even when nonprescription
topical products are used frequently—every 2 hours while a person is awake—at the
first sign of an outbreak, they may only speed recovery time by a few hours or
Penciclovir cream (Denavir) is an antiviral cream that
may reduce healing time by 1 to 2 days, especially if the cold sore was
triggered by sunlight exposure. It also reduces the pain, itching, burning, and tenderness
of cold sores.1
Penciclovir cream may cause side
effects such as mild pain or stinging when it is applied. It is possible,
although rare, that the cream may also cause a skin rash or headache.
Acyclovir ointment or cream works best
if it is used at the first sign of cold sore symptoms. Side effects of the
ointment may include mild pain or stinging at the site where it is applied.
The U.S. Food and Drug Administration (FDA) approved
acyclovir cream to treat recurrent cold sores in people older than age 12. The
cream can improve healing time by up to half a day. The cream may cause
temporary skin irritation.
Tetracaine cream (Viractin) and lidocaine (Zilactin-L) are topical anesthetics that can relieve
the pain and itching of cold sores. These products are applied to cold sores up to
6 times a day for best results. Pain and itching are relieved usually within 2
to 3 days after a person first applies the product.
Docosanol 10% (Abreva) should be
applied at the first signs of a cold sore outbreak.
It is the first nonprescription cold sore medicine approved by the U.S. Food
and Drug Administration (FDA) to shorten healing time and the duration of
Benzyl alcohol (Zilactin) is a gel that relieves the pain of cold sores and may help
shorten healing time, especially if it is used as soon as a cold sore begins to
Dimethicone with sunscreen (Herpecin-L) is a product that moisturizes your lips and protects them
from the sun. This can help reduce the pain and itching of cold sores. It can
also help prevent cold sores from returning, especially if they were triggered
by sun exposure.
Cold sores usually heal on their own without
prescription medicines or complementary therapies.
Worrall G (2009). Herpes labialis, search date February 2009. Online version of BMJ Clinical Evidence: http://www.clinicalevidence.com.
Habif TP (2010). Warts, herpes simplex, and other viral infections. In Clinical Dermatology, A Color Guide to Diagnosis and Therapy, 5th ed., pp. 454–490. Edinburgh: Mosby Elsevier.
February 1, 2012
E. Gregory Thompson, MD - Internal Medicine
& Thomas M. Bailey, MD - Family Medicine
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