docosanol
Docosanol (Abreva) is a cream that's applied to the face or lips to help treat cold sores (also known as fever blisters). It works best if you follow the directions and apply it 5 times a day as soon as your cold sore symptoms start. It's available over the counter (OTC) as a brand-name or lower-cost generic medication. Most people don't experience much side effects from docosanol (Abreva), but it might cause some mild stinging.
What is Docosanol (Abreva)?
What is Docosanol (Abreva) used for?
- Lessen healing time and symptoms (tingling, pain, burning, itching) of cold sores
How Docosanol (Abreva) works
Docosanol (Abreva) is a topical antiviral cream. It works by preventing the herpes simplex virus (HSV), the virus that causes cold sores, from entering healthy cells and making copies of itself. As a result, docosanol (Abreva) slows the virus from spreading.
Drug facts
More on Docosanol (Abreva) essentials
Side effects of Docosanol (Abreva)
The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.
Common Side Effects
Less Common Side Effects
Docosanol (Abreva) serious side effects
Contact your healthcare provider immediately if you experience any of the following.
- Serious allergic reactions: Hives, rash, facial swelling, wheezing, or difficulty breathing
The following Docosanol (Abreva) side effects have also been reported
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
More common
Headache
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
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Pros and cons of Docosanol (Abreva)
Pros
- The only FDA-approved OTC medication that can shorten healing time of cold sores
- Available over the counter as a brand-name or lower-cost generic
- Can continue to use makeup
- Side effects are usually mild
Cons
- Needs to be applied 5 times a day
- Needs to be started at the first sign of a cold sore for the best results
- Can only be used on the face or lips
- Doesn't come with an applicator, so it must be applied with your finger or a cotton swab
Pharmacist tips for Docosanol (Abreva)
- Docosanol (Abreva) works best when you use apply it at the first signs of a cold sore.
- Before applying docosanol (Abreva), wash your hands first and remove any makeup covering the affected area.
- Apply docosanol (Abreva) to the areas on your face or lips where you feel tingling or itching, or where you have a cold sore. Use your fingertip or a cotton swab and rub in docosanol (Abreva) gently but completely. Wash your hands after applying the medication.
- Don't apply docosanol (Abreva) inside your mouth or in or around your eyes. If you accidentally swallow docosanol (Abreva), you should contact a Poison Control Center (1-800-222-1222).
- Cold sores are contagious until your sores are completely healed. This can take up to 3 weeks. Try to avoid close physical contact with other people when you have a cold sore, even when you're treating it with docosanol (Abreva) because cold sores are easily spread to others.
- When treating a cold sore with docosanol (Abreva), it can be helpful to wear a lip balm with an SPF of 30 or higher to protect your lips. Sunlight can be a trigger for colds sores for some people, so wearing sun protection daily can be a helpful tool to prevent outbreaks.
- If you get cold sores often, talk with your provider. They might be able to prescribe you antivirals pills to prevent outbreaks.
Common questions about Docosanol (Abreva)
It's not clear whether docosanol (Abreva) works well if you use it after the blister from a cold sore appears. Docosanol (Abreva) works best when you apply it at the first sign of a cold sore because it stops the virus from spreading and causing more symptoms. Blisters typically appear later on in the infection. Using docosanol (Abreva) when you already have blisters means that the virus already had some time to spread. It's best to apply docosanol (Abreva) when you first start to feel symptoms of a cold sore, such as a tingling or itchy sensation.
A cold sore outbreak can last up to 10 days, but studies showed that applying docosanol (Abreva) early can shorten healing time by around one day.
Using more docosanol (Abreva) than you need is unlikely to help your cold sore heal any better or faster. Use just enough cream to cover your cold sore completely and the area around it.
Apply docosanol (Abreva) five times a day until your cold sore is healed. If your cold sore isn't healed or gets worse after 10 days of using docosanol (Abreva) you should contact your healthcare provider.
No, avoid applying docosanol (Abreva) inside your mouth because that area is more sensitive. You might experience skin irritation if you get a small amount of docosanol (Abreva) in the mouth, but it's very unlikely that you'll experience any serious side effects. If you squeeze a larger amount of medication in the mouth by accident, wipe off the cream and then use water to rinse out your mouth. Talk with your provider if you notice sores inside your mouth and they can talk with you about more appropriate treatment options.
No, docosanol (Abreva) can only be used to treat a cold sore outbreak on the face or lips. The virus that causes genital herpes is different than the one that causes cold sores. If you have tingling or red, itchy bumps on other areas of your body, you should contact your healthcare provider.
Docosanol (Abreva) is the only OTC cold sore treatment approved to shorten healing time and duration of symptoms. There are some other treatments, like valacyclovir (Valtrex) or acyclovir (Zovirax), that can be helpful to treat and prevent cold sores, but they require a prescription. If you're looking for alternative treatments, speak with your healthcare provider.
Yes, you can apply makeup over docosanol (Abreva) but you should use a disposable applicator, like a cotton swab, if you're applying makeup to an active cold sore. This will help prevent the cold sore from spreading. Be sure to remove any makeup on the affected area before applying docosanol (Abreva).
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Risks and warnings for Docosanol (Abreva)
Docosanol (Abreva) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Allergic reaction
In some rare cases, docosanol (Abreva) can cause an allergic reaction. Stop using docosanol (Abreva) and contact your provider right away if your face swells or if you develop hives, wheezing or difficulty breathing, or a serious rash. These could be signs of an allergic reaction to the medication and you'll need another treatment for your cold sore(s).
Docosanol (Abreva) dosage
Typical dosage for Docosanol (Abreva)
- People ages 12 years and older: Apply to the affected area on the face or lips at the first sign of a cold sore 5 times daily until healed.
- Children under 12 years old: Check with your child’s provider.
Interactions between Docosanol (Abreva) and other drugs
Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. Tell your healthcare professional if you are taking any other prescription or nonprescription (over-the-counter [OTC]) medicine.
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