Zovirax vs. Abreva for Cold Sores: Important Differences and Potential Risks.

Key takeaways

Acyclovir (Zovirax) and docosanol (Abreva) are both antiviral medications used to treat cold sores, but they have some key differences. Acyclovir (Zovirax) is available in various forms, including oral pills, buccal tablets, and topical creams or ointments, and it requires a prescription. It treats a range of herpes virus infections, including genital herpes, shingles, and chickenpox. In contrast, docosanol (Abreva) is an over-the-counter cream specifically for cold sores on the face or lips. Acyclovir works by stopping the virus from making copies of itself, while docosanol prevents the virus from entering healthy cells. Acyclovir needs to be taken or applied multiple times a day, depending on the form, whereas docosanol is applied five times a day. Acyclovir can cause side effects like nausea and diarrhea, while docosanol's side effects are usually mild, such as stinging at the application site.

Acyclovir

(Zovirax)

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Docosanol

(Abreva)

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Summary for Zovirax

Prescription only

Acyclovir (Zovirax) is an antiviral topical medication used to treat certain infections caused by the herpes virus, including cold sores on the lips and face, as well as genital herpes. It's FDA approved as a cream for people 12 years and older and as an ointment for adults. You typically apply it 5 to 6 times daily to the affected area. Common side effects include mild skin irritation, burning, or itching at the application site.

Indications for Zovirax

Genital herpes in adults - ointment only
Herpes infections in adults with a weakened immune system) - ointment only
Cold sores that keep coming back in people 12 years and older - cream only

Pros and Cons for Zovirax

Pros

Not many interactions with other medications
Applied directly to the affected area
Typically only used for 4 to 7 days

Cons

Must be applied multiple times daily
Can cause burning and stinging at the application site
Ointment not FDA approved for children

Common Side Effects for Zovirax

Ointment:

Burning and stinging at application site (30%)

Cream:

Application site reaction (5%)

Warnings for Zovirax

For use on the skin only
Skin irritation

Summary for Abreva

Over-the-counter

Docosanol (Abreva) is an antiviral cream used to treat cold sores (also known as fever blisters) on your lips or face. It works best when you start using it as soon as you notice symptoms. You apply it to the affected area 5 times a day until the cold sore heals. It's available over the counter (OTC) for people 12 years and older. Most people don't have many side effects from this cold sore treatment, but it might cause some mild stinging where you apply it.