A Guide to Cold Sore Medicines (Prescription and OTC)
Key takeaways:
Most cold sores go away within about 10 days. But if you find cold sores to be bothersome or painful, you may consider medication to help them go away faster and lessen your symptoms.
Cold sore medicines like docosanol (Abreva) can be purchased over the counter at your local pharmacy or retailer. Medications like valacyclovir (Valtrex) require a prescription from your healthcare provider.
The earlier you begin treatment for a cold sore, the more effective the treatment will be. Your healthcare provider can tell you which medication would be best for your situation.
There are various ways to save on cold sore medicines. Many options are available as lower-cost generics, and GoodRx can help make your prescription more affordable.
Table of contents
Cold sores — also called fever blisters — are caused by a germ called herpes simplex virus type 1 (HSV-1). Over half of people in the U.S., ages 14 to 49, carry this virus in their bodies, but it doesn't always appear as a cold sore. Yet, when sores do develop, you’re probably well aware of how irritating and painful they can be.
There’s no cure for cold sores, and they often heal on their own within about 10 days. But, in some cases, a cold sore can last longer or cause unruly pain. When this happens, you may consider looking for a treatment that can improve your symptoms. But what medications can you choose from? And is one option better than the rest?
Cold sore symptoms
Painful mouth sores are the most common cold sore symptom. Other possible cold sore symptoms include:
Sore throat
Swollen lymph nodes
Headache
Body pain
Fever
Nausea
Cold sore symptoms such as these range in severity and vary based on how long the virus has been in your body. People experiencing a cold sore for the first time will likely experience more severe symptoms than people who have had them in the past. Many people find that cold sore symptoms become less severe after the first outbreak.
Cold sore treatment options
A number of creams, ointments, and oral medications are available to treat cold sores. They have been shown to help reduce the symptoms and recovery time of cold sores when used as directed.
Although some medications require a prescription from your healthcare provider, many are available over the counter (OTC) for symptomatic relief.
OTC cold sore medicines
When a cold sore strikes, it’s normal to want fast-acting relief. Thankfully, there are several OTC treatment options available at pharmacies, grocers, and big box retailers.
Docosanol (Abreva) cream works by slowing down HSV-1, minimizing the severity and duration of the cold sore.
L-lysine ointment can help reduce cold sore symptoms within 4 days.
Campho-Phenique (camphor and phenol) helps alleviate cold sore symptoms. It can also dry out the blister to promote healing.
Benzocaine (Orajel) and benzyl alcohol (Zilactin) can provide fast-acting pain relief when applied directly to a cold sore.
Zinc oxide and glycine cream has been shown to improve recovery time from a cold sore.
Herpecin L (dimethicone / meradimate / octinoxate / octisalate / oxybenzone) helps lessen irritation at the cold sore site by numbing and soothing the area.
Ask your local pharmacist if you need assistance finding one of these products. Many are readily available in stores. Others may need to be special ordered or purchased online.
Prescription cold sore medicines
In addition to OTC cold sore treatments, prescription medications are also available. Since a cold sore is caused by a virus, an antiviral can be prescribed when needed.
Prescription antiviral medications for cold sores include:
Valacyclovir (Valtrex) oral tablets
Acyclovir (Zovirax) topical cream or oral tablets
Penciclovir (Denavir) topical cream
Famciclovir oral tablets
In clinical studies, oral antiviral medications appear to decrease the duration of symptoms and accelerate healing time. The topical options may speed up recovery time too, but they’re less likely to provide pain control.
Choosing the right cold sore medication
The best cold sore medication depends on the person. Ask a healthcare provider if a prescription or OTC cold sore medicine is right for you. The dose and medication recommended for you will depend on your circumstances.
What’s more, treatment with a prescription medication — rather than an OTC medication — may be recommended if you have any of the following:
Eczema
Frequent cold sore outbreaks
Sores that spread to other areas of your body, especially near your eyes
Many painful sores
A weak immune system (or take a medication that weakens your immune system)
A cold sore outbreak lasting longer than 2 weeks
How fast do cold sore treatments start working?
It depends on the medication.
For example, on average, it takes about 5 days to heal a cold sore when zinc oxide and glycine cream is applied as soon as symptoms appear. It should be applied every 2 hours until symptom-free.
In general, prescription medications usually work a bit faster. Valacyclovir is one popular option that’s taken for one day at a time, and it can shorten cold sore episodes by at least 1 to 2 days. But this also can be difficult because the time it takes to schedule a visit with your healthcare provider may lower the chances of the medication working.
If you experience cold sores frequently, you may be able to learn over time when a cold sore is coming on. In this case, your healthcare provider may prescribe you a medication to have at home to use when needed for future cold sores.
How to prevent cold sores
Prevention strategies are the key to stopping pesky cold sores in their tracks. These are some recommended ways to help prevent cold sores:
Always use sunscreen or chapstick with SPF 30 or higher when spending time in the sun.
Avoid kissing and skin contact with people who have visible blisters. Cold sore blisters are the most contagious within the first 48 hours (2 days) of appearing.
Refrain from sharing items with people when cold sores are visible — especially food, drinks, and eating utensils.
If you’ve had cold sores before and feel one coming on, starting oral antiviral therapy early can prevent a cold sore from appearing on the skin. It can also accelerate healing time if it appears anyway. Treatment should begin as soon as you feel a familiar tingling or painful sensation around your mouth prior to the appearance of a visible sore.
If you experience frequent cold sore outbreaks, talk to your healthcare provider about preventative medication options. Oral antiviral medications, such as acyclovir, may be taken daily for cold sore prevention.
How to save on cold sore medicines
There are ways to save on your cold sore medicine. GoodRx can help you navigate your options, which may include GoodRx discounts and patient assistance programs. You can find cold sore medicine prices for as low as $13 with a free GoodRx discount.
The bottom line
Many cold sore medicines, such as docosanol (Abreva) and benzocaine (Orajel), are available over the counter. Other medications, such as valacyclovir and acyclovir, require a prescription from your healthcare provider. Your provider can tell you which medication may be the best choice for your situation. Specific medications aside, beginning treatment as early as possible is one of the most important factors for successful cold sore management.
Why trust our experts?
References
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