Key takeaways:
Most cold sores go away on their own 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/or lessen your symptoms.
You can purchase some cold sore medicines, such as docosanol (Abreva), over the counter at your local pharmacy or retailer. Other medications, such as valacyclovir (Valtrex), require a prescription from a healthcare professional.
The earlier you begin treatment for a cold sore, the more effective the treatment will be. Your healthcare professional can tell you which medication would be best for your situation.
There are ways to save on cold sore medicines. Many options are available as lower-cost generics, and GoodRx can help make your prescription more affordable.
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Cold sores (fever blisters) are caused by the herpes simplex virus type 1 (HSV-1), which is surprisingly common. Some estimates suggest that over half of people in the U.S. between the ages of 14 and 49 carry this virus, although it doesn't always lead to visible sores. When cold sores do appear, they can be painful, frustrating, and show up at inconvenient times.
Along with painful blisters, cold sore symptoms may include a sore throat, swollen lymph nodes, and headaches. Some people also complain of body aches, fever, and nausea. These symptoms typically become less severe after the first few cold sores you experience, but they’re still a hassle to deal with.
There’s no cure for cold sores. And they usually heal on their own within about 10 days. But if the sores become particularly painful or long lasting, it’s understandable to want something that can ease the discomfort and help them heal faster.
Here, we’ll provide an overview of cold sore medicines and how to choose the right one for you.
Cold sore medicines: OTC and prescription options
Several 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 a healthcare professional, many are available over the counter (OTC).
OTC cold sore medicines
When a cold sore strikes, it’s normal to want fast-acting relief. You can find these OTC treatment options at several pharmacies, grocers, and big box retailers.
Topical antiviral: Docosanol (Abreva) cream works by slowing down HSV-1, minimizing the severity and duration of a cold sore.
Pain relievers: Benzocaine (Orajel) and benzyl alcohol (Zilactin) can provide fast-acting pain relief when applied directly to a cold sore.
Soothing agent: Herpecin L (dimethicone / meradimate / octinoxate / octisalate / oxybenzone) helps lessen irritation at the cold sore site by numbing and soothing the area.
Astringents: Campho-Phenique (camphor and phenol) helps alleviate cold sore symptoms. It can also dry out a blister to promote healing.
Skin protectants: Zinc oxide and glycine cream has been shown to improve recovery time from a cold sore.
Supplements: Lysine ointment could help reduce cold sore symptoms, but the evidence that it works isn’t totally clear. Oral lysine supplements are also available.
Talk to your pharmacist if you need assistance finding one of these products or narrowing down which one(s) to try. 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, Sitavig) topical cream, oral tablets, or buccal tablets
Acyclovir / hydrocortisone (Xerese) cream
Penciclovir (Denavir) topical cream
Famciclovir oral tablets
What does a cold sore feel like? Read these firsthand accounts to better understand cold sore symptoms.
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Comparing popular cold sore treatments: Pharmacists describe the key differences between lysine and Abreva (docosanol), including how they work and when to apply them.
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 relief.
Don’t worry about navigating these medications on your own. It’ll ultimately be your prescriber’s job to recommend the best prescription cold sore medicine for your symptoms and situation.
How fast do cold sore treatments start working?
It depends on the medication. And the timeframe isn’t set in stone, either.
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Prescription antivirals, such as valacyclovir, can help shorten cold sore outbreaks by at least 1 to 2 days when started at the very first sign of symptoms. However, because these require a clinic visit, delays in obtaining a prescription can make them less effective. If you already have a prescription and can start treatment right away, they’re typically faster than OTC options.
By comparison, OTC medications like docosanol are easier to access. They can also work quickly when started early. For example, some data suggests that applying docosanol 5 times a day as soon as symptoms appear may help heal a cold sore in about 4 days (about 18 hours faster than a placebo cream). This makes it one of the fastest OTC cold sore treatments available. Another OTC option is zinc oxide and glycine cream, which takes about 5 days on average to treat a cold sore (about 1.5 days faster than no treatment).
Choosing the right cold sore cold sore medicine
The best cold sore medication depends on the person. Ask a healthcare professional 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 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 (even during the colder months of the year).
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 accelerate healing time and help reduce pain. 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 a healthcare professional 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 cold sore medicines. GoodRx can help you navigate your options, which may include GoodRx discounts, manufacturer copay cards, and patient assistance programs. You can find cold sore medicine prices for as low as $11 with a free GoodRx discount.
Frequently asked questions
Cold sores usually heal on their own in about 10 days. But starting treatment early — ideally at the first sign of tingling or itching — can help them go away a little faster. Try applying an OTC antiviral cream, such as docosanol, as soon as symptoms start and reapply it as directed. You can also use cold compresses and pain relievers like ibuprofen (Advil, Motrin) or acetaminophen (Tylenol) to reduce discomfort. Protecting your lips from the sun may also help.
Abreva, or docosanol, works best if you start using it right when you feel the first sign of a cold sore — such as tingling, burning, or itching. Once the cold sore turns into a blister or scab, docosanol becomes less effective. You can keep applying it 5 times a day for up to 10 days, but the earlier you start, the better your results may be. If your cold sore isn’t improving after 10 days, check in with a healthcare professional.
There’s no clear-cut answer. But most experts recommend keeping a cold sore slightly moist with something like petroleum jelly. This helps prevent cracking, bleeding, and pain. Letting it dry out completely can make it more uncomfortable and may slow healing, while keeping it too wet isn’t ideal either.
Cold sores usually heal on their own in about 10 days. But starting treatment early — ideally at the first sign of tingling or itching — can help them go away a little faster. Try applying an OTC antiviral cream, such as docosanol, as soon as symptoms start and reapply it as directed. You can also use cold compresses and pain relievers like ibuprofen (Advil, Motrin) or acetaminophen (Tylenol) to reduce discomfort. Protecting your lips from the sun may also help.
Abreva, or docosanol, works best if you start using it right when you feel the first sign of a cold sore — such as tingling, burning, or itching. Once the cold sore turns into a blister or scab, docosanol becomes less effective. You can keep applying it 5 times a day for up to 10 days, but the earlier you start, the better your results may be. If your cold sore isn’t improving after 10 days, check in with a healthcare professional.
There’s no clear-cut answer. But most experts recommend keeping a cold sore slightly moist with something like petroleum jelly. This helps prevent cracking, bleeding, and pain. Letting it dry out completely can make it more uncomfortable and may slow healing, while keeping it too wet isn’t ideal either.
The bottom line
Many cold sore medicines, such as docosanol (Abreva) and benzocaine (Orajel), are available over the counter. Other medications, such as valacyclovir (Valtrex) and acyclovir (Zovirax, Sitavig), require a prescription from a healthcare professional. There isn’t one best cold sore medicine overall, so your pharmacist or prescriber 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.
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