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.
Lessen healing time and symptoms (tingling, pain, burning, itching) of cold sores
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.
Source:Â DailyMed
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.
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
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
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.
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.
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).
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.
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.
Lessen healing time and symptoms (tingling, pain, burning, itching) of cold sores
Chickenpox (varicella) in children ages 2 to 17 years old
Cold sores in people age 12 years and older
Genital herpes in adults
Shingles (herpes zoster) in adults
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Haleon US Holdings LLC. (2023). Abreva- docosanol cream [package insert]. DailyMed.
Katz, D.H., et al. (1991). Antiviral activity of 1-docosanol, an inhibitor of lipid-enveloped viruses including herpes simplex. Proceedings of the National Academy of Sciences of the United States of America.
Ludmann, P. (n.d.). Cold sores: Diagnosis and treatment. American Academy of Dermatology Association.
Pham, P. (2001). Docosanol (Abreva®). Infectious Diseases in Clinical Practice.
Sacks, S. L., et al. (2001). Clinical efficacy of topical docosanol 10% cream for herpes simplex labialis: A multicenter, randomized, placebo-controlled trial. Journal of the American Academy of Dermatology.
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