How to Get Rid of a Cold Sore
Medically reviewed by Mary Choy, PharmD
Cold sores (fever blisters) can be a painful nuisance that often potentiates stress and embarrassment in daily life. And without treatment, cold sores can take up to 10 days to disappear.
To make matters worse, there is no permanent cure for the herpes virus (the virus that causes cold sores). Instead, the available treatment options can help to heal cold sores faster and ease symptoms.
Fortunately, various treatment choices are available in the United States to help manage cold sores. Options include natural remedies, over-the-counter (OTC) medicines, and prescription drugs.
Additionally, antiviral medications can be prescribed to treat new or recurrent episodes and work to shorten the duration of symptoms.
Read on to learn more about how to treat cold sores, including what you should and shouldn’t do to eliminate them.
What Are Cold Sores?
Cold sores, also known as oral herpes, are a common condition caused by a viral infection. Cold sores appear as fluid-filled blisters around your mouth, often grouped in patches.
After some time, these blisters break, forming scabs that can last for several days to weeks. While most cold sores heal after a few weeks, some can leave scars.
Cold sores are caused by herpes simplex virus (HSV). There are two types of HSV: type 1 (HSV-1) and type 2 (HSV-2).
Type 1 is transmitted by oral contact and mainly causes oral herpes, while type 2 primarily spreads by sexual contact and causes genital herpes.
HSV-1 is the most common cause of cold sores in and around the mouth, but HSV-2 can also cause them.
Cold sores are highly contagious. They are transmitted by person-to-person contact through kissing, intimacy, and oral sex. To prevent transmission, avoid these activities when a cold sore is on you or your partner.
How to Treat Cold Sores
Cold sores are very common. The World Health Organization estimates 3.7 billion people under age 50 have global cold sores caused by HSV-1.
And within the United States, nearly 50% of people under 50 had HSV-1 in 2018, according to the Centers for Disease Control and Prevention (CDC).
As a result, there are many approaches to treating cold sores, from prescription to OTC medications and home remedies.
If you’re experiencing a cold sore for the first time, or if your cold sores seem to worsen with treatment, you should consult a healthcare provider to determine the best treatment plan.
Home Remedies
Home remedies can help relieve discomfort associated with cold sores.
Some examples of home remedies include using protective lip balms, applying warm compresses, and icing the area.
Lip balms can alleviate cold sore symptoms by creating a physical barrier over the sore to protect and moisturize the area, which helps prevent bleeding and cracking.
Warm compresses or ice packs can also help relieve pain associated with cold sores. Applying compresses will not shorten the cold sore outbreak but can soothe the affected area and draw your focus away from the painful sensation.
Cold sore breakouts are linked to stress. Cold sores may recur when the body goes through stressful situations such as surgery, illness, stress, or hormone fluctuations.
Managing stress at home with healthy coping techniques can reduce the reactivation of the herpes virus and the recurrence of cold sore outbreaks.
Alternative Therapies
Alternative therapies, also known as natural remedies, can help to reduce the painful symptoms of cold sores, but they may not work for everyone.
Alternative remedies for treating cold sores include aloe vera, tea tree and peppermint oils, and lysine.
Aloe vera may help reduce the burning sensation caused by cold sores. Another study suggests aloe vera has antiviral effects by blocking viruses from binding to cells and replicating. While widely used, limited research supports aloe vera for cold sores.
Tea tree oil is believed to have an antiviral effect on HSV. It also has antiseptic and anti-inflammatory effects.
Peppermint oil can alleviate the painful symptoms of cold sores by providing a numbing sensation on the lips. A past study showed that painful symptoms were reduced when people with HSV used peppermint oil.
Lysine, an essential amino acid, may help slow the growth of cold sores.
Pharmaceutical Options
Pharmaceutical treatments are available OTC and by prescription (Rx). Rx treatments require a consultation with a healthcare provider.
OTC options include:
Pain relievers: Pain relief medications, such as Acephen (acetaminophen), Advil (ibuprofen), and naproxen, are oral medications that relieve pain associated with cold sores.
Numbing agents: Numbing agents, also called topical anesthetics, numb the pain when applied topically to the cold sore. Products include the active ingredients benzocaine or lidocaine.
Abreva (docosanol): Another topical OTC option is Abreva. You apply it directly to the cold sore at the first outbreak symptom, such as tingling. Abreva has been proven to shorten the healing time for cold sores and reduce pain, itching, and burning symptoms. Its active ingredient—docosanol—is the only non-prescription drug US Food and Drug Administration (FDA)-approved to speed healing and treat cold sore symptoms. Abreva is approved for adults and children 12 and older.
Rx options include:
Oral antivirals: Healthcare providers commonly prescribe antiviral tablets or capsules that you swallow to treat cold sores. Examples include Sitavig (acyclovir), famciclovir, and Valtrex (valacyclovir). These medications are most effective when you start them within 48 hours after symptoms begin.
Topical antivirals: Topical antiviral medications, such as creams and ointments, are available by prescription to treat cold sores. You apply it externally, directly to the cold sore. One example is Zovirax (acyclovir) cream, which is approved to treat recurrent herpes in people ages 12 and older. However, a downside of topical antivirals is the frequent dosing; acyclovir cream typically requires five applications daily for four days.
Keep in mind that Rx antiviral drugs do not cure a viral infection. Even after the cold sore heals, the virus will remain in your body and can get reactivated in the future.
Also, antiviral medications do not prevent you from being contagious. When cold sores are present, you can still transmit HSV to others during antiviral treatment.
How Not to Treat a Cold Sore
Some of the following tips might seem like common sense, but it’s worth noting what not to do when you have a cold sore.
These tips can heal your cold sore more quickly:
Avoid picking at the cold sore, especially when scabs form. This can lead to further irritation and delay the healing process.
Avoid touching the cold sore. When you feel it, you could introduce germs, worsening your infection. Keep your hands away from your mouth, and ensure they are clean by washing them often before touching the area to prevent further disease.
Skip acidic foods like citrus fruits, tomatoes, alcohol, and coffee. Contact with acidic substances can further irritate your mouth and lips.
Preventing Cold Sores
Fortunately, there are steps you can take to prevent future cold sores.
Best practices include:
Wear lip balm with a high sun protection factor (SPF): Sunburns can trigger a stress response in the body, leading to the reactivation of the HSV virus that causes cold sores.
Take care of yourself: Stress and illness can activate cold sores. Take steps to manage your physical and mental health proactively. Examples include getting enough rest, eating a balanced diet, and prioritizing healthy activities that you enjoy.
Avoid intimacy with someone with a cold sore: This is how cold sores are transmitted, so avoiding intimate contact helps control the spread of HSV.
Be aware of your genetic disposition: Some research suggests that some people may be more prone to developing cold sores due to genetic differences and their effect on the immune system. Environmental triggers like stress, illness, and sun exposure also play a role in cold sore susceptibility.
When to Seek Professional Help
See a healthcare provider if your cold sore worsens or becomes more painful, spreads further, or does not clear up within two weeks.
You should also consult a healthcare provider if you have eczema and get a cold sore. If an HSV infection spreads to the open skin of eczema patches, an eczema herpeticum can occur.
Early treatment with antiviral medications can prevent this infection from worsening, so seeking medical care is essential.
Because of their less-developed immune systems, children and infants with eczema are particularly susceptible to this infection.
Summary
Cold sores are a common symptom of the HSV-1 virus. It is transmitted through oral contact or kissing.
While cold sores can be uncomfortable, there are measures you can take to ease the pain and get rid of them faster.
OTC and prescription medications are available to treat cold sores. Some people find relief with home remedies, alternative therapies, or a combination of approaches.
Correction - September 8, 2023: This article was updated to include lysine as an alternative therapy.
Read the original article on Verywell Health.
