Creams and Ointments for Cold Sores

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Creams and Ointments for Cold Sores

Topic Overview

Topical products, such as creams or gels, are sometimes used to treat cold sores. Many are prescription medicines that may slightly shorten the duration of cold sores, usually by just 1 to 2 days.1, 2

Some experts find that even when non-prescription topical products are used frequently—every 2 hours while a person is awake—at the first sign of an outbreak, they may only speed recovery time by a few hours or a day.3

Prescription creams and ointments

Penciclovir cream (Denavir) is an antiviral cream that may reduce healing time by 1 to 2 days, especially if the cold sore was triggered by sunlight exposure. It also reduces the pain, itching, burning, and tenderness of cold sores.1, 2

Penciclovir cream may cause side effects such as mild pain or stinging when it is applied. It is possible, although rare, that the cream may also cause a skin rash or headache.

Acyclovir ointment or cream is used up to 6 times a day for 10 days.

Treatment with acyclovir ointment works best if it is used at the first sign of cold sore symptoms. Side effects of the ointment may include mild pain or stinging at the site where it is applied.

Acyclovir can be used to treat recurrent cold sores in people older than age 12. The cream can improve healing time by up to half a day. The cream may cause temporary skin irritation.

Non-prescription creams and ointments

Tetracaine cream (Viractin) and lidocaine are non-prescription topical anesthetics that can relieve the pain and itching of cold sores. These products are applied to cold sores up to 6 times a day for best results. Pain and itching are relieved usually within 2 to 3 days after a person first applies the product.

Docosanol 10% (Abreva) is a newer non-prescription cream that is safe and effective for treating cold sores. It works best when applied at the first signs of a cold sore outbreak. It can shorten healing time and the duration of symptoms.4

Dimethicone with sunscreen (Blistex) is a product that moisturizes your lips and protects them from the sun. This can help reduce the pain and itching of cold sores. It can also help prevent cold sores from returning, especially if they were triggered by sun exposure.

Cold sores usually heal on their own without prescription medicines or complementary therapies.

Related Information

References

Citations

  1. Worrall G (2009). Herpes labialis, search date February 2009. Online version of BMJ Clinical Evidence: http://www.clinicalevidence.com.
  2. Woo SB, Challacombe SJ (2007). Management of recurrent oral herpes simplex infections. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology, 103(Suppl 1): S12.e1–S12.e18.
  3. Habif TP (2004). Herpes simplex. In Clinical Dermatology: A Color Guide to Diagnosis and Therapy, 4th ed., pp. 381–387. Philadelphia: Mosby.
  4. Sacks SL, 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, 45(2): 222–230.

Credits

By Healthwise Staff
Primary Medical Reviewer Kathleen Romito, MD - Family Medicine
Specialist Medical Reviewer Alexander H. Murray, MD, FRCPC - Dermatology
Last Revised April 13, 2010

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