Most cold sores will clear up on their own after 7-10 days. Most
treatment options are focused on reducing the discomfort and pain
associated with cold sores and reducing the length of the outbreak.
Some treatment options may even help prevent cold sore blisters from
forming.
This is non-prescription medication available at your local drug store. Abreva has been clinically proven to reduce both the symptoms (including pain and itching) and the length of the cold sore outbreak. Abreva is most effective is used at the first sign or symptom of a cold sore (prodromal stage). Abreva is applied five times a day from the time of the initial symptoms for up to 10 days.
Skin Protectants and Analgesics
Denavir® is a non-greasy cream that works by penetrating the area to block the virus that causes cold sores. It is first topical anti-viral approved in Canada with the indication for cold sores. Denavir® has been found to be most effective when applied during the early signs of a cold sore although it can also be useful in later stages. It helps cold sores heal on average in four and a half days.
Acyclovir Cream/Ointment (Zovirax)
Zovirax has been shown to help reduce cold sore intensity and symptoms (including pain). Zovirax is most effective if used at the first sign or symptom of a cold sore (prodromal stage). Zovirax is applied 4-6 times a day for 10 days
Acylcovir (Zovirax)
Reduces pain and healing time to scab or crust formation but does not appear to affect or reduce progression, size or healing time of the cold sore. Zovirax oral is most effective if used at the first sign or symptom of a cold sore (prodromal stage). Zovirax oral dosing is 200mg five times a day for 5 days.
Famciclovir (Famvir)
Reduces the duration, healing time and pain of a cold sore. Currently this drug is only indicated for treatment of recurrent episodes of HSV infections in HIV-infected patients although new indications for the treatment and prevention of cold sores are being explored. Currently, dosing is 500mg twice daily for 7 days.
Valacyclovir (Valtrex)
Reduces duration, healing time and pain of a cold sore. Valtrex may help prevent cold sore outbreak if taken during prodromal stage. Most effective if used at the first sign or symptom of a cold sore (prodromal stage). Valtrex dosing is 2 grams every 12 hours for two doses.
Non-Prescription Treatments
Topical
- Skin protectants
- Analgesics/anaesthetics
- Abreva (docosanol)
- Lipactin (zinc, heparin)
Oral
- Analgesics
This is non-prescription medication available at your local drug store. Abreva has been clinically proven to reduce both the symptoms (including pain and itching) and the length of the cold sore outbreak. Abreva is most effective is used at the first sign or symptom of a cold sore (prodromal stage). Abreva is applied five times a day from the time of the initial symptoms for up to 10 days.
Skin Protectants and Analgesics
- Skin protectants and lip moisturizers with allantoin, dimethicone, cocoa butter, white petrolatum or glycerin provide moisturization to keep the cold sore moist as well as a mechanical barrier to guard the skin and lips from irritants
- Topical analgesics/anaesthetics including benzocaine, lidocaine, benzyl alcohol, camphor, menthol and phenol help provide local pain control and may help reduce the itching.
- Oral analgesics such as ibuprofen and acetominophen also provide temporary relief from the pain
Other Products
Other non-prescription products containing zinc and heparin
(Lipactin, topical gel) are also available. This product may help
shorten the duration of the cold sore if used early during the outbreak,
applied 3-6 times a day for up to 14 days
Prescription Treatments
Topical
- Denavir® (penciclovir cream)
- Zovirax (acyclovir)
Denavir® is a non-greasy cream that works by penetrating the area to block the virus that causes cold sores. It is first topical anti-viral approved in Canada with the indication for cold sores. Denavir® has been found to be most effective when applied during the early signs of a cold sore although it can also be useful in later stages. It helps cold sores heal on average in four and a half days.
Acyclovir Cream/Ointment (Zovirax)
Zovirax has been shown to help reduce cold sore intensity and symptoms (including pain). Zovirax is most effective if used at the first sign or symptom of a cold sore (prodromal stage). Zovirax is applied 4-6 times a day for 10 days
Oral
- Famvir (famciclovir)
- Valtrex (valacyclovir)
- Zovirax (acyclovir)
Acylcovir (Zovirax)
Reduces pain and healing time to scab or crust formation but does not appear to affect or reduce progression, size or healing time of the cold sore. Zovirax oral is most effective if used at the first sign or symptom of a cold sore (prodromal stage). Zovirax oral dosing is 200mg five times a day for 5 days.
Famciclovir (Famvir)
Reduces the duration, healing time and pain of a cold sore. Currently this drug is only indicated for treatment of recurrent episodes of HSV infections in HIV-infected patients although new indications for the treatment and prevention of cold sores are being explored. Currently, dosing is 500mg twice daily for 7 days.
Valacyclovir (Valtrex)
Reduces duration, healing time and pain of a cold sore. Valtrex may help prevent cold sore outbreak if taken during prodromal stage. Most effective if used at the first sign or symptom of a cold sore (prodromal stage). Valtrex dosing is 2 grams every 12 hours for two doses.
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