Healthy Living

What Are the Treatments for Cold Sores?

What Are the Treatments for Cold Sores?

Cold sores are inflamed fluid-filled blisters, which appear in clusters on and around the mouth or lips. They can be seen when a person has a weakened immune system during fever, cold, or any other disease. Usually, cold sores are not harmful and should heal on their own within two to four weeks after you get them.

The area where the cold sore is likely to appear itches at first, and then the blisters appear. If the blister breaks open, it can be a little painful until it is dried up. However, care should be taken not to touch the cold sore fluid and then touch other body parts or kiss another person, as the infection can spread.

Cold sores are usually selfheal within a period of 7 to 10 days but the treatment to be effective, they must be taken care when the initial sore arrears or when you feel the initial sensation of tingling around the mouth as after initial period the antiviral creams don’t tend to be that effective.

There are some medications that can help reduce the severity of the symptoms and their duration. Home remedies such as an ice pack or cold tea bags can give some pain relief. However, in order to speed up the healing process, antiviral medications such as acyclovir, valacyclovir, famciclovir, and penciclovir are prescribed.

These drugs can be taken orally or can be in the form of creams, which can be dabbed over the cold sores and not rubbed. Typically, pills work better than antiviral creams. There are also some antiviral drugs that can be administered through injections, which are given for people with a severe infection.

Antiviral Creams

Acyclovir, Abreva, and penciclovir are examples of antiviral creams that reduce the pain in the cold sore area, by making the area numb. Acyclovir and Abreva may be bought over-the-counter while penciclovir has to be prescribed by a physician. The purpose of these drugs is to prevent the virus from multiplying, not killing it. Acyclovir must be applied five times a day for five days while the application of penciclovir is done every two hours during the waking hours for four days. Repeated application of these creams can aid in a quicker recovery.

The creams only have a little effect to the existing blisters, but they can prevent them from getting worse. The creams also provide protection for cold sores that are caused or triggered by sunlight. To provide a better protection, the creams must be applied prior to sun exposure.

If these antiviral creams are used as soon as the symptoms start to appear, the cold sore could be less severe and will not last long. Antiviral creams do not usually remove the virus completely, so there are possibilities of cold sore reoccurrence in the same area.

Antiviral Tablets

  • Acyclovir - is available in both cream and tablet form.
  • Valaciclovir - is quite expensive when compared to acyclovir or famciclovir. However, it is absorbed quite quickly by our digestive system, which makes it much more effective.

Antiviral tablets are not usually used for the treatment of cold sores. The tablets are mainly prescribed for severe infections of cold sores in newborn babies and people who are immunocompromised. Usually, these tablets are effective when taken within the first 48 hours of a cold sore eruption.

The antiviral tablets can help prevent further attacks. They aim to stop the virus from multiplying and prevent the cold sores from becoming very severe. A severe herpes infection and other severe viral infections are extremely harmful to people who are immunocompromised.

Laser Treatment

Narrowband light therapy is a type of laser treatment that has been effective in treating cold sores for some people. The machine called Avert Electronic Cold Sore Machine delivers a narrowband light and can be bought in pharmacies. Narrowband light therapy is also called as a "photodynamic therapy."

Generally, cold sores are not that dangerous. Moreover, they do not cause any permanent damage to the skin. To prevent the development of a secondary infection as well as scarring, avoid breaking the blisters or picking the scab.

Cortisone Injection

If there is a need for you to quickly get rid of your cold sores, you can consult a doctor who might inject a diluted cortisone into the sores. A cortisone injection can considerably bring down the swelling and pain in your sores.

Cold Sore Patches

Cold sores take some time to heal and have to be prevented from dust and dirt accumulation. A medicinal cold sore patch, which has a healing gel called hydrocolloid, helps in treating cold sores and can be used to cover the sore.


There is no cure for cold sores. The virus stays deep in the nerve roots, which makes it difficult to completely wipe it out through the available antiviral medications. The virus continues to live and hide in the nerve roots even after treatment. Thus, many people will continue to have cold sore outbreaks throughout their lives. Moreover, if people have cancer or AIDS, which can suppress their immune system, the appearance of cold sores might be regular and more severe in nature.

The herpes simplex virus can be spread to other parts of the body. This is called as autoinoculation. It commonly occurs during the time of the primary infection. To prevent the spread of the virus to another area, it is very important to wash your hands every time you touch the sore. Do not apply any makeup or powder on the cold sore, as the blisters might increase if your allergic to makeup. 

One should also be careful not to touch the eye area after touching a cold sore. Doing so can cause swelling in the eye or even develop a secondary eye infection called as "herpetic keratoconjunctivitis."

Children might especially face the problem of swollen gums, which can be painful while brushing and eating. In order to avoid the spread of the infection, consult a doctor immediately, who may prescribe medications or an oral mouthwash.

Genital and ocular herpes may also develop as complications. Ocular herpes is a more serious complication as it causes pain around the eye. If left untreated, it can lead to eye damage or blindness. On the other hand, genital herpes may auto-inoculate in the genital area, but most cases are acquired through sexual intercourse.

Side effects

Some of the medication used to treat cold sores can cause certain side effects, here’s a list of some of the common side effects which you may experience when taking medication, especially antivirals to treat your cold sores. It should also be noted that pregnant women can also develop cold sores but need to treat the same, post consultations with their respective doctors.

Some of the most common side effects when treating cold sores with antiviral medications are as follows –

  • Nausea – Some patients are more sensitive to medications such as acyclovir, which is an antiviral that’s used to alleviate some of the painful cold sore symptoms.  As a result of this heightened sensitivity, patients are known to experience mild to severer cases of nausea on orally ingesting this medication.
  • Diarrhea – A few others are known to develop gastro-intestinal distress on ingesting acyclovir, on account of being sensitive to the drug. Should you experience similar side effects on ingesting acyclovir, you need to consult your physician right away, to seek immediate relief and prevent further dehydration which would only serve to exacerbate the cold sores.
  • Headaches – Some patients are known to develop persistent headaches on ingesting acyclovir. And if you suffer from the same and if the headache does not go away despite taking medication to alleviate the same, you may want to consult your physician and get him to prescribe an alternative to acyclovir.
  • Itching – Famiclovir is also one of the antivirals that are often prescribed to treat cold sores and it is generally ingested orally, in the form of tablets. Patients sensitive to this particular drug can develop itching sensation in various parts of the body due to their increased sensitivity to the drug in question. If you continue to suffer from this particular side effect on orally ingesting the tablets then you need to consult your physician right away, before the condition gets worse.
  • Fever – Famiclovir is also known to cause fever as one of its side effects especially in patients who are sensitive to this particular drug. Furthermore, if the fever persists, you may want to opt for alternative medicines and therapies to treat those cold sores.
  • Fatigue – Famiclovir is also known to increase lethargy and cause chronic fatigue in patients who are sensitive to this particular antiviral. Consult your doctor , and seek alternative medication and treatment for those cold sores.
  • Famiclovir, headaches – This drug is also known to cause patients to suffer from prolonged headaches, as a result of their sensitivity to the drug in question. And if this side effect continues to persist despite taking medications to alleviate the headaches, then you need to consult your doctor and come up with better alternative to help treat those cold sores
  • Famiclovir, nausea – Famiclovir is also known to cause patients to experience sudden onset of nausea on orally ingesting the tablets. It is advisable to consult a physician if these side effects continue to persist after a while. Moreover, persistent nausea can indicate heightened sensitivity to the drug in question so you may want to consult your physician for alternative medications to help treat those cold sores.
  • Valacyclovir, skin rash – This drug is available only through prescription and cannot be obtained over the counter, at a local pharmacist without one. Valacyclovir is often prescribed to treat cold sores as it is easily absorbed by the body but it comes with its own side effects. It is known to cause you to develop sudden skin rash all over your body on orally ingesting the valacyclovir tablets.
  • Valacyclovir, allergic reactions – This particular drug is also known to cause patients to develop mild to severe allergic reactions from skin rash to tongue, lips and even parts of the face to swell up on ingesting the tablets. It is advisable that you seek immediate medical consultation with your physician and opt for alternative medications. Do note that some of the allergic reactions could also be on account of the antiviral reacting with some of the other medication you could be ingesting at the moment. So inform your doctor regarding your allergy, whether you are taking in other medications and whether you are seeking treatment for other health conditions as it can impact your current treatment for cold sores.
  • Valacyclovir, dizziness – Valacyclovir is known to cause dizziness in a few patients on ingesting the antiviral. Since the drug is easily absorbed by the body, the onset of the side effects can be almost instantaneous. It is highly recommended that you discontinue the drug if the side effects continue to persist and seek alternative medicines to help treat your cold sores.
  • Valacyclovir, Insomnia – This antiviral is known to cause a few patients to experience insomnia; the severity of the side effect can vary, depending on your sensitivity to the drug in question.  If these side effects do not subside immediately, kindly consult your physician for alternative treatments for those cold sores.
  • Valacyclovir, fatigue – This drug is also known to cause patients to experience prolonged bursts of lethargy coupled with fatigue. The severity of these side effects can vary from one person to another and depends more on their sensitivity to the drug. You may want to inform your doctor regarding this side effect and take some corrective measures such as opting for alternative forms of medication and treatment for those cold sores.

There are cases of dehydration also as it is difficult to intake fluids, Cold sores are usually mild but It should also be pointed out that patients with suppressed immune system as is the case with HIV patients, pregnant women, patients in post-operative care and young children are advised to consult their physicians and specialists for treating these cold sores, since the medication prescribed can vary.