According to that study and another older study from 2007, the following essential oils show antiviral effects against the herpes virus:
The Best Cold Sore Medicines for Quick Treatment, According to Doctors
Jennifer Nied has written about health, fitness and wellness for over 10 years. She has a degree in magazine journalism from Northwestern University’s Medill School of Journalism.
Simone is the health editorial director for performance marketing at Verywell. She has over a decade of experience as a professional journalist covering mental health, chronic conditions, medicine, and science.
Leah Ansell, MD, is a board-certified dermatologist and an assistant professor of dermatology at Columbia University.
Cold sores are uncomfortable and, unfortunately, very common. “About 20 to 40 percent of the population will develop at least one lesion in their lifetime,” says Tsippora Shainhouse, MD, FAAD, board-certified dermatologist in Beverly Hills, California. Because active cold sores are highly contagious, using cold sore medicine is key.
Reviewed & Approved
Our top choice, Abreva’s 10% Docosanol Cream, treats cold sores and fever blisters in just two days. We also recommend Zilactin’s Cold Sore Medicated Gel for treating blisters.
We researched dozens of cold sore medicines and evaluated them for ingredients, price, application, and safety. We also consulted with experts, including Dr. Shainhouse.
What to Look for in a Cold Sore Medicine
Ingredients
Cold sore medications, both prescription and OTC, rely on a variety of different active ingredients to offer relief and healing, per Dr. Shainhouse. There are drying agents (Domeboro solution, calamine lotion, zinc oxide, witch hazel), which when dabbed on the sore help dry up the blister and its fluid. Topical steroids or anti-inflammatory cream, like hydrocortisone, can be applied a few times a day to reduce the pain, itch, redness, and inflammation. They provide comfort and can be used with anti-virals. Prescription topical anti-viral creams can reduce the severity and duration of a cold sore. The most effective are penciclovir and acyclovir and should be started ASAP at the first signs of a prodrome, per Dr. Shainhouse.
Another option is topical anesthetics, like prescription lidocaine or OTC benzocaine, which are available as mouthwashes, creams, and ointments. They can be applied to the sore up to three times a day as needed for local pain relief. Dr. Shainhouse recommends applying them before eating, especially if the sore is making it too painful to eat.
Form
Cold sore relief comes in many different forms. There are oral medications and topical options as well as devices and patches that block the virus causing the cold sores and treat symptoms.
Topical over-the-counter cream, such as Abreva, has not shown significant efficacy in medical studies, per Dr. Shainhouse. “One study suggests that it may reduce the total time of the cold sore episode by 18 hours.”
“Certain medications, such as Abreva, may also help cold sores heal faster if used as soon as you feel a cold sore developing. Abreva works by helping to prevent the herpes virus from spreading to healthy skin cells,” adds Jin Lin, DMD, pediatric dentist with Hurst Pediatric Dentistry.
Topical barrier gels and ointments help lessen discomfort while the sore heals. “They act as a barrier from outside irritants (food, drinks, talking) and may keep out bacteria, which can cause a secondary infection in the viral sore. Try Vaseline, Aquaphor, Chapstick (don’t double-dip or keep the stick/jar for cold sores only!). Topical hydropropyl cellulose adheres to the lesion to keep out irritants (Zilactin and Ziladent are both over the counter), per Dr. Shainhouse.
Frequently Asked Questions
Does cold sore medicine work for canker sores?
Cold sores and canker sores are two different things and so treatment is different for both. “Cold sores are blisters, caused by the herpes virus, that often form around the lips, although they can also form on the gums or the roof of the mouth. Once the blister pops, a scab forms,” explains Jin Lin, DMD, pediatric dentist with Hurst Pediatric Dentistry. “Canker sores, in contrast, are small ulcers that appear inside your mouth, often on the inside of your cheeks or lips,” he continues. “They typically have a white, yellow, or grayish center and a red border. The exact cause of canker sores is unknown, but common triggers include stress and trauma to soft tissues in the oral cavity—for example if you bite the inside of your cheek.” Most medications aimed at treating cold sores are antivirals in order to stop the herpes virus from replicating. This means they won’t work on canker sores, where there is no virus. In addition, says Chris Airey, MD, Medical Director at Optimale, “most cold sore medicine you can buy without a prescription is not meant to be ingested and is intended for topical use.” So you can’t apply them inside your mouth. One notable exception is Zilactin, which is safe for inside your mouth. Its active ingredient is benzyl alcohol, which helps numb the pain of canker sores and cold sores, though it doesn’t treat cold sores in the same way as Abreva.
Can you use cold sore medicine while pregnant?
It depends on the medicine, which is why it is best that a pregnant person runs all of their medications past their OB/GYN. However, “Abreva and Zovirax and Valtrex (two prescription cold sore options) are considered safe for pregnant patients,” says Todd Minars, MD, dermatologist with Minars Dermatology. “The FDA hasn’t specifically evaluated the products for use on pregnant patients [but] research has been done to suggest they’re more than likely safe.” In addition, he adds “once a parent passes their 36th week of pregnancy these antivirals carry less concern for the developing baby.”
How long does it take cold sore medicine to work?
“It depends on the patient, their cold sore history, and the medication,” says Dr. Minars. But in general, topical OTC creams should cause you to show improvement somewhere between 72 hours to four days later. Sometimes, though, it can take a week or more. But in general, your OTC medication should speed up recovery by two to three days. That said, according to Airey, “sometimes if medication is taken at the first signs of a cold sore, you can prevent a breakout entirely.” Plus, while the healing does take time, some topical treatments can reduce your pain within just a few minutes, making you feel better even if the cold sore hasn’t gone away.
How much does a cold sore medicine cost?
Most cold sore medicines are affordable, over-the-counter solutions that cost between $10 and $20. Our least expensive product was Lysine+ Lip Treatment at $12. We also considered non-OTC treatment, Virulite, including a reusable cold sore treatment device at $129.
Here are the best cold sore treatments on the market.
How to Get Rid of a Cold Sore as Fast as Possible
You may call them cold sores or fever blisters. Whichever name you prefer, these sores tend to develop on the lip or around the mouth.
They are caused by the herpes simplex virus — usually, type 1. Also known as HSV-1, the virus causes these blisters, or ulcers, which can be painful.
There’s nothing to be embarrassed about if you notice one near your mouth. Lots of people get cold sores. Chances are, you know someone who’s had one before, or maybe you’ve had one, too.
HSV-1 is the most commonly recurring viral infection. In fact, more than half of all Americans between ages 14 and 49 carry this virus.
Cold sores typically clear up within 10 days in people with healthy immune systems and no other underlying health conditions, like eczema.
Unfortunately, nothing can clear up a cold sore overnight — but some medications and treatments can shorten the life span of a cold sore and make you feel better, too.
One of the most important things to remember about treating a cold sore: Don’t wait. Start treating it right away, and you may be able to reduce the time you have it. When you notice that telltale tingle, go ahead and start applying a topical antiviral medication to the spot.
Where to start
Consider using an over-the-counter (OTC) antiviral ointment. You may have seen tubes of docosanol (Abreva) at your local drugstore. Many people start with this common OTC option and use it until their cold sores have healed.
With this product, healing times may be comparable to other treatments, according to research from 2001.
Prescription options
An OTC topical cream isn’t your only option. You can also try prescription antiviral medication. Talk with your doctor to see if one of these might be a good option for you:
- Acyclovir (Zovirax): available in oral form and as a topical cream
- Famciclovir: available as an oral medication
- Penciclovir (Denavir): available as a cream
- Valacyclovir (Valtrex): available as a tablet
Experts strongly suggest taking or using these medications as early as you can to speed up the healing cycle. When your cold sore begins to crust over and form a scab, you might also try applying a moisturizing cream.
You should note that while applying treatments may help quicken healing time, it may only be a slight increase.
A 2018 review found that acyclovir, penciclovir, or docosanol were only “marginally” more efficient at treating cold sores than a placebo, shortening participants’ pain duration by fewer than 24 hours.
If you’re interested in a complementary approach for healing a cold sore, you have several options to choose from.
However, you should know that there is insufficient data to support the routine use of these complementary therapies in treating cold sores. You should discuss them with your doctor before use, and they shouldn’t replace more conventional treatments.
Use caution when applying any new substances to your skin. Reactions like irritation and allergic contact dermatitis have been known to occur from some of these treatments.
For example, it’s well-known that propolis, which is mentioned below, can cause allergic contact dermatitis in some individuals. Before using this treatment, it may be best to discuss it with your dermatologist first.
You may also want to test it on a small area of skin, such as the inner forearm, to see how you react before applying it elsewhere. This is called a patch test.
Apple cider vinegar
Many people are interested in using apple cider vinegar as a treatment because of its proposed ability to fight off bacteria, viruses, and other germs, according to 2019 research .
However, full-strength apple cider vinegar is too intense to use directly on a cold sore and could seriously irritate your skin. Be sure to dilute it before using, and then apply only once or twice per day.
Essential oils
Studies have found that a variety of essential oils — which are concentrated oils containing plant compounds — have inhibitory effects against the herpes simplex virus that causes cold sores.
Although research is limited, a study from 2015 found that a variety of essential oils may slow down or prevent viral replication of the herpes virus, helping heal and prevent cold sores.
According to that study and another older study from 2007, the following essential oils show antiviral effects against the herpes virus:
- rosemary essential oil
- peppermint oil
- tea tree oil
- clove essential oil
- cinnamon essential oil
- basil essential oil
- ginger essential oil
- thyme essential oil
- hyssop essential oil
- sandalwood essential oil
- Zataria multiflora essential oil
- Eucalyptus caesia essential oil
- Artemisia kermanensis essential oil
Unfortunately, much of the research on essential oils and HSV-1 is outdated. A 2001 study found that tea tree oil displays some antiviral effects that could help fight off the herpes simplex virus, while another lab study from 2003 shows that peppermint oil is effective in fighting off both the HSV-1 and herpes simplex virus type 2 (HSV-2).
A 2007 study suggests that ginger, thyme, hyssop, and sandalwood essential oils could even be effective treatments for drug-resistant versions of the virus.
Notably, these studies have limitations, and evidence may be anecdotal. Both studies used herpes cells from monkeys, not humans. Plus, they were conducted in vitro, which means in a test tube or culture dish.
More research is needed to confirm the extent of these oil’s antiviral effects in humans.
As with apple cider vinegar, you’ll want to dilute any essential oils in a carrier oil before dabbing on your skin, and apply as soon as you feel the tingle of a developing cold sore.
While research suggests there are health benefits, the FDA doesn’t monitor or regulate the purity or quality of essential oils. It’s important to talk with a healthcare professional before you begin using essential oils and be sure to research the quality of a brand’s products. Always do a patch test before trying a new essential oil.
Kanuka honey
Honey already has a reputation for helping wounds and skin injuries heal, and a 2018 study found that kanuka honey, which comes from the manuka tree in New Zealand, could be useful for treating cold sores, too.
In fact, the large randomized clinical trial found that a medical-grade version of this honey seemed to be as effective at treating cold sores as acyclovir.
Propolis
Like honey, propolis is another bee product that holds some promise for healing wounds and skin lesions. The antiviral properties of propolis could make it a candidate for healing your cold sores a little more quickly, 2016 research suggests.
Lemon balm
The research is dated, but a 2008 study suggests that applying an extract of lemon balm, which is an herb from the mint family, has an inhibitory effect against the HSV virus that causes cold sores. The study’s authors suggest that lemon balm could be used to treat HSV, but note that more clinical trials are needed.
A 2020 case report found that applying a gel containing lemon balm as well as St. John’s Wort, lavender, licorice, and Siberian ginseng worked as an effective and rapid-acting alternative to OTC cold sore medications.
However, larger-scale studies are needed to determine the extent of this treatment’s therapeutic benefits.
Lemon balm is also available in capsule form and is used for a variety of other therapeutic purposes, according to a 2015 research review.
Lysine
Per a 2017 review , studies have shown that people taking lysine were less likely to experience recurrences of cold sores. However, these studies have limits, and some of the evidence is contradictory.
For example, no optimal dose or even particular type of preparation of lysine was recommended. However, doses greater than 3 grams per day appear to improve the patient’s “subjective experience” of the disease.
Also, research from 2015 suggests that using lysine won’t prevent the occurrence of a cold sore, but it doesn’t hurt to try.
This essential amino acid is available as an oral supplement or a cream.
It’s important to know that OTC oral supplements, including lysine, are poorly regulated by the FDA. Before taking any oral supplement, you should first discuss it with a healthcare professional. Some supplements can be contaminated with active pharmaceuticals that may be harmful to you, 2018 research shows.
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