Medications for Cold Sores (Herpes Simplex Type 1)

Common names include:

• Acyclovir
• Famciclovir
• Penciclovir
• Valacyclovir

Antivirals slow the growth and spread of the virus. It helps the body fight the virus more effectively. Antivirals work best if started before the sores breaks out. The first sign that a breakout is coming may be a tingling or burning sensation in the skin.

Oral antivirals include acylovir, valacyclovir, and famciclovir. They are used to shorten the length of the outbreak. Acyclovir may be given for the first or later outbreak of cold sores.

Topical prescription antivirals include acyclovir cream, and penciclovir cream. These creams help reduce the discomfort and may slightly shorten the length of an outbreak. The cream is applied to the area as soon as the first sign of an outbreak appears. It is used only on the face and lips—not the inside of the mouth and nose or around the eyes.

Side effects are rare, but may include:

• Allergic reaction, which may include rash, swelling of the face, or difficulty breathing
• Upset stomach, decreased appetite
• Headache
• Local numbness or tingling in area of application

Common names include:

• Docosanol

Docosanol is an ointment that helps reduce the discomfort and length of an outbreak. It is similar in its action to the prescription antiviral cream, but it is sold over-the-counter. The cream is applied to the area as soon as the first sign of an outbreak appears. It is used only on the face and lips—not the inside of the mouth and nose or around the eyes.

Possible side effects include:

• Headaches
• Allergic reaction, which may include rash, swelling of the face, or difficulty breathing

Common names include:

• Acetaminophen
• Ibuprofen

Pain relievers will help relieve the pain that accompanies a cold sore outbreak. They are taken on an as-needed basis. The dose depends on the amount of pain you are having. For severe pain and inflammation, ibuprofen is available in higher doses by prescription. Ibuprofen should be taken with food or a full glass of water.

Possible side effects include:

• Headache
• Upset stomach

There are many cold sore creams and ointments available at drug stores that can help protect the lips and reduce the discomfort of a cold sore outbreak. These medications usually contain sunscreen and medicine to help relieve pain.

Common brand names include:

• Neosporin
• Polysporin

Antibiotic ointments contain one or a combination of antibiotics that are sometimes effective in fighting bacterial skin infections. Cold sores are caused by a virus, not bacteria, but these ointments may be used to help treat a secondary bacterial infection. They are applied directly to the cold sore. They should not be used inside the mouth or too near the eyes. Use only as directed. Possible side effects include skin irritation or allergy.

Common names include:

• Benzocaine

Anesthetic ointments work by numbing the area of the cold sore. This helps relieve the pain. Dry the area well before applying the ointment, and apply no more than 4 times per day. Side effects rarely occur.