What is the Best Cold Sore Treatment?

Tricia Christensen
Tricia Christensen

A cold sore, which typically appears on a location around the mouth is an expression of infection with a herpes virus, usually herpes simplex I. When people get one cold sore they’re very likely to have them again because the virus remains in the body, and periodically expresses itself in the form of a new cold sore. Therefore, discussion of the best cold sore treatment needs to revolve around antiviral medications that may help shorten duration of a single cold sore infection.

Antiviral ointments are often used to treat cold sores.
Antiviral ointments are often used to treat cold sores.

The first time a person gets a cold sore, the best cold sore treatment is oral medication of acyclovir, also called Zovirax®. Some doctors may choose to ask patients to take the oral form and also to use an ointment or cream form at the same time. Since cold sores can be long lasting, acyclovir is a very good choice because it tends to reduce length of infection and also makes people less contagious. Length of infection time may be reduced by about 60%, which is encouraging.

Topical over-the-counter creams are often used for cold sores.
Topical over-the-counter creams are often used for cold sores.

There are other antiviral medications that might be used to treat a cold sore infection. These include famciclovir and valacyclovir or Famvir® and Valtrex®. In general, both of these medications are not as effective of acyclovir. They will slightly reduce the duration of infection, but not to the extent of acyclovir. However, should a person have problems using acyclovir, these other medications should be viewed as the best alternatives. Another medication, penciclovir, available in ointment form, may be considered too.

The best cold sore treatment doesn’t just depend on what medication is administered. It also relies on when treatment starts. Obviously with the first infection, people may not know they’re getting a cold sore. Thereafter, people should be wary of what is called the prodromal stage. This occurs before appearance of the cold sore, and can include symptoms of tingling, numbness, pain, burning or redness on one area of the mouth.

When people suspect they are in the prodromal stage, they should start cold sore treatment, usually with an ointment or cream. This may cause the cold sore to not appear and the prodromal symptoms to simply recede. If a cold sore still shows up, usually it will be less severe and go away faster.

Discussion continues to be ongoing about whether people should take ongoing oral antiviral medication to suppress cold sores all of the time. Some doctors may recommend this for patients who get cold sores very frequently. It is not yet universally acknowledge that this form of therapy, now widely used for those with genital herpes, is appropriate as cold sore treatment for everyone.

Tricia Christensen
Tricia Christensen

Tricia has a Literature degree from Sonoma State University and has been a frequent wiseGEEK contributor for many years. She is especially passionate about reading and writing, although her other interests include medicine, art, film, history, politics, ethics, and religion. Tricia lives in Northern California and is currently working on her first novel.

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Discussion Comments


Acyclovir is an excellent treatment, and so are lysine supplements. I've been battling cold sores for years and these two get rid of them quickly and prevent them too.


@stoneMason-- If you have health insurance, you should ask your doctor to prescribe something for you. You might still have to pay something, but it will be much less. And prescription treatments are more effective, as the article said.

The other option is trying various home remedies. There are lots of different ideas out there about what works for cold sores. But beware because some remedies don't help and can even make things worse by irritating your skin. Stay away from so-called remedies like nail polish.


There are quite a few topical ointments for cold sores at the pharmacy with anti-viral ingredients. They claim to reduce healing time and prevent cold sores. But they're very expensive.

I'm looking for an affordable cold sore treatment that I can use at the onset of symptoms as well as after the cold sore has already developed. Does anyone have any recommendations?

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