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Treatments and drugs
By Mayo Clinic staffCold sores generally clear up without treatment within about two weeks.
Topical treatments that may help relieve your symptoms include:
- Lidocaine may provide short-term pain relief.
- Benzocaine (Zilactin) may protect cold sores from trauma and irritation. Benzocaine has been linked to a rare but serious, sometimes deadly, condition that decreases the amount of oxygen that the blood can carry. Don't use benzocaine in children younger than age 2 without supervision from a health care professional, as this age group has been the most affected. If you're an adult, never use more than the recommended dose of benzocaine and consider talking with your doctor.
Oral antiviral medications are available that may modestly shorten the duration of cold sores and decrease your pain, if started very early. These include:
- Acyclovir (Zovirax)
- Famciclovir (Famvir)
- Valacyclovir (Valtrex)
Your doctor also may prescribe an antiviral medication to prevent a recurrence of cold sores, particularly if you:
- Have very frequent bouts of cold sores
- Experience significant, related illness during a cold sore outbreak
- Have an identifiable trigger of cold sore recurrences — such as intense sunlight — and you anticipate exposure to that trigger
- Herpes simplex. American Academy of Dermatology. http://www.aad.org/public/publications/pamphlets/viral_herpes_simplex.html. Accessed Jan. 8, 2010.
- Klien RS. Clinical manifestations and diagnosis of herpes simplex virus type 1 infection. http://www.uptodate.com/home/index.html. Accessed Jan. 8, 2010.
- Klien RS. Treatment and prevention of herpes simplex virus type 1 infection. http://www.uptodate.com/home/index.html. Accessed Jan. 8, 2010.
- Ferri FF. Herpes simplex. In: Ferri FF. Ferri's Clinical Advisor 2010. St. Louis, Mo.: Mosby; 2009. http://www.mdconsult.com/das/book/body/177412534-3/0/2088/299.html. Accessed Jan. 8, 2010.
- Oral-labial herpes simplex. In: Habif TP. Habif: Clinical Dermatology. 4th ed. St. Louis, Mo.: Mosby; 2006. http://www.mdconsult.com/book/player/book.do?method=display&type=bookPage&decorator=header&eid=4-u1.0-B978-0-7234-3541-9..00021-3--s0380&uniq=177412534&isbn=978-0-7234-3541-9&sid=936136390#lpState=open&lpTab=contentsTab&content=4-u1.0-B978-0-7234-3541-9..00021-3--s0370%3Bfrom%3Dcontent%3Bisbn%3D978-0-7234-3541-9%3Btype%3DbookPage. Accessed Jan. 8, 2010.
- Klien RS. Epidemiology of herpes simplex virus type 1 infection. http://www.uptodate.com/home/index.html. Accessed Jan. 8, 2010.
- Gibson LE (expert opinion). Mayo Clinic, Rochester, Minn. Jan. 12, 2010.
- Benzocaine topical products: Sprays, gels and liquids — risk of methemoglobinemia. U.S. Food and Drug Administration. http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts/ucm250264.htm. Accessed Apr. 8, 2011.
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