How can I manage cold sores?

Question: How can I manage my cold sores?
Answer: Ideally it’s best to prevent an outbreak before it starts by understanding and avoiding triggers. If an outbreak can’t be prevented there are some over-the-counter and prescription products that can help lessen the severity and length of outbreaks.
Reducing Spread:

During a cold sore outbreak, it is possible to spread the virus that causes cold sore (HSV-1) to items that you regularly use. HSV-1 can survive on surfaces anywhere from a few hours to several weeks. Coming into contact with these surfaces may trigger another outbreak. Therefore it is recommended to:

  • Replace your razor or shave with a disposable razor during an outbreak
  • Replace your toothbrush
  • Wash your bedsheets and towels
  • Avoid touching a cold sore, this can spread the infection to other parts of your body or to others. Only touch to apply cream
  • Don’t kiss others or share personal items
Avoiding Triggers:

There are certain things that can trigger cold sore outbreaks. Avoiding these triggers can be an effective way to decrease the frequency of outbreaks. Common cold sore triggers include:

  • Sun exposure (this includes tanning beds)
  • Stress
  • A cold or other illness
  • Fatigue/lack of sleep
  • Hormonal changes
  • Weakened immune system
  • An injury to the affected area
Start Treatment Early:

The earlier you start treating your cold sore outbreak the better chance of minimizing the severity and duration of your outbreak. It is best to start your treatment at the first sign of an outbreak, typically a tingling sensation. Treatment options are discussed below.

Over the Counter Products:

These products can help reduce the severity and duration of outbreaks but they do not help cure or prevent the transmission of the virus.

Abreva® Cream

  • This is the only over the counter product approved by the FDA to shorten healing time and duration of symptoms.
  • Start using Abreva® at the first signs or symptoms of an outbreak (do not wait until you develop blisters).
  • Apply cream to affected area per package instructions. Apply with a Q-tip to reduce spread to other parts of your body.

Other over-the-counter remedies can include Releev, lemon balm cream, zinc oxide cream, lysine, and rhubarb and sage, however their effectiveness has not been as well established.

Visiting the Doctor

If you tried the above methods but the cold sore outbreaks are still unmanageable there are a few prescription medications that can help reduce the severity and duration of symptoms. This may be through a prescription you take daily, or when there are signs of an outbreak.

Prepared by Artem Popov PharmD Candidate 2020

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