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Creams and Ointments for Cold Sores

Topic Overview

Topical products, such as creams or gels, are sometimes used to treat cold sores. Many are prescription medicines that may slightly shorten the duration of cold sores, usually by just 1 to 2 days.1

Some experts find that even when nonprescription topical products are used frequently—every 2 hours while a person is awake—at the first sign of an outbreak, they may only speed recovery time by a few hours or a day.2

Prescription creams and ointments

Penciclovir cream (Denavir) is an antiviral cream that may reduce healing time by 1 to 2 days, especially if the cold sore was triggered by sunlight exposure. It also reduces the pain, itching, burning, and tenderness of cold sores.1

Penciclovir cream may cause side effects such as mild pain or stinging when it is applied. It is possible, although rare, that the cream may also cause a skin rash or headache.

Acyclovir ointment or cream works best if it is used at the first sign of cold sore symptoms. Side effects of the ointment may include mild pain or stinging at the site where it is applied.

The U.S. Food and Drug Administration (FDA) approved acyclovir cream to treat recurrent cold sores in people older than age 12. The cream can improve healing time by up to half a day. The cream may cause temporary skin irritation.

Nonprescription creams and ointments

Tetracaine cream (Viractin) and lidocaine (Zilactin-L) are topical anesthetics that can relieve the pain and itching of cold sores. These products are applied to cold sores up to 6 times a day for best results. Pain and itching are relieved usually within 2 to 3 days after a person first applies the product.

Docosanol 10% (Abreva) should be applied at the first signs of a cold sore outbreak. It is the first nonprescription cold sore medicine approved by the U.S. Food and Drug Administration (FDA) to shorten healing time and the duration of symptoms.

Benzyl alcohol (Zilactin) is a gel that relieves the pain of cold sores and may help shorten healing time, especially if it is used as soon as a cold sore begins to form.

Dimethicone with sunscreen (Herpecin-L) is a product that moisturizes your lips and protects them from the sun. This can help reduce the pain and itching of cold sores. It can also help prevent cold sores from returning, especially if they were triggered by sun exposure.

Cold sores usually heal on their own without prescription medicines or complementary therapies.

Related Information

References

Citations

  1. Worrall G (2009). Herpes labialis, search date February 2009. Online version of BMJ Clinical Evidence: http://www.clinicalevidence.com.
  2. Habif TP (2010). Warts, herpes simplex, and other viral infections. In Clinical Dermatology, A Color Guide to Diagnosis and Therapy, 5th ed., pp. 454–490. Edinburgh: Mosby Elsevier.

Credits

By Healthwise Staff
Primary Medical Reviewer E. Gregory Thompson, MD - Internal Medicine
Specialist Medical Reviewer Thomas M. Bailey, MD - Family Medicine
Last Revised February 1, 2012

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