Prescription oral antivirals are your best bet, but OTC creams can help, too

Cold sores always seem to choose the worst possible moments to appear — and once they arrive, they like to take their time clearing up.

“They tend to go away on their own in 10 to 14 days, but that doesn’t make them any less annoying,” says family medicine physician Sarah Pickering Beers, MD.

Here’s Dr. Pickering Beer’s advice for dealing with these stubborn sore spots.

Cold sore remedies

The fastest way to send your cold sore packing is to see your primary care provider and get a prescription. If you’re not able to get in for a visit, over-the-counter and home remedies can also help.

Dr. Pickering Beers recommends the following to ease the discomfort and send that sore on its way.

Oral antiviral medications

“The quickest way to get rid of cold sores is to visit your provider and get a prescription for oral antiviral medications,” Dr. Pickering Beers says. These medications reduce pain and speed healing. They work best if you start taking them within the first day or so of the cold sore developing. If you wait longer, they won’t do much to help.

“If you’re one of the unlucky people who tends to get cold sore after cold sore, your doctor might be able to prescribe a daily antiviral to keep them at bay,” she adds.

Antiviral cream

If you can’t make it to your healthcare provider’s office, consider using docosanol (Abreva®) — it’s the only over-the-counter antiviral cream that’s U.S. Food and Drug Administration (FDA)-approved to knock back a cold sore.

“A cream is slightly less effective than oral antivirals, but they do reduce the pain and duration of the sore,” Dr. Pickering Beers notes. But like oral medications, you have to start using the cream ASAP for it to work.

Over-the-counter pain-relieving creams

Over-the-counter creams containing lidocaine and benzocaine can numb the burning and ease the discomfort of a cold sore — but they won’t make it heal any faster.

Pro tip: These creams are often marketed for dental pain, so Dr. Pickering Beers suggests looking for them in the dental section of your drug store.

Over-the-counter pain medications

Acetaminophen and ibuprofen may help reduce the redness, swelling and pain that comes with a cold sore. Bonus: You can use them in concert with most topical treatments.

Other home remedies

DIY remedies aren’t likely to make a cold sore disappear any faster. But there are things that can help ease the pain, like:

  • Lip balm or petrolatum jelly: Keeping your lips and mouth moisturized keeps the sore from drying out and peeling. Remember: Using a product directly on your cold sore contaminates it. “Throw it away once your cold sore is better,” Dr. Pickering Beers stresses.
  • Cold therapy: Using a simple cold compress can help reduce pain, redness and swelling. Apply it for five to 10 minutes several times a day as soon as that tingling feeling starts. Ice in a wet rag works well. Never apply ice directly to your cold sore, as that could cause damage.
  • Aloe:Aloe won’t make your cold sore heal any faster, but some studies suggest it can moisturize and calm skin inflammation. But be sure to do a patch test on your arm before putting it on your face: You don’t need an allergic reaction, too!
  • Manuka honey:A 2021 study found that medical-grade Manuka honey is a strong alternative to standard cold sore treatments. Just keep in mind that you need to patch test it before using it. Also, licking the sticky stuff off would both defeat the purpose and dry out your skin!

Other potential alternative treatments you’ll see online — like propolis, lemon balm ointment, sage-rhubarb cream and olive leaf extract — may look promising, but require more research. The same is true of lysine and vitamin E oil. Recent studies on lysine supplementation suggest it’s unlikely to help prevent or treat cold sores. A small study conducted in 1980 suggests that putting vitamin E oil on a cold sore decreased pain and sped up wound healing, but those findings have never been confirmed.

Things to avoid

Not every DIY treatment is a winner. Here are a few Dr. Pickering Beers suggests skipping:

  • Popping the sore: Try to resist the temptation to claw at your cold sore. “It’s instinct to pick at it and scrape the peeling skin, but you need to let it heal itself,” she urges. Popping a sore could spread the infection, too.
  • Eating acidic, spicy, or salty food: Drop those buffalo wings! In theory, capsaicin can reduce pain and inflammation. But getting hot, sour or salty food in an open sore can be really painful.
  • Essential oils:Some essential oils have antibacterial properties, but there’s little research to support their use on cold sores. There’s even less on how diluted they need to be. Also, essential oils might sting or burn when applied to an open wound. And many are toxic when ingested.
  • Toothpaste:Don’t believe the myth that toothpaste can heal acne and cold sores. It’s drying, yes, but not in a good way. Putting toothpaste on your skin can cause irritation — and your lips have some of the most sensitive skin on your body.

Final thoughts

Cold sores are no fun. And the last thing you want to do is inflict them on others. Especially kids. That’s because the virus can be life-threatening in a baby.

“As much as you might want to see your niece or nephew or grandbaby, please don’t shower them with kisses if you have an active cold sore,” Dr. Pickering Beers advises.

If you can’t avoid babies, keep them safe by:

  • Covering the cold sore with a bandage or face mask
  • Washing your hands frequently
  • Not sharing your utensils, towels or other personal items

See a healthcare provider if your cold sore doesn’t heal within two weeks, you’re unable to manage your pain, you’re immunocompromised or you develop other symptoms, like a fever.