3 Ways to Treat Cold Sores

Stop a cold sore in its tracks with these products and treatments.

Woman with a cold sore looks in the mirror and touches her mouth

If you get cold sores, you know the drill: an itchy, tingling sensation that turns into an unsightly blister within hours

(Of course, a cold sore usually sprouts at the worst moments — like just before a special occasion, or on a vacation.)

What causes a cold sore?

“Cold sores are caused by the herpes simplex virus type 1, which is transmitted by skin-to-skin contact and may lie dormant for months,” says Dr. Jaggi Rao, an Edmonton-based dermatologist and associate clinical professor of dermatology at the University of Alberta. But an outbreak can be triggered by stress, a fever or even menstruation. And although cold sores can strike at any time of year, sunlight encourages flare-ups because UV exposure weakens the immune system and allows the virus to multiply.

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Preventing cold sores

While you can’t get rid of the virus — once contracted, it lurks in your system forever — you can help prevent cold sores by wearing a broad-spectrum SPF 30 lip balm to protect your lips and keep them moist. If you do have an outbreak, keep your hands off your face and wash them often, in order to avoid spreading the virus to other parts of your body or to other people. “Don’t apply lip products directly from the applicator, and don’t share utensils, cups or lip products until the site is fully healed,” says Dr. David Zloty, a Vancouver-based dermatologist and clinical assistant professor of dermatology at the University of British Columbia.

Treating cold sores

Left untreated, most cold sores last five to 10 days, but you can find relief for symptoms — and in some cases speed up healing — with over-the-counter remedies. We asked Rao, Zloty and Shakeel Bhatti, a pharmacist in Langley, B.C., and clinical instructor at the faculty of pharmaceutical sciences at the University of British Columbia, for their suggestions.

1. To reduce duration

Examples
Abreva or Lipactin Gel

How they work
Abreva contains a chemical called docosanol, which alters cell membranes. “It prevents the virus from entering cells, which effectively stops it from replicating,” says Bhatti. Lipactin contains zinc and heparin and may have antiviral and antibacterial properties, says Zloty.

Need to know
These topical formulations require several applications a day, and work best if you start at the first sign of a tingle, redness, bump, swelling or itch. If you begin treatment with Abreva at this stage, you can reduce the time it takes the sore to heal by almost 18 hours and shorten the duration of symptoms. Lipactin also claims to accelerate healing, but Zloty says there’s not enough evidence yet to determine how quickly it really works.

2. To alleviate pain and itching

Examples
Viractin Gel, Zilactin Early Relief Cold Sore Gel or Zilactin-L Early Relief Cold Sore Liquid

How they work
Viractin contains tetracaine, an anesthetic, while the active ingredient in Zilactin products is benzyl alcohol, a preservative that prevents bacteria from multiplying and can help with pain and itching, says Zloty.

Need to know
“These treatments offer symptom relief, but they won’t really help the healing process,” says Bhatti. So use them if your cold sore hurts or is itchy, but don’t expect them to decrease its duration.

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3. To prevent an outbreak or reduce duration

Examples
Intercept CS Cold Sore Prevention System (available at Shoppers Drug Mart and Pharmaprix stores) or Zeno CS (available at Shoppers Drug Mart)

How they work
These hand-held devices deliver a low-level dosage of heat when placed in direct contact with a cold sore. Each Zeno treatment lasts four minutes, while the Intercept system requires just 30 seconds.

Need to know
When applied every four hours at the first indication of a cold sore, Zeno can prevent it from developing at all, says Rao, who headed clinical trials on the product last year. Even if an outbreak occurs, it can cut healing time in half, which Rao says is faster than prescription oral antiviral treatments. Intercept is meant to prevent eruptions: It’s applied at five-minute intervals in the first three hours of early symptoms.

Prescription options

The best treatments for cold sores are prescription antiviral agents such as Zovirax (acyclovir), Valtrex (valacyclovir) and Famvir (famciclovir) taken orally, says Rao. “These should be ingested at the first evidence that a cold sore is coming, and may reduce the duration by a day or two.”  Zloty says topical treatments such as Zovirax Cream or Denavir (penciclovir) are less effective and can be tedious, since they require multiple applications per day over several days.

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This article was originally titled “Lip Service,” in the May 2009 issue of Best Health. Subscribe today to get the full Best Health experience — and never miss an issue!

Originally Published in Best Health Canada

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