Cold sores, also known as oral herpes, are caused by the highly contagious herpes simplex virus. They may appear as painful ulcers inside your mouth or around your lips.
According to the World Health Organization (WHO), over 3.5 billion people globally have the virus that causes cold sores. The most prominent symptoms are painful blisters, but people infected with cold sores for the first time may manifest the following symptoms:¹
Enlarged lymph nodes
These signs and symptoms may not manifest with subsequent infection and are not always present in everyone infected. Some people may unknowingly have the virus. Statistics show that only about 20%–40% of infected people develop cold sores, which may recur several times yearly.²
While there's no cure yet for cold sores, you can use over-the-counter medications to manage the symptoms and reduce recurrence.
Here are four over-the-counter cold sore medicines currently available.
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Abreva cold sore cream is an FDA-approved over-the-counter medicine. According to the manufacturer, the white cream is tasteless, odorless, and dries clear after application.
It contains 10% docosanol as the active ingredient. Clinical research has shown that applying docosanol cream five times a day is effective and safe in treating a cold sore.³
The cream treats cold sores by shortening the healing time and reducing cold sore symptoms, such as pain, itching, and burning sensation. According to the manufacturer, most users treat the symptoms in about two and a half days (60 hours), but the average healing time is 4.1 days.
According to DailyMed, only adults and children aged 12 and over should use Abreva cold sore cream as an over-the-counter medicine. Consult with a doctor regarding children under 12 years.
Directions for using the product:
Apply it to affected areas on the lips (do not use it near the eyes)
Wash hands before and after using Abreva cold sore cream
Apply it five times a day until the cold sore blisters disappear, or up to 10 days
The cream is not recommended for women who are pregnant or breastfeeding
Note: Abreva cold sore cream can cause severe allergic reactions that may manifest as a rash, facial swelling, and/or breathing difficulties.
This over-the-counter cold sore medicine contains 10% benzyl alcohol as the main ingredient. You can use it to temporarily relieve cold sore pain for up to six hours and promote healing. Zilactin cold sore gel dries clear when applied to affected areas to form a protective seal over the blisters.
Adults and children aged two years and older can apply this gel to the affected area up to four times daily. Then, allow the gel to dry for 30–60 seconds. Children under two years should not use this product. Some users on Amazon have reported that Zilactin gel eliminates cold sores within two to three days.
Note: If the cold sores don't disappear after a week, stop using the gel and see a doctor. Additionally, Zilactin cold sore gel is flammable, so don't expose the gel to naked flames.
Campho-Phenique is a pain reliever with camphorated phenol (camphor 10.8% and phenol 4.7%) as the active ingredient. As a result, it relieves pain and itching associated with cold sores and promotes healing.
It's suitable for people aged two years and above. Simply apply a small amount on the affected area one to three times daily, and don’t cover it with a dressing. However, you can't use it for cold sores inside the mouth; it's strictly for external use.
Don't use this cold sore cream near the eyes, and don’t apply it to deep wounds without consulting a qualified physician. According to the manufacturer, Campho-Phenique gives immediate pain relief when applied to cold sores.
Rather than a gel or cream like most medications on this list, this is a small medicated patch that covers the cold sore. According to the manufacturer, each Compeed cold sore patch contains active hydrocolloid gel that promotes healing and prevents the infection from spreading.
The manufacturer says Compeed cold sore patches are discreet, as they are translucent and can blend well with the skin to reduce the appearance of blisters. The patch can stay in place for about 12 hours, reducing the chances of contamination and preventing the blister from worsening.
Currently, there's no cure for cold sores. Cold sores can naturally go away without treatment, which may take several days. However, some over-the-counter medications like the ones we've listed above can hasten the healing process.
Since over-the-counter cold sore creams, patches, and gels do not require a prescription, their effectiveness relies on following instructions correctly. Start the treatment as soon as symptoms appear. The sooner you start treating the cold sore, the better.
If symptoms persist after a few days, please see a doctor for a diagnosis and prescription.
Cold sores usually heal on their own in a week or two. Buying over-the-counter cold sore medications can hasten the healing process by relieving pain and preventing the infection from spreading. Treatment can accelerate the healing process and can sometimes prevent blisters from forming.
While the specific triggers for cold sores are still unknown, the following factors increase the chances of recurrence:
Overexposure to sunlight
Recurring cold sores are common in the initial 12 months after the first outbreak and reduce over time.
No research has proven that Vaseline helps treat cold sore symptoms.
No, it worsens the condition. According to the National Health Service (NHS), acidic or salty food can worsen cold sores.⁴
Herpes simplex virus | World Health Organization
Cold sores: Overview (2018)
Cold sores | NHS
Label: Abreva- docosanol cream | Daily Med
Cold sores: Signs and symptoms | American Academy of Dermatology Association
About Abreva cold sores cream | Abreva.com
Oral herpes | Johns Hopkins Medicine