If you have herpes simplex virus (HSV), cold sores may appear periodically on or around your lips. HSV-1 is a virus present in around half of Americans aged 14–49, and it’s the primary cause of cold sores. These sores are contagious from the moment symptoms appear until they clear up, meaning the virus can spread to other people and further areas of your body.
While some people may worry about the appearance of a cold sore, the itching, tingling, and burning accompanying your cold sore can make it unbearable. With so many people dealing with cold sores, you’re not alone if you’re concerned about clearing up a cold sore quickly.
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Cold sores are flare-ups caused by the herpes simplex virus that stays in your body for your lifetime. These sores typically clear up within two weeks without any treatment, depending on your immune response and the severity of the infection.
If you don't want to wait this long or your cold sores have persisted after this period, you may want to seek treatment.
Treatment options for cold sores include over-the-counter (OTC) creams, orally administered pills, and certain home remedies. Speaking to your doctor is the best option if you’re unsure of the right treatment in your case.
Some of the most used treatment options for herpes simplex infection are OTC ointments. While these are easily accessible, they’re not as effective as antivirals and are not medically recommended, as topical therapy needs to be administered multiple times daily and is nowhere near as effective as systemic treatment.
However, they’ve still been shown to statistically decrease healing time, albeit really modestly, in the vicinity of half a day on average
A 2020 study showed that cold sores healed within 9.3–9.8 days using OTC products. The same study states that cold sores typically heal within 7–10 days without treatment.¹
When your doctor confirms herpes simplex is causing your cold sores, they may prescribe antiviral pills. These include active ingredients of acyclovir, valacyclovir, and famciclovir. Your doctor will work with you to determine the best option, as cost and dosing frequency are points to consider with cold sore treatment.
While it’s best to consult your doctor or pharmacist about cold sore treatment, you can also try home remedies. However, some of these may cause allergic or unwanted reactions, so use caution when trying non-medical options.
Scientists have researched the effects of some essential oils on cold sores. While some studies have shown these oils have antiviral properties, these were in vitro experiments.
In vitro studies are “test tube” experiments that take place outside the human body, so it’s harder to know if they work in real-life contexts. Additionally, most of this research is from 2000–2010, so we need more evidence of essential oil efficacy as an antiviral. Furthermore, the dosages used in some of these studies would be toxic to take orally.
Essential oils are not FDA-regulated, meaning their ingredients aren’t to a regulatory standard, so they could contain toxic ingredients. You should be cautious when using essential oils, especially as they can be poisonous if you ingest them.
One promising 2021 study discovered that a medical-grade honey product (L-Mesitran Soft) outperformed typical antiviral treatments for cold sores. Participants experienced fewer side effects and preferred the honey-based product to the usual treatments.²
However, it’s important to note that two of the researchers in this study are employees of the companies that create and distribute the product, posing a strong conflict of interest.
Another in vitro study from 2016 investigated the antiviral properties of a substance called Hatay propolis, a bee byproduct. The researchers found that propolis suppressed HSV activity and increased the efficacy of acyclovir when using the two together.³
You can also use a moisturizing lotion to soften the scab and place a warm damp cloth on the spot to reduce inflammation.
Some crucial tips to follow include:
Stay away from kissing and oral sex to prevent spreading the virus to others
Avoid touching open sores to reduce the risk of spreading them to other parts of the body
Never pop the sore
Avoid peeling the scab, as this prolongs the healing process
Stay away from acidic or salty foods to prevent additional discomfort
Wash your hands with soap and water before and after applying an ointment to your sore
Don’t share any products you use on your lips during a flare-up
Don’t share towels, dishes, or cutlery
Don’t kiss infants: Neonatal herpes infection in babies can be deadly
Although you can treat your cold sores at home, it’s best to visit your doctor for a proper diagnosis. They will be able to recommend treatment options if you experience recurring sores or accompanying eye infections or inflammation.
It’s wise to try and pin down what causes flare-ups for you. Common triggers include:
Another infection or illness, such as a cold
Injury to the area
Hot or cold temperatures
Once you know what causes your cold sores, you can try and avoid your triggers. If sunlight triggers your cold sores, you may want to try zinc-based sunscreens. Discuss prophylactic antiviral therapy with your physician if you get recurrent cold sores.
Cold sores are a typical sign of herpes simplex 1, a virus that stays in your body for life after infection. Whether you use OTC creams, prescribed medications, or home remedies, treat cold sores as soon as they appear to get the best results. It’s important to take action to prevent them from recurring or spreading to other areas of your body or other people.
Prevalence of herpes simplex virus type 1 and type 2 in persons aged 14–49: United States, 2015–2016 | Centers for Disease Control and Prevention (CDC)
Cold sores: Overview (2006)