Without treatment, cold sore should heal within 2 weeks.
Depending on how bad it is, we can use over the counter medications to take care of this. But know that there is no cure for it
If your cold sore comes on frequently, we recommend you see a doctor not only to treat the cold sore but to get a prescription medication like valcyclovir for suppression.
Let's take a look at what is available over the counter to help with the symptoms of a cold sore and use this information to manage it effectively.
Docosanol
Blocks herpes Simplex Virus from entering the skin cells where it can replicate.
The result is cold sore with lesser symptoms, severity and shorter duration.
When used at the first sign, the tingling stage, it may shorten healing time by about a day or two. The key is using it early.
Example Abreva®
Pain relieving creams
These are basically numbing agents.
Numbing the area will reduce itching and pain associated with the damaged skin of the lips.
Examples are Camphor, benzyl alcohol, phenol, thymol, menthol, benzocaine, lidocaine.
Skin protectants
They keep the area moist and prevent cracking which can cause pain.
They also act as a barrier to protect the skin and lips from external irritants.
Skin protectants are useful during the scabbing stage to make scabs less likely to crack and bleed.
Zinc oxide, allantoin, petroleum jelly are good examples.
Pain relief + protectants
They combine pain relief with lip protection. This should make you comfortable enough while the cold sore heals on its own.
Examples are Anbesol cold sore therapy®, Orajel single dose®.
Antiseptics
Benzalkonium chloride.
Will help prevent a secondary bacterial infection speeding up healing time. Usually, when your skin barrier is broken, bacteria is already diving in to do some damage making it worse.
Benzalkonium chloride helps to reduce the level and risk of bacterial infection.
Antiseptics + pain relievers
This combination is actually very useful in cold sores. The combination of numbing, anti-itch, antiseptic, pain relief reduce cold sore awareness and the urge to touch the area. This promotes faster healing.
We strongly recommend you add this to your treatment regimen especially at the blistering stages.
A good example is Bactine® (lidocaine + benzalkonium).
Lemon balm
Lip balms containing 1% lemon extract shorten the healing time, prevent it from spreading and reduce recurrences.
Example Cold sore relief®
Lysine
Increase lysine intake to replace the arginine on skin cells thereby depriving the virus of arginine needed for replication. The virus needs arginine found in the skin to replicate while lysine depletes the skin of arginine by competing with its affinity for skin cells.
If you are prone to cold sores, you may want to make this a daily vitamin or start taking it when you feel something is coming on.
Others
Red eyes relief eye drops:
To take the red out of cold sores on the skin. Use this if you want to conceal the cold sore by taking the redness out - which we all do anyway.
Ice
Non-Steroidal anti-inflammatory drugs (NSAIDS).
Hydrocortisone 1% cream:
Use in extreme cases of inflammation. It may delay healing time.
Last updated by pharmacist on : 03/25/2018
Let's use this information to choose a good over the counter remedy to help with this cold sore.
Which of the symptoms listed below are you experiencing right now?
Choose the nature of this cold sore from the list below and see what you can use over-the-counter.
You must have this coldsores really bad.
You will need to see a health care professional for this.
Possibly need an anti-viral medication. These are prescriptions.
If you see a healthcare professional, make sure you get a prescription for the tablets. Even if your healthcare professional determines a cream will be better for you, still ask for a prescription for the tablets just in case. The thing is that most insurance does not like to pay for the creams and they are expensive. The tablets are on their formulary list.
We must have left something out.
We must have left some things out. Please be sure to seek medical advice.
Using over-the-counter medication is not recommended.
Need to see a health care professional for this.
May require an anti-viral prescription medication.
If you see a healthcare professional, make sure you get a prescription for the tablets. Even if your healthcare professional determines a cream will be better for you, still ask for a prescription for the tablets just in case. Most insurance do not like to pay for the creams and they are expensive. The tablets are on their formulary list and much cheaper.
docosanol
This blocks the herpes Simplex Virus from entering the skin cells where it can replicate.
The result is a cold sore with lesser symptoms, severity and shorter duration.
When used at the first sign, the tingling stage, it may shorten healing time by about a day or two.
Avoid the store brand equivalents. Some stores promote a substitute by providing similar packaging as the original, but there is no substitute. If you read the ingredients carefully, you will find it does not contain the active ingredient docosanol.
Abreva®
anti-inflammatory
NSAIDS (Non-Steroidal Anti-Inflammatory Drugs)
Take Ibuprofen or naproxen to help with the pain and inflammation.
Creams
If the area is very inflamed, you may want to daub 1% hydrocortisone on the affected area.
Do this not more than 2 days as it may delay healing if done often. The goal is to reduce the inflammation quickly and continue other symptom relief creams.
analgesic
Numb the area to prevent itching and reduce pain.
Camphor, benzyl alcohol, phenol, thymol, menthol, benzocaine, lidocaine are ingredients that will do this.
antiseptic
To prevent secondary bacterial infection of the affected area and speed up healing.
An antiseptic like Benzalkonium chloride will act to reduce the level and risk of bacterial infection.
We suggest using it in combination with lidocaine or other numbing agents.
lip protectants
The affected area needs to be kept moist and also, you need to prevent cracking which can lead to pain and bleeding.
Skin protectants also act as a barrier to protect the skin and lips from external irritants.
Zinc oxide, allantoin, or petroleum jelly (vaseline) are good protectants.
supplements
Take Lysine to replace and deplete the arginine on skin cells that the virus needs for replication.
If you are prone to cold sores, you may want to take this daily or start taking it when you feel something is coming on.
Combination Products
1. Pain relief + Antiseptic
This combines numbing agent lidocaine with the antiseptic benzalkonium chloride.
We love this combination and recommend it if you have not tried it before. Example Bactine®
2. Pain relief + Skin protectant
Numbing the area with a numbing agent will reduce itching, pain and combining with a skin protectant should speed up healing and make this cold sore less disruptive to you.
Example Anbesol cold sore therapy®, Orajel single dose®
Worth doing
Reducing the redness
Styptic pencil. This is an astringent that stops bleeding from nicks and cuts while shaving. It should help reduce the redness by shrinking the tiny capillary skin blood vessels exposed during the cold sore infection.
Eye drops. Use redness-reducing eye drops to take the redness away. 1 to 2 drops should do it preferably 3 times a day. If they can reduce the redness of the eyes, they should help with the inflamed skin.
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