How to Treat a Cold Sore

Skin Problems Image Gallery Cold sores can be unsightly and embarrassing. See more pictures of skin problems.
Skin Problems Image Gallery Cold sores can be unsightly and embarrassing. See more pictures of skin problems.
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Your lip stings and tingles, you feel feverish and your throat's a little sore. Oh, no -- you know what's coming next -- and your blind date is just two days away. Cold sores, also called fever blisters, can be painful and unsightly, not to mention embarrassing. So, what can you do when you get one?

The first thing to understand is that, for now at least, you can only treat a cold sore -- there is no cure. Cold sores are caused by a herpes virus. Although there are more than 20 viruses within the Herpesviridae family, less than half of those affect humans with any regularity. Some of the most common herpes viruses are:


  • Herpes simplex virus Type 1 - The HSV-1 virus typically causes cold sores, but it can also cause other lesion-related conditions (including genital herpes) as well as herpes keratitis, an eye infection and HSV encephalitis.
  • Herpes simplex virus Type 2 - The HSV-2 virus typically causes genital herpes, but it can also cause cold sores and other lesion-related conditions as well as HSV meningitis.
  • Epstein Barr virus - The Epstein Barr virus is most commonly known in the U.S. for causing infectious mononucleosis but in other areas of the globe, it's associated with Burkitt's lymphoma and nasopharyngeal cancer.
  • Herpes or Varicella Zoster Virus - This virus causes chicken pox and shingles.

[source: Hunt]

Once you're infected with a herpes virus, it remains with you for life. The virus can immediately cause a visible condition or disease or it can remain dormant for years. HSV-1 and HSV-2 are both transmitted through close contact and a person does not have to have an active or apparent lesion to spread the virus. With cold sores, close contact doesn't necessarily mean kissing. While it's true that smooching is a surefire way to spread HSV-1, it can also be transmitted by sharing beverages, silverware, toothbrushes or towels. And for those infected with the virus, if you're prepping for an intense job interview or your Facebook relationship status is set to "It's complicated," brace yourself for a breakout -- cold sores typically emerge in times of emotional stress [source: Coffman].

Other triggers include hormonal fluctuations, getting sick with the flu or a cold, sunbathing and visiting the dentist, orthodontist or even the periodontist for dental treatment. No matter what inspired that cold sore to sprout along your smile, it's likely you'll want it to go away as fast as it arrived. So, what treatments are available to help these lip lesions make a hasty retreat? Keep reading to find out.


Cold Sore Treatments

Since the virus that causes cold sores lasts a lifetime, one of the keys to treating cold sores is actually to try preventing them. As mentioned on the previous page, there are a number of things that can trigger a cold sore outbreak including illness, stress and sun exposure. So, to stave off a sore, you need to avoid these triggers. During cold and flu season, get plenty of rest, maintain proper nutrition, take a multi-vitamin and consider getting a flu shot. To alleviate stress, make time for exercise and consider taking up a mindful practice like yoga or meditation. When you're going to be outside, make sure to wear sunscreen on your face and lips. Many skin care products, lip balms and lipsticks now contain sunscreen, so be sure to select and use those products.

If you haven't managed to prevent a cold sore from gracing your face, there are a number of over-the-counter options to help treat it. To alleviate pain and discomfort, look for topicals that contain anesthetics such as lidocaine, tetracaine, dibucaine, benzyl alcohol or benzocaine [sources: Mayo Clinic and MedicineNet]. An untreated cold sore will typically go away on its own in about a week or 10 days. If you're hoping to find a treatment that can shorten the stay of your cold sore, you could try using the over-the-counter topical Abreva (docosanol) [source:]. Directions suggest that you use this product at the very first sign -- maybe that stinging sensation -- of an impending outbreak and then reapply several times a day, every day until the lesions are gone.


Other options for speeding up healing time include prescription topicals and oral medications. Your physician can prescribe creams that contain either acyclovir or penciclovir, or oral antivirals such as acyclovir, valacyclover or famciclovir [source: MedicineNet]. These antivirals are particularly helpful for people who find themselves getting cold sores on a regular basis. Although these medications do not offer a cure, they can help control the number of outbreaks -- and their durations -- you suffer.

For more information about cold sore medications, read Cold Sore Medications: Fast Facts.

If you'd prefer trying home or natural remedies, head on over to the next page.


Home Remedies for Cold Sores

It doesn't matter whether you're the type of person used to using over-the-counter treatments from the local pharmacy or you prefer to find natural treatments or home remedies, prevention is still an essential component in treating your cold sores. In addition to taking care of your health, keeping stress at bay and protecting your skin from the sun, you should also do the following when you are in contact with someone who has or has recently had an outbreak of cold sores:

  • Do not share personal items such as lip balm or lipstick, makeup, straws, utensils, scarves, toothpaste or towels.
  • Do not directly share beverages or food items.
  • Refrain from kissing.
  • Wash your hands thoroughly and regularly, and avoid touching your face or your eyes while near that person.

While it's not exactly possible to reinfect yourself, since technically once you have the herpes virus, you'll always have it, you can instigate more cold sores. For example, the herpes virus can "live" on your toothbrush for seven days, meaning if you repeatedly use that toothbrush during an outbreak, you could develop more sores. The solution: Throw your toothbrush away and replace it with a new one when you first notice you're getting a cold sore and do that again after your sore heals [source: Mother Nature]. Also, do not attempt to pick or pop your cold sore; releasing any liquid from inside the sore can cause it to spread.


Now that we have prevention covered, let's discuss home remedies and natural treatments. Although most of these are not backed by scientific research, they are believed by some to be helpful in combating cold sores:

  • Cold compresses
  • Warm compresses
  • Lysine, taken as a supplement
  • Vitamin C, taken as a supplement
  • Vitamin E, taken as a supplement
  • Vitamin B-12, taken as a supplement
  • Tea tree oil, applied as a topical treatment
  • Zinc, applied as a topical treatment

[sources: Mother Nature, MedicineNet and Roberts].

To learn more about cold sores and other lip-related conditions, visit the links on the next page.


Lots More Information

Related HowStuffWorks Articles

  • Coffman, Alicia. "Fact or Fiction: Is a cold sore an STD?" May 12, 2008 (Accessed 11/5/09)
  • "Abreva." (Accessed 11/04/09)
  • Hunt, Dr. Richard. "Virology - Chapter Eleven: Herpes Viruses." Microbilogy and Immunology On-line University of South Carolina School of Medicine. May 5, 2009 (Accessed 11/5/09)
  • Mayo Clinic. "Cold Sore." 3/13/2008 (Accessed 9/30/09)
  • MedicineNet. "Herpes Simplex Infections (Non-Genital)." (Accessed 9/30/09)
  • Mother Nature. "Cold Sores: 17 Hints to Heal Herpes Simplex." (Accessed 9/30/09)
  • Roberts, Theresa. "ABC's of Bumps & Bruises: A Guide to Home & Herbal Remedies for Children." (Accessed 9/30/09)
  • WebMD. "Cold Sores -- Home Treatment." 3/13/2008 (Accessed 9/30/09)
  • WebMD. "Cold Sores -- Topic Overview." 3/13/2008 (Accessed 9/20/09)