Cold sores are frequent, uncomfortable viral lesions—small, fluid-filled blisters appearing on or around the lips. Because they are visible and often painful, many people search for quick, accessible home remedies to shorten healing time. This search for immediate relief sometimes leads to applying common household items, such as table salt. However, applying harsh substances can do more harm than good to the delicate tissue.
Is Salt Advisable for Cold Sores?
Salt is generally not recommended for direct application to a cold sore, as it causes significant discomfort and irritation. Salt is an osmotic agent that draws out moisture, which some believe will “dry up” the blister. However, this action can be counterproductive to healing, and applying salt to an open lesion results in an intense burning sensation.
Excessive drying of the blistered area can lead to cracking and splitting of the skin, potentially delaying the natural healing process. Cold sores are caused by a viral infection, and salt lacks the necessary antiviral properties to address the root cause. Direct application of salt paste is too harsh for the sensitive tissue. Medical professionals do not endorse using salt as a primary treatment because its efficacy is not scientifically validated, and it may prolong healing.
The Progression of a Cold Sore
Cold sores are caused by the highly common Herpes Simplex Virus Type 1 (HSV-1). Once a person is infected, the virus remains dormant within the nerve cells for life, occasionally reactivating to cause an outbreak. An outbreak typically progresses through several distinct stages over a period of one to two weeks.
The first sign is often a tingling, itching, or burning sensation in the area where the sore will appear, known as the prodrome stage. This phase occurs as the virus begins to replicate and travel along the nerve to the skin surface. Within 24 to 48 hours, the next stage begins with the formation of a cluster of small, fluid-filled blisters.
These blisters rupture, or weep, releasing the fluid and forming an open sore. This weeping phase is when the cold sore is at its most contagious. Following this, the ulceration dries out, leading to the crusting stage, where a yellowish or brownish scab forms over the sore. The final stage is healing, where the scab shrinks and eventually flakes off.
Medically Recommended Treatments and Safe Home Care
The most effective medical treatments work by targeting the underlying viral cause of the cold sore. Over-the-counter creams containing docosanol, such as Abreva, can help shorten the duration of an outbreak if applied at the very first sign of tingling. These topical antiviral medications work best when used within the first 48 hours of the initial symptoms.
Prescription antiviral medications, such as acyclovir, valacyclovir, and famciclovir, can significantly decrease the severity and duration of an outbreak. Oral antivirals are often prescribed for individuals who experience frequent or severe outbreaks. These medications are most beneficial when started during the prodrome, or tingling, phase before the blisters fully erupt.
For safe, supportive home care, applying a cold compress can help reduce swelling and ease pain. Avoid touching the sore to prevent spreading the virus to other areas of the body or to other people. Using a moisturizing cream or petroleum jelly can keep the scab soft, which prevents painful cracking and promotes natural healing. Consult a medical professional if a cold sore is very large, does not begin to heal after ten days, or if the outbreak is accompanied by fever or eye irritation.