Cold sores are small, fluid-filled blisters that typically appear on or around the lips, caused by the herpes simplex virus type 1 (HSV-1). Once contracted, the virus remains dormant in nerve cells and can reactivate periodically, leading to an outbreak. Selecting the correct lip balm during an outbreak is important for managing symptoms, supporting healing, and preventing further irritation. This guide navigates the ingredients and practices necessary to choose a product that aids recovery.
Ingredients That Support Healing
The most effective lip balms for an active cold sore contain ingredients that interfere with the virus or protect the healing skin. The only over-the-counter medication approved to treat cold sores is docosanol, an antiviral compound. Docosanol works by inhibiting the fusion of the herpes simplex virus with healthy human cells, preventing the virus from entering and replicating inside them. For best results, this treatment should be applied five times daily at the very first sign of a cold sore, such as the initial tingling or itching sensation.
Another supportive ingredient to look for is the amino acid L-lysine, which may be incorporated into topical creams or taken as an oral supplement. The herpes virus requires another amino acid, arginine, to replicate itself. Lysine is thought to interfere with the body’s absorption of arginine, effectively limiting the nutrient the virus needs for growth. Studies suggest that both topical and oral lysine may help reduce the frequency and severity of outbreaks, and shorten the healing time.
While not an antiviral, barrier protectants like white petroleum jelly or dimethicone are beneficial for keeping the lesion moist. A cold sore that is allowed to dry out can crack and bleed. Applying a thin layer of a simple occlusive helps prevent this uncomfortable cracking and shields the sore from environmental irritants and secondary bacterial infection. Some balms also include mild topical analgesics like lidocaine or benzocaine, which offer temporary numbing relief from the pain and burning associated with the lesion.
Ingredients That Can Worsen Symptoms
Many common lip balm ingredients can irritate an already inflamed cold sore, prolonging the outbreak. Highly flavored or fragranced products should be avoided entirely during an outbreak. Flavorings like cinnamon, citrus, peppermint, and spearmint, along with synthetic fragrances, are known irritants for compromised lip skin. These ingredients can cause a burning sensation that is often mistaken for the product “working,” but is actually a sign of irritation that can hinder healing.
Certain compounds often included for their cooling or exfoliating properties can be especially detrimental to a cold sore. Menthol and camphor, while offering a temporary cooling feeling, can dry out the skin and cause further irritation or peeling around the sore. Similarly, exfoliating agents like salicylic acid are too harsh for the blistered area. The goal during a cold sore outbreak is to soothe and protect, not to strip or exfoliate the skin barrier.
Heavy occlusive balms that lack any antiviral or protective components can also be problematic if they create an overly warm, moist environment. This environment may slow the natural drying and scabbing process required for the sore to heal properly. Look for simple, non-irritating formulas with minimal ingredients to reduce the risk of an adverse reaction. Products containing alcohol should also be avoided as they are highly drying and will exacerbate cracking.
Sun Protection as a Preventative Measure
Sun exposure is one of the most common environmental triggers for a cold sore outbreak, as ultraviolet (UV) light can reactivate the dormant HSV-1 virus. Therefore, a lip balm containing sun protection is a simple, yet highly effective, preventative measure.
Any lip product used for cold sore management or prevention should be broad-spectrum and have a Sun Protection Factor (SPF) of 30 or higher. This protection is necessary year-round, not just in summer, because UV light is present even on cloudy days. Mineral sunscreens, such as zinc oxide or titanium dioxide, are often preferred because they sit on the skin’s surface and are less likely to cause irritation than some chemical sunscreens. Consistent daily application of an SPF lip balm protects the lips from this known viral trigger, helping to reduce the likelihood of a future outbreak.
Safe Application and Hygiene Practices
Proper hygiene during a cold sore outbreak prevents the spread of the virus to others or to other parts of your body. Never apply lip balm directly from a tube or stick onto an active cold sore, as this contaminates the entire product with the virus. Instead, use a clean, disposable applicator, such as a cotton swab, to scoop a small amount of the balm or cream.
Handwashing before and immediately after application is an important step to avoid transferring the virus. The cold sore itself, as well as the fluid it contains, is highly contagious. After the cold sore has fully healed, discard the lip balm tube or pot used during the outbreak. Even with careful application, the product may be contaminated with viral particles and could trigger a new infection.
Avoid sharing any lip products, utensils, or towels with others while you have a cold sore. Using a dedicated tube or jar of balm solely for the outbreak period minimizes the risk of transmission. Maintaining a clean approach to application ensures that the balm helps the healing process without creating a hygiene risk.