Cold sores, also known as fever blisters, are a common manifestation of the herpes simplex virus type 1 (HSV-1) infection. These small, fluid-filled blisters typically form on or around the lips, though they can also appear on other areas of the face. Once contracted, the virus remains dormant and can reactivate periodically, leading to an outbreak. While there is no cure, over-the-counter (OTC) creams can help manage symptoms and potentially shorten outbreak duration, alleviating discomfort and promoting healing.
Understanding Over-the-Counter Options
Over-the-counter creams for cold sores primarily focus on two approaches: directly inhibiting the virus or providing symptomatic relief. Docosanol, an active ingredient found in products like Abreva, represents an antiviral approach. It works by preventing the herpes simplex virus from entering healthy skin cells, thereby limiting its spread and reducing the severity and duration of the cold sore.
Other OTC options often contain topical anesthetics or skin protectants. Topical anesthetics, such as benzocaine or lidocaine, numb the affected area to temporarily ease pain, itching, and burning sensations. These ingredients provide relief from discomfort but do not target the virus itself. Skin protectants, like zinc oxide or petrolatum, can create a barrier over the sore, which may help soothe the area and prevent cracking while promoting a moist healing environment.
Effective Use and Expected Relief
For optimal effectiveness, apply an over-the-counter cold sore cream at the very first sign of an impending outbreak. This often includes a tingling, itching, burning, or numb sensation around the lips, occurring hours to a day or two before visible blisters appear. Early application during this “prodromal” stage can help reduce outbreak severity and potentially shorten healing time. Before application, wash your hands thoroughly to prevent spreading the virus.
A thin layer of the cream should be gently rubbed into the affected area, ensuring complete coverage. For products like docosanol, application is typically recommended five times a day until the cold sore is fully healed, which can take up to 10 days. While OTC creams do not cure herpes, they can shorten healing time, often by about a day or two, and lessen symptoms like pain, itching, and tingling. Continue using the cream as directed, even if symptoms improve, and avoid picking at scabs to prevent damage.
When Professional Care is Necessary
While over-the-counter creams can be helpful for managing cold sore symptoms, professional medical care is sometimes important. Consult a healthcare provider if OTC creams are not providing sufficient relief, or if the cold sore is particularly severe, very large, or widespread. Frequent or recurring outbreaks may also indicate a need for prescription antiviral medications, which can help suppress the virus and reduce the frequency and severity of future episodes.
Complications, such as signs of a bacterial infection (e.g., pus, spreading redness, fever), or if the cold sore spreads to the eyes, require immediate medical attention. An eye infection from the herpes virus can lead to vision problems. If there is uncertainty about whether a lesion is indeed a cold sore or something else, a medical professional can provide an accurate diagnosis. OTC cold sore creams are not for genital herpes; a medical consultation is necessary for its proper diagnosis and management. Individuals with weakened immune systems, such as those with HIV or undergoing chemotherapy, should also consult a doctor for cold sores, as they may experience more severe or widespread infections.