What to do if you have a cold sore

Get early treatment. The earlier you treat a cold sore, the better. In fact, the best time to start treatment is as soon as you feel the telltale tingle. The standard treatment is aciclovir cream, applied five times a day for 5 days. If your cold sore is on the lips, you may have to reapply the cream after eating or drinking. Aciclovir is an antiviral drug that prevents the virus from multiplying and speeds up healing. You can buy it from pharmacies without a prescription. (Another antiviral cream, penciclovir, is available, but requires a doctor’s prescription in the UK, and needs to be applied more frequently than aciclovir.)

Do not expect miracles from the cream. If you start treatment early enough, it will shorten the attack from about 8 days to about 6 days (Journal of Family Practice 2004;53:923–4). If you often get recurrences, it makes sense to ensure that you have a supply of antiviral cream in readiness, so that you can start treatment promptly.

Dry the sore up or keep it moist? This is a dilemma, because a sore that is oozing does not look very nice. Some people like to dry it by dabbing on surgical spirit or witch hazel (from a pharmacy), or even gin or vodka. However, it is possible that cold sores heal better when they are kept moist. Of course, aciclovir cream will keep it moist as well as having a specific antiviral action. Tea tree oil, or oil from a vitamin A or vitamin C capsule, are other methods of keeping it moist and may reduce inflammation slightly.

Be hygienic. Hygiene is important, because you do not want a bacterial infection to move in.

Try not to touch the sore with your hands.
If you apply any cream or oil to the sore, use a new cotton-wool bud each time.
To wash the area, dab it gently with a moistened tissue. Do not apply any disinfectant, because this may be too harsh for the damaged skin.

Protect your eyes. Herpes simplex can cause a nasty eye infection, so take care.

Be careful when applying eye make-up – it is easy to touch your cold sore without realizing it.
Wash your hands very thoroughly before putting in contact lenses (this is one reason why you should never use saliva to moisten contact lenses).
If your eye does become sore, see your doctor straight away.

Do not infect anyone who is vulnerable. Although herpes simplex is not normally a damaging virus, it can cause serious problems in people whose immune system is poor.

Keep away from babies.
Do not kiss anyone who is unwell for any reason, or who is pregnant, old, or has eczema (herpes can cause a nasty infection in skin already affected by eczema).
Do not share your toothbrush or eating utensils with anyone (because the virus can be passed in saliva).
Do not give oral sex to anyone until the sore has healed completely, or you could be giving them genital herpes.

Written by: Dr Margaret Stearn
Edited by: Dr Margaret Stearn
Last updated: Saturday, February 13th 2010

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Comments on this article

Posted by Optional on 08/07/2010 at 10:26:54 am

I have sufferd for a long time and i find that putting tea tree oil on it 5 times a day and to was use a cheap face wash to keep it clean gud luck

Posted by Anonymous on 24/10/2009 at 01:18:00 pm

To treat my cold sore I use Blistex Antiviral cream with Aciclovir and Blackmores Lyp-sine tablets which prevent the cold sore altogether (if I act as soon as the tingle happens) or it reduces the healing time by about 4 days. I always get my cold sore in the same place, is it the same for other people?

Posted by Anonymous on 23/10/2009 at 10:01:00 am

when ever i am tired i know that im going to get a cold sore the next day, this is happened to me since i was 6. what i want to know is why? my job at the office keeps me up to the late evenings so how can i stop them from expolding on my face

Posted by Anonymous on 09/09/2009 at 04:50:00 am

I recently discovered i have the HSV-1 cold sore virus, I had a dry uncomfortable sensation in my left eye, then very bloodshot... it turns out the blemishes under my lip were not pimples but cold sores, after touching them and then my eye i now have a severe viral eye infection. My doctor prescribed me oral famvir to fight the HSV-1 virus in my lip, along with an oral antibiotic as well as eyedrop antibiotic and anti-inflammatory to take care of my eye. all from one cheeky drunken kiss with a girl i wasnt all that keen on... :(

Posted by Anonymous on 19/08/2009 at 12:09:00 am

i find that changing brands of coldsore cream (including the own brand half the price products)each time and during really helps reduce the inflamation/erruption.

Posted by Juney on 14/08/2009 at 02:15:00 pm

years and years ive been suffering from cold sores tryed everything possible, dont no if ive found a cure but found in my experience when i feel as if im getting a col sore i start by putting aftershave or perfume on it, it really stops it from progressing, please give me some feed back from others if it works for you.

Posted by MEG2U2 on 23/04/2009 at 10:01:00 pm

I suffer from cold sores,I have 4 at present 3 on my bottom lip and one on the upper.These can be very painful and eating and drinking causes problems.I have tried allsorts of creams and lotions and find nothing works,so I just let nature take it's course and stay indoors till they go away.If anyone has any new creams to try I would love to hear about them.