Basic Essential Information About Cold Sores and the Herpes Simplex Virus
Cold sores are an external symptom of infection by the herpes simplex type 1 virus (although it’s rare, it is possible for the type 2 strain, normally responsible for genital herpes, to cause cold sores), for which there is, regrettably, no cure currently known–once you’re infected by the herpes virus you’re infected for life and doomed to suffer cold sore outbreaks for all eternity (sorry). Although, one thing that should make you feel better is that over time your body slowly builds up an immunity to the virus so that the outbreaks will become less frequent and the ones you do get will be shorter in duration and less in severity–cold sore outbreaks are particularly frequent and acute during the first year of infection.
Oral herpes cycles through periods of active and dormant stages with the active stages (where you’ve got a visible cold sore) lasting between 2 and 21 days with a week being about average for most people. The dormant stage is where you don’t have any visible sores and the virus has retreated into the sensory nerve cells near the site of initial infection, which is typically the face and more specifically the lips and around the mouth.
Available Prescription Anti-Viral Treatments for Cold Sores
Acyclovir (Zovirax): This will shorten the duration of the pain by up to 1 day, and can reduce the healing time of your first (ever) cold sore outbreak by 1 to 2 days.
Famciclovir: This medication is occasionally used to treat the herpes virus that causes cold sores as well as genital herpes (it acts on both the type 1 and type 2 strains, in other words), and studies have shown that it works as well as Acyclovir in treating oral herpes outbreaks. Possible side effects include itching, fever, headache, fatigue, nausea, or diarrhea.
Valacyclovir: Valacyclovir was approved by the FDA specifically to reduce cold sore duration in people who are at least 12 years of age or older, and it’s also known that Valacyclovir is absorbed much easier than other anti-viral medications such as Acyclovir and Famciclovir. Possible side effects include allergic reaction, headache, skin rash, insomnia, dizziness, and fatigue.
Topical Over-the-Counter Creams
Tetracaine cream (Viractin) and Lidocaine (Zilactin-L): These are topical anesthetics (painkillers) that can relieve the pain and itching associated with cold sores. Initial studies show that tetracaine cream can reduce the healing time of cold sores by up to 2 days. These products are applied to cold sores up to 6 times daily for best results. Pain and itching are relieved usually within 2 to 3 days after a person first applies the product.
Docosanol 10% (Abreva): A newer nonprescription cream that is safe and effective for treating cold sores. It is most effective when applied at the first signs of a cold sore outbreak. It is the first nonprescription cold sore medicine approved by the U.S. Food and Drug Administration (FDA) to shorten healing time and the duration of symptoms. I’ve tried this and, although I did noticed a bit of an improvement, I wasn’t particularly impressed with it.
Benzyl alcohol (Zilactin): This is a gel that relieves the pain of cold sores and may help shorten healing time, especially if used as soon as a cold sore begins to form. Let me say that this is probably, by far, the most effective over-the-counter treatment that I’ve ever tried. Apply it to the cold sore with a q-tip once every two hours.
Dimethicone with sunscreen (Herpecin-L): This is a product that moisturizes your lips and protects them from the sun. This can help reduce the pain and itching of cold sores. It can also help prevent cold sores from returning, especially if they were triggered by sun exposure.