From the Guidelines
For adult treatment of acute cold sores, start treatment at the first sign of symptoms with antiviral medications like oral valacyclovir, famciclovir, or acyclovir, as these have been shown to be effective in shortening the duration of symptoms and accelerating healing of the lesions associated with herpes labialis 1. When treating acute cold sores, it is essential to consider the following:
- Antiviral medications should be started during the tingling or prodrome phase for maximum effectiveness
- Oral antivirals, such as famciclovir, have been reclassified from prescription-only to pharmacist-controlled status in some countries, increasing accessibility for patients 1
- Topical antivirals and over-the-counter options, like docosanol 10% cream, can also be used to manage symptoms
- Pain relief medications, such as acetaminophen or ibuprofen, can be used as needed to manage discomfort
- Keeping the sore clean, avoiding touching, and applying petroleum jelly can aid in healing and prevent spreading the virus
- Identifying and avoiding triggers, like sun exposure, stress, and fatigue, can help prevent frequent occurrences
- For patients experiencing frequent cold sores (more than 6 times per year), suppressive therapy should be considered after consulting a healthcare provider.
From the FDA Drug Label
2.1 Dosing Recommendation in Immunocompetent Adult Patients Herpes labialis (cold sores):The recommended dosage of famciclovir tablets for the treatment of recurrent herpes labialis is 1500 mg as a single dose. Therapy should be initiated at the first sign or symptom of herpes labialis (e.g., tingling, itching, burning, pain, or lesion).
Treatment for Acute Cold Sore in Adults: The recommended treatment for acute cold sore in adults is famciclovir 1500 mg as a single dose 2. Alternatively, valacyclovir can be used for the treatment of cold sores (herpes labialis) in adults, however the exact dosage is not provided in the given text for this specific indication 3. Therapy should be initiated at the first sign or symptom of herpes labialis.
From the Research
Adult Treatment for Acute Cold Sore
- The typical treatment for cold sores includes antiviral medications, with acyclovir and valacyclovir being the most commonly prescribed 4.
- Valacyclovir has been shown to be effective in treating herpes zoster and genital herpes, with a more convenient oral dosage regimen compared to acyclovir 5.
- A study found that valacyclovir reduced the duration of viral shedding, hastened lesion healing, and decreased lesion-associated pain in patients with genital herpes 5.
- Another study demonstrated that valacyclovir was effective in suppressing recurrent episodes of genital herpes, with dosages of 500 mg daily or more recommended for immunocompetent individuals 6.
- Topical treatment with ME-609, a combination of 5% acyclovir and 1% hydrocortisone, has been shown to prevent the progression of cold sores to ulcerative lesions and reduce the cumulative lesion area compared to acyclovir and placebo 7.
- The use of valacyclovir and acyclovir has been increasing over time, with valacyclovir becoming a more popular treatment option due to its convenience and efficacy 4, 5, 6.
Treatment Options
- Antiviral medications such as acyclovir and valacyclovir are commonly used to treat cold sores 4, 5, 6.
- Topical treatments like ME-609 can be effective in preventing the progression of cold sores to ulcerative lesions and reducing the cumulative lesion area 7.
- The choice of treatment may depend on the severity of the cold sore, the patient's medical history, and the presence of any underlying conditions 4, 5, 6.
Efficacy of Treatment
- Valacyclovir has been shown to be effective in reducing the duration of viral shedding, hastening lesion healing, and decreasing lesion-associated pain in patients with genital herpes 5.
- ME-609 has been demonstrated to prevent the progression of cold sores to ulcerative lesions and reduce the cumulative lesion area compared to acyclovir and placebo 7.
- The efficacy of treatment may vary depending on the individual patient and the specific treatment used 4, 5, 6, 7.