From the Guidelines
For the treatment of Herpes Simplex Labialis (cold sores), antiviral medications should be started as soon to the onset of symptoms as possible, with topical creams like docosanol or benzyl alcohol applied every 2-3 hours for 4-5 days, or oral antivirals such as acyclovir, valacyclovir, or famciclovir prescribed by a doctor for more severe cases. The goal of treatment is to block viral replication, shorten the duration of symptoms, and accelerate healing of the lesions associated with herpes labialis, as discussed in the study by 1.
Treatment Options
- Topical antiviral creams: docosanol (Abreva) or benzyl alcohol applied every 2-3 hours for 4-5 days
- Oral antiviral medications:
- Acyclovir (400 mg three times daily for 5 days)
- Valacyclovir (2 grams twice daily for 1 day)
- Famciclovir (1500 mg once) These treatments work best when started within 48 hours of symptom onset, as noted in the study by 1.
Additional Measures
- Apply ice to the affected area to alleviate discomfort
- Take over-the-counter pain relievers like acetaminophen or ibuprofen
- Keep the area clean and dry
- Avoid touching or picking at the sore to prevent bacterial infection and spreading the virus
- Lysine supplements (1000 mg three times daily) may help reduce outbreak duration
Long-term Management
- For frequent outbreaks, daily suppressive therapy with oral antivirals may be recommended
- Avoid triggers like stress, lack of sleep, and excessive sun exposure
- If sores persist beyond two weeks, are extremely painful, or occur near the eyes, consult a healthcare provider, as emphasized in the study by 1.
From the FDA Drug Label
1 INDICATIONS AND USAGE
1.1 Adult Patients Cold Sores (Herpes Labialis) VALTREX is indicated for treatment of cold sores (herpes labialis).
1 INDICATIONS & USAGE
- 1 Immunocompetent Adult Patients Herpes labialis (cold sores):Famciclovir tablets are indicated for the treatment of recurrent herpes labialis in adult patients.
The treatment options for Herpes Simplex Labialis (Cold Sores) are:
- Valacyclovir (PO): indicated for treatment of cold sores (herpes labialis) in adult patients and pediatric patients aged greater than or equal to 12 years 2
- Famciclovir (PO): indicated for the treatment of recurrent herpes labialis in adult patients, with a recommended dosage of 1500 mg as a single dose, initiated at the first sign or symptom of herpes labialis 3 3
From the Research
Treatment Options for Herpes Simplex Labialis (Cold Sores)
The treatment options for Herpes Simplex Labialis (Cold Sores) include:
- Antiviral medications, such as valacyclovir and acyclovir, which are effective in reducing the duration and severity of cold sore episodes 4, 5
- Topical treatments, such as aciclovir cream, which can reduce the duration of the episode 6
- Simple hygiene measures, such as avoiding touching the affected area and keeping the area clean, which can help prevent the spread of the virus 6
Antiviral Medications
Antiviral medications, such as valacyclovir and acyclovir, are commonly used to treat cold sores. These medications can:
- Reduce the duration of the episode by 1-2 days 4
- Prevent the development of cold sore lesions and reduce the severity of symptoms 4
- Be effective when started within 72 hours of symptom onset 7
- Have a similar efficacy to famciclovir, another antiviral medication 8, 7
Topical Treatments
Topical treatments, such as aciclovir cream, can be used to treat cold sores. However:
- The addition of hydrocortisone to aciclovir cream does not provide significant benefits over aciclovir alone 6
- Corticosteroids, such as hydrocortisone, may aggravate infections and should be used with caution 6