From the Guidelines
For managing fever blister (herpes simplex) residue, the most effective prescription option is valacyclovir (1000mg twice daily for 5-7 days), as it has been shown to be effective in reducing the duration and severity of symptoms 1. When it comes to over-the-counter (OTC) options, docosanol 10% cream (Abreva) can be applied five times daily at the first sign of symptoms until healing occurs. Additional OTC treatments include lip balms containing zinc oxide or SPF protection to help protect healing areas. For residual redness or scarring, moisturizers containing aloe vera or vitamin E can promote healing. It is essential to keep the area clean with gentle washing and avoid picking at scabs for proper healing. These treatments work by either directly fighting the virus (antivirals) or supporting the skin's natural healing process. Some key points to consider when managing fever blister residue include:
- Starting treatment at the first sign of symptoms to reduce the duration and severity of the outbreak
- Using antiviral medications, such as valacyclovir, for prescription treatment
- Keeping the area clean and avoiding picking at scabs to promote healing
- Considering moisturizers for residual redness or scarring If residual symptoms persist beyond two weeks or worsen despite treatment, it is crucial to consult a healthcare provider as this may indicate secondary infection or another condition requiring different management 1.
From the FDA Drug Label
Denavir is a prescription topical cream for the treatment of cold sores (recurrent herpes labialis) that occur on the face and lips. Principal display panel Compare to the active ingredient in Abreva®† docosanol cream, 10% cold sore/ fever blister treatment Non-prescription medicine to shorten healing time*
The options for managing fever blister (herpes simplex) residue are:
- Prescription option: Penciclovir (Denavir) topical cream 2
- Over-the-counter (OTC) option: Docosanol (Abreva) cream, 10% 3
From the Research
Over-the-Counter (OTC) Options
- Docosanol cream, available OTC, has been shown to be barely more effective than an excipient in treating acute episodes of herpes labialis 4
- Penciclovir cream, also available OTC, has been found to be effective in reducing lesion number, area, and virus titer compared to its vehicle control 5
Prescription Options
- Acyclovir, available by prescription, has been shown to reduce healing time by about 2 days when started as soon as the first symptoms appear 4
- Valacyclovir, a prescription medication, has been found to be effective in treating recurrent oral herpes simplex infections and can be used to suppress erythema multiforme triggered by HSV 6, 7
- Famciclovir, another prescription option, has been shown to speed the healing of herpes zoster and decrease associated acute and chronic pain in people 50 years of age or older 6
Treatment Considerations
- Topical antiviral use has shown modest but statistically significant efficacy in treating herpes labialis, with most studies demonstrating a significant reduction in episode length and/or healing time 6
- Oral acyclovir, valacyclovir, and famciclovir are efficacious and safe for the treatment of the first episode and recurrent genital herpes and are useful as suppressive therapy for individuals with frequent genital herpes recurrences 6
- Lifestyle measures, such as sunscreen use, can also be effective in preventing recurrent herpes labialis 7