From the Guidelines
To prevent cold sores, it is essential to avoid triggers like sun exposure, stress, and illness by using SPF lip balm, practicing stress management, and maintaining good health, as supported by the study 1.
Prevention Strategies
- Avoiding triggers such as sun exposure, stress, and illness can help prevent cold sores, as mentioned in the study 1.
- Using SPF lip balm can help decrease the probability of recurrent outbreaks, as stated in the study 1.
- Practicing stress management and maintaining good health can also help prevent cold sores.
Treatment Options
- At the first sign of a cold sore (tingling sensation), applying over-the-counter medications containing docosanol (Abreva) or prescription antivirals like acyclovir (Zovirax), valacyclovir (Valtrex), or famciclovir (Famvir) can help reduce the duration of symptoms, as indicated in the study 1.
- For frequent outbreaks (more than 6 per year), talking to a doctor about daily suppressive therapy with valacyclovir 500-1000mg daily or acyclovir 400mg twice daily can be beneficial, as suggested by the study 1.
Preventing the Spread of Herpes Simplex Virus
- Avoiding touching or picking at cold sores, washing hands frequently, and not sharing personal items like lip balm or towels can help prevent the spread of the herpes simplex virus, as implied by the study 1.
- Keeping the immune system strong through adequate sleep, balanced nutrition, and regular exercise can also help prevent cold sores, as supported by the study 1.
From the FDA Drug Label
Two double‑blind, placebo‑controlled clinical trials were conducted in 1,856 healthy adults and adolescents (aged greater than or equal to 12 years) with a history of recurrent cold sores. The mean duration of cold sore episodes was about 1 day shorter in treated subjects as compared with placebo. No significant difference was observed between subjects receiving VALTREX or placebo in the prevention of progression of cold sore lesions beyond the papular stage.
Cold Sore Prevention:
- The provided studies do not directly support the use of valacyclovir for cold sore prevention, but rather for treatment.
- There is no evidence to suggest that valacyclovir prevents cold sores.
- The studies focus on the treatment of cold sores, not prevention 2.
From the Research
Cold Sore Prevention Methods
- Oral antiviral medications such as acyclovir, valacyclovir, and famciclovir have been shown to be effective in preventing recurrent herpes labialis 3, 4, 5
- Valacyclovir 500 mg once daily for 4 months has been found to be effective and well tolerated for the prevention of recurrent herpes labialis 4
- Chronic suppressive therapy with oral antiviral agents should be considered for patients with severe or frequent (six or more episodes per year) recurrences 6
- Topical antiviral agents are not effective in the prevention of recurrent herpes labialis, but can be used for episodic treatment 6, 7
Key Findings
- Oral acyclovir and valacyclovir have been shown to be effective in preventing recurrent herpes labialis when taken prior to the appearance of any symptoms or exposure to triggers 5
- The use of systemic acyclovir and valacyclovir for the prevention of recurrent herpes labialis has been supported by a systematic review and meta-analysis 5
- Treatment with oral antivirals decreases the duration of lesion episodes and pain by approximately one day, but does not abort lesions from developing 7
Treatment Options
- Oral antiviral agents such as acyclovir, valacyclovir, and famciclovir are available for the treatment and prevention of recurrent herpes labialis 3, 4, 6, 7, 5
- Topical antiviral agents such as 5% acyclovir cream/ointment, 1% penciclovir cream, and 50 mg Buccal Adhesive Tablet can be used for episodic treatment of herpes labialis 6