There is no cure for cold sores, nor is there a cure for the herpes simplex virus (HSV) that causes them. Most cold sores will go away on their own. But medications may slightly reduce the duration of cold sores and sometimes prevent a future outbreak.

Treatment with medications depends on whether you are having a first outbreak or a recurrent outbreak or are trying to prevent future outbreaks.

When treating a first outbreak of cold sores, oral antiviral medications may reduce pain and slightly improve healing time.

For treatment of recurrent cold sores, the following medications may reduce the severity and duration of the outbreak:²

• Topical creams or ointments, which are available with or without a prescription, can reduce pain, itching, and healing time.
• Oral antiviral medications, which are available by prescription only, may be used when the first symptoms (such as burning or itching) develop. These medications have little effect once the sore develops.

Oral antivirals may also be taken daily to prevent recurring cold sores, especially in people who have frequent and painful outbreaks.

If you have a weakened immune system and develop cold sores, you may need higher doses of these medications to control your symptoms or daily doses to prevent outbreaks.

Although it is rare, children and adults with weakened immune systems may also need to take antibiotics during severe episodes of cold sores to treat bacterial infections that may develop.

Other treatments

The first episode of cold sores can be so painful that you may have difficulty eating, drinking, and sleeping. A child who has a fever and many mouth sores may need to be encouraged to drink water and other fluids to prevent dehydration.

Adults and older children who have a painful first episode of cold sores may sometimes need a prescription-strength medicated mouth rinse to reduce pain.

Complementary medicine

No complementary medicines have been proved through scientific studies to be effective in the treatment or prevention of cold sores. But several complementary treatments are available if you wish to try an alternative way to ease your symptoms.

Vitamin C, lysine supplements, and lemon balm are examples of complementary treatments that may provide some relief during a cold sore outbreak.

One study showed that zinc oxide/glycine topical cream reduced the duration of an outbreak.³