Abreva (Docosanol) - Topical

What Is Abreva?

Abreva (docosanol) is a topical cream used to treat facial cold sores and fever blisters caused by the herpes simplex virus type 1 (HSV-1). It contains the active ingredient docosanol, which is an antiviral drug. Docosanol works by acting as the only non-prescription ingredient that can shorten healing time and the duration of symptoms, including pain, itching, and burning.

Abreva is available for over-the-counter (OTC) use and is intended for people 12 and older.

Abreva contains 10% docosanol and is traditionally sold in 2-gram tubes and pump bottles.

Drug Facts

Generic Name: Docosanol

Brand Name(s): Abreva

Drug Availability: OTC

Administration Route: Topical

Therapeutic Classification: Antiviral

Available Generically: Yes

Controlled Substance: N/A

Active Ingredient: Docosanol

Dosage Form(s): Cream

What Is Abreva Used For?

The Food and Drug Administration (FDA) approves Abreva to treat cold sores on the lips and face in adults and children 12 and older. It is used to shorten the healing time and duration of cold sore symptoms such as burning and itching.

Specifically, HSV-1 is the most common cause of cold sores. HSV-1 can be spread through contact with the skin or saliva of an infected person. HSV-1 can also be spread through oral sex and cause genital sores. Currently, there is no cure for HSV-1, so cold sores can recur periodically.

After the cold sore heals, the virus stays dormant in your body but can be reactivated by triggers like stress and illness.

Remember, Abreva is only used to treat symptoms caused by HSV-1 that appear on the face or lips. It is not to be used for cold sores or fever blisters resulting from genital herpes simplex virus type 2 (HSV-2).

How to Use Abreva

Use Abreva immediately after you notice the first sign of a cold sore for the best results. Apply Abreva cream to the affected area of your lip or skin five times per day. Make sure to rub the cream in completely, but be gentle. Wash your hands before and after each application. Be careful not to get the cream in your mouth or eyes.

It's important to note that Abreva is only meant for use on the face (not the genitals). Abreva works best when applied at the first sign of a cold sore. This is usually a tingling or itching sensation along the border of the lips that occurs before a cold sore visibly breaks out.

After the cold sore heals, you can stop applying Abreva. However, this medicine doesn't prevent cold sores from recurring.

Storage

Store Abreva at room temperature in a dry place, away from moisture. Keep Abreva and all medications where children and pets cannot get access to them. Do not store in a bathroom.

How Long Does Abreva Take to Work?

Abreva is an antiviral cream that begins working right away. When you apply Abreva at the first sign of a cold sore and use it properly, it usually helps to heal a cold sore within a few days.

In a 2012 clinical study, Abreva helped to relieve discomfort due to cold sores within three days.

What Are the Side Effects of Abreva?

This is not a complete list of side effects, and others may occur. A healthcare provider can advise you on side effects. If you experience other effects, contact your pharmacist or a healthcare provider. You may report side effects to the FDA at fda.gov/medwatch or 800-FDA-1088.

Common Side Effects

Common side effects of Abreva may include:

  • Redness or swelling at the site of application (cold sores may also cause these symptoms)

Severe Side Effects

Less commonly, Abreva may cause a severe allergic reaction.

Symptoms may include:

Report Side Effects

Abreva may cause other side effects. Call your healthcare provider if you have any unusual problems while taking this medication.

If you experience a serious side effect, you or your healthcare provider may send a report to the FDA's MedWatch Adverse Event Reporting Program or by phone (800-332-1088).

Dosage: How Much Abreva Should I Take?

Drug Content Provided and Reviewed by IBM Micromedex®

The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

  • For topical dosage form (cream):
    • Adults and adolescents:
      • Apply to the affected area(s), five times a day until sore is healed.
      • Rub in gently and completely
    • Children under 12 years of age
      • Use and dosage must be determined by your doctor.

Modifications

Users should be aware of the following before beginning Abreva:

Older adults: People 65 and older should feel safe using this cream as the label does not indicate extra care or attention is required in dosing.

Pediatrics: Abreva is not intended for people younger than 12. If needed, consult your healthcare provider for alternatives to treat HSV-1.

People with kidney or liver problems: Potential negative hepatic outcomes are not associated nor do they correlate alongside Abreva use.

Pregnant people: No studies have shown negative or potentially adverse reactions related to a birthing person, a newborn baby, or a developing fetus as the result of Abreva use.

Nursing people: No studies have shown negative or potentially harmful adverse reactions related to a nursing person, a newborn baby, or a developing fetus as the result of Abreva use.

Missed Dose

If you miss an application of Abreva, apply it as soon as you remember. Abreva should be applied five times daily until your cold sore is healed.

Overdose: What Happens If I Use Too Much Abreva?

Abreva is meant for external use only and should not be swallowed. Also, be careful not to lick your lips after applying this cream.

If you swallow Abreva cream, contact your healthcare provider or the Poison Control Center right away for advice.

What Happens If I Overdose on Abreva?

If you think you or someone else may have overdosed on Abreva, call a healthcare provider or the Poison Control Center (800-222-1222).

If someone collapses or isn't breathing after taking Abreva, call 911 immediately.

Precautions

Drug Content Provided and Reviewed by IBM Micromedex®

What Are Reasons I Shouldn’t Use Abreva?

You should not use Abreva if you are allergic to docosanol or any other ingredients in Abreva.

Again, you should also not use Abreva if the cold sores and fever blisters you are experiencing are the product of genital-based HSV-2, as Abreva is intended to treat the symptoms of HSV-1 only.

What Other Medications May Interact With Abreva?

Abreva is a topical cream. Very little of this medication gets absorbed into your body, so it should not cause interactions with other drugs.

It is still important to tell your healthcare provider about all the medications you take, including prescription drugs, OTC drugs, vitamins, and supplements. They can advise you on how to prevent or manage drug interactions.

Also, if your healthcare provider prescribes other topical medications for you, they may recommend spacing the applications apart. This helps to ensure each topical product has time to dry and work.

What Medications Are Similar?

Examples of other antiviral medications used to treat cold sores include:

  • Denavir (penciclovir): A prescription recurrent cold sore cream
  • Zovirax (acyclovir): Available in the form of Rx cream, ointment, an oral tablet, a capsule, and as a liquid suspension
  • Xerese (acyclovir and hydrocortisone): Two-in-one combination cream containing an antiviral drug plus a steroid
  • Valtrex (valacyclovir): Rx-only tablet
  • Famciclovir: Rx-only tablet

Unlike Abreva, all of the above medications require a prescription from a healthcare provider. Other OTC products, such as petrolatum, cocoa butter, and camphor, can be used to protect the skin and ease cold sore symptoms. However, these products do not provide antiviral or healing effects.

Another common ingredient in other OTC cold sore treatments, such as Orajel Touch-Free, is benzalkonium chloride. While it is not an antiviral, it is an antiseptic that helps guard against secondary bacterial infections that can occur with cold sores.

Frequently Asked Questions

  • Can I still wear makeup or lipstick with Abreva?

    Yes, but there are some special instructions. First, wash off any makeup or lipstick before you apply Abreva. You will want to apply Abreva first, then let it dry before putting on makeup, lipstick, or lip balm.

    Be sure to apply the cosmetic using a disposable applicator such as a cotton-tip swab, then throw it away. This will help prevent the cold sore from spreading.

  • Can I share Abreva with a friend or family member that also has a cold sore?

    No, you should not share a tube of Abreva with anyone else. Sharing can spread the cold sore and other infections or worsen your cold sores.

  • What should I do if Abreva does not work to heal my cold sore?

    If you’ve used Abreva for 10 days and your cold sore has not healed, or if it worsens, you should stop using it and contact your healthcare provider. They may need to examine you to determine the next best steps.

How Can I Stay Healthy While Taking Abreva?

Before and during a cold sore outbreak, remember that you can easily spread the virus to others. The virus that causes cold sores can be spread through your saliva until the cold sore heals and scabs over.

To prevent spreading cold sores to others, avoid touching the cold sore. You should also avoid kissing, oral sex, and sharing things like drinks, utensils, towels, or lip balm.

If your cold sore hasn't healed within 10 days, discontinue Abreva and see a healthcare provider. In some cases, a bacterial infection can occur on top of a cold sore and may require antibiotic treatment.

After you've had a cold sore, certain triggers can cause repeat outbreaks.

Avoiding or minimizing the following triggers may help prevent cold sores from recurring:

Managing stress, getting a good night's sleep, using sunscreen, and taking steps to avoid getting sick can help prevent more cold sores.

Medical Disclaimer

Verywell Health's drug information is meant for educational purposes only and is not intended to replace medical advice, diagnosis, or treatment from a healthcare provider. Consult your healthcare provider before taking any new medication(s). IBM Watson Micromedex provides some of the drug content, as indicated on the page.

6 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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By Patricia Weiser, PharmD
Patricia Weiser, PharmD, is a licensed pharmacist and freelance medical writer. She has more than 14 years of professional experience.