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.

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.

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:

• Itching
• Rash and/or urticaria (hives)
• Facial swelling
• Blistering
• Peeling skin
• Wheezing
  

Dosage: How Much Abreva Should I Take?

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.

Precautions

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.

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:

• Stress
• Sunlight
• Extreme hot or cold temperatures
• Illness, such as a cold or flu
• Lack of sleep

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