The 6 Best Cold Sore Medicines of 2020

Ease painful blisters with these over-the-counter soothers

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First Look

Best Overall: Abreva Cold Sore Treatment at Amazon

"It’s the only FDA-approved, non-prescription medicine to treat cold sores with the active ingredient Docosanol."

Best for Blisters: Zilactin Cold Sore Gel at Amazon

"This gel creates a protective layer over cold sores and envelopes them with pain relief."

Best For Kids: Cold Sores Begone at Amazon

"This herbal remedy is safe for children and still lessens the duration of cold sores with natural and organic ingredients."

Best Patch: Compeed Cold Sore Patch at Amazon

"These handy patches conceal while they heal even the most painful cold sores and offer multiple benefits."

Best Device: Virulite Invisible Light Electronic Cold Sore Treatment Device at Amazon

"This breakthrough cold sore gadget uses light technology to shorten the healing time of your cold sore."

Best Lip Balm: Lip Clear Lysine+ Cold Sore Treatment at cvs.com

"Swipe on instant soothing relief with this lip balm."

Cold sores are uncomfortable and, unfortunately, very common. “Up to 80% of the US population has herpes simplex virus (HSV) antibodies to herpes circulating in their blood, meaning that they have personally been exposed to the HSV virus. You can have these antibodies, but never actually develop a herpes sore on your skin. About 20-40% of the population will develop at least one lesion in their lifetime,” according to Tsippora Shainhouse, MD, FAAD, board-certified dermatologist in Beverly Hills.

HSV is the virus that causes cold sores. Like the chickenpox virus, it lives permanently in a nerve with branches to the skin and small amounts of virus are constantly shed via the skin, blood, and other body fluids, with or without an active lesion. However, when you do have an active cold sore, it is very contagious. 

“Herpes lesions develop on keratinized skin, meaning the white or lip outer lip area, nose, cheek, and chin,” says Dr. Shainhouse. “This is different than canker sores that develop inside the mouth and tongue, which are not herpes at all.” That, and the accompanying pain give good motivation for finding effective relief.

Being proactive with your treatment is key. “Many people have a prodrome period immediately before the sore develops,” says Dr. Shainhouse. “You can feel pain, itch, tingling up to one day prior to the sore developing. It is associated with viral replication and nerve irritation. This is the time to treat with oral medications to prevent the sore from developing. If you can catch it early, you can hopefully prevent the blisters, or at least reduce the severity and duration of the episode.” 

“The sore itself may start off looking like a small pimple, which then grows, often starts to weep clear liquid and develops a crust. It can take one to two weeks to heal. It is very contagious while it is wet/crusted.”

If you catch that tingle in time, there are many topical and oral medications available over the counter and with a prescription that can halt its painful progress.

Our Top Picks

1

Best Overall: Abreva Cold Sore Treatment

Abreva Docosanol

 Courtesy of Amazon

Abreva is great for abbreviating cold sores. It’s the only FDA-approved, non-prescription medicine to treat cold sores with the active ingredient Docosanol. The sooner you catch the initial signs of a cold sore, the better this cream works to block the virus that causes it.

When applied upon the first tingle, it eliminates pain, itching, and burning and knocks out the cold sore in as few as two and a half days. It is safe for external use for adults and children 12 and over, but avoid putting it directly in your mouth.

2

Best for Blisters: Zilactin Cold Sore Gel

This gel creates a protective layer over cold sores and envelopes them with pain relief. The active ingredient, 10% benzyl alcohol, is designed to heal and dull pain relief for up to six hours, and it’s safe to be used around and in the mouth.

Because it’s safe inside the mouth, it helps treat canker sores, fever blisters, and gum irritations in addition to cold sores. It makes all activities more comfortable as the cold sore totally heals. “Zilactin works amazing because even if you miss the first step it helps heal everything amazingly,” according to reviewers.

3

Best For Kids: Cold Sores Begone

This herbal remedy is safe for children and still lessens the severity and duration of cold sores with natural and organic ingredients. Ingredients include coconut oil, beeswax, lemon balm, L-Lysine, grapefruit seed extract, echinacea, chaparrel extract, goldenseal, and peppermint and eucalyptus essential oil.

"Since I’ve started using this stick every night before bed I have not had a single outbreak nor have I even felt any of the warning signs of an outbreak coming on. This stick is honestly amazing and it lasts so long," one reviewer wrote. Another added, "This is the best prevention and healer of cold sores, it moisturizers as it heals. If you catch the sore at the first tingle, you can prevent it from progressing."

4

Best Patch: Compeed Cold Sore Patch

These handy patches conceal while they heal even the most painful cold sores and offer multiple benefits. One patch offers up to twelve hours of protection and reduces scabbing. Reviewers call them “amazing” because they cover the cold sore completely and offer quick relief. The patches also remove the worry that the virus is spreading to others and eliminates the “gross scabby period of time.”

"Cold sores suck, but a big stressor about them is worrying that I'm accidentally spreading the virus while it's shedding," one reviewer wrote. "These cover them up, removing that worry, and they also help avoid the gross scabby period of time, too, since they're covering the sore and keeping it moist."

5

Best Device: Virulite Invisible Light Electronic Cold Sore Treatment Device

This breakthrough cold sore gadget uses light technology to shorten the healing time of your cold sore. It’s cleared by the FDA and available without a prescription for at-home use. It’s clinically proven to shorten the healing time of cold sores when it’s used three times a day for two days. It’s mess-free and convenient, but the results garner hundreds of rave reviews.

While it's a little pricier than some of it's competitors, the Virulite Invisible Light Electronic Cold Sore Treatment Device is a great investment for anyone with regular cold sores who is tired of replacing their topical cream treatment every few months.

6

Best Lip Balm: Lip Clear Lysine+ Cold Sore Treatment

Lysine

Swipe on instant soothing relief with this lip balm. Pain, burning, and itching are diminished on contact. Research studies demonstrated the balm cut cold sore healing time in half and can fully cure symptoms in as little as three days. The active ingredients include menthol for pain relief and lysine. Lysine inhibits arginine activity, which is a common trigger of cold sore outbreaks.

Final Verdict

As the only FDA-approved, non-prescription medicine to treat cold sores with the active ingredient Docosanol, Abreva Docosanol 10% Cream blocks the virus that causes cold sores and relieves the unpleasant symptoms. But, if your goal is avoiding the mess and discomfort consider the Compeed Cold Sore Patch. These protective covers offer relief and keep the contagious virus from spreading as it heals.

What to Look For in a Cold Sore Medicine:

Ingredients: Cold sore medications, both prescription and OTC, rely on a variety of different active ingredients to offer relief and healing, per Dr. Shainhouse. There are drying agents (Domeboro solution, calamine lotion, zinc oxide, witch hazel), which when dabbed on the sore help dry up the blister and its fluid. Topical steroids or anti-inflammatory cream (hydrocortisone) can be applied a few times a day to reduce the pain, itch, redness, and inflammation. They provide comfort and can be used with anti-virals. Prescription topical anti-viral creams can reduce the severity and duration of a cold sore. The most effective are penciclovir and acyclovir and should be started ASAP at the first signs of a prodrome, per Dr. Shainhouse.

Another option are topical anesthetics, like prescription lidocaine or OTC benzocaine, which are available as mouthwashes, creams, and ointments. They can be applied to the sore up to three times a day as needed for local pain relief. Dr. Shainhouse recommends applying them before eating, especially if the sore is making it too painful to eat.

Form: Cold sore relief comes in many different forms. There are oral medications and topical options as well as devices and patches that block the virus causing the cold sores and treat symptoms.

Topical over-the-counter cream (Abreva) has not shown significant efficacy in medical studies, per Dr. Shainhouse. “One study suggests that it may reduce the total time of the cold sore episode by 18 hours.” 

Topical barrier gels and ointments helps lessen discomfort while the sore heals. “They act as a barrier from outside irritants (food, drinks, talking) and may keep out bacteria, which can cause a secondary infection in the viral sore. Try Vaseline, Aquaphor, Chapstick (don’t double-dip or keep the stick/jar for cold sores only!). Topical hydropropyl cellulose adheres to the lesion to keep out irritants (Zilactin and Ziladent are both over the counter), per Dr. Shainhouse.

Why Trust Verywell Health

As a seasoned health writer, Jennifer Nied understands how vital quality product recommendations are for treating symptoms safely and effectively at home. For over 10 years, she has reviewed products, interviewed experts, scrutinized ingredients, and pored over research studies and claims, to help readers like you understand what works for your specific conditions. Every product in this piece was selected taking into account recommendations from doctors, published research, and real customer reviews.

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  1. Johns Hopkins Medicine. Oral Herpes.

  2. Mailoo VJ, Rampes S. Lysine for Herpes Simplex Prophylaxis: A Review of the Evidence. Integr Med (Encinitas). 2017 Jun;16(3):42-46.