If you’re prone to cold sores, you know that a tingling feeling in your lip usually only means one thing: a new blisters is set to erupt.
Cold sores are usually caused by herpes simplex virus type 1 (HSV-1), a strain closely related to the type 2 bug responsible for genital blisters. These are just two of the eight types of virus in the herpes family that affect humans—another well known one causes chickenpox (herpes zoster). It used to be that HSV-2 was the virus mostly seen in genital herpes. But today, HSV-1 is often a cause; oral sex can transmit HSV-1 to the genitals. It can also transmit HSV-2 to the mouth.
There’s no question that cold sores are seriously uncomfortable. On their own, they usually clear up in two to four weeks. But that’s two to four weeks that are kind of a drag: the blisters are red, and ooze and crust. Fortunately, there are some cold sore treatments that can speed up the healing process, especially if you catch the cold sore early. But before you need those, take a look at how you might prevent these troublesome outbreaks—also known as fever blisters—altogether.
Preventing cold sores
Once you pick up the cold sore virus—lots of people pick up HSV-1 in their first six months to three years of life—it sits dormant in your nerve cells. In fact, the word herpes comes from the Greek word “to creep,” since the virus tends to creep along a nerve pathway and sit at the end until a trigger prompts it to rear its ugly head again. So the best way to avoid an outbreak is to reduce your exposure to certain triggers.
Classic triggers: Exposure to sunlight, stress, physical stress, being sick with a common cold or fever, getting a minor injury or having cracks in the lips, and using steroids.
One thing about cold sores is that they often give you a heads up via symptoms like tingling, itching, inflammation, or soreness where the fever blister is about to appear. Doctors call this the “prodromal stage,” and it actually does you a favor. If you catch it in the early stages and call a doctor to get an antiviral medication, you may prevent a cold sore from breaking out or at least keep it from sticking around so long.
Getting rid of cold sores fast
1) Use an antiviral medication.
Topical over-the-counter meds don’t work as well as prescription antivirals as cold sore treatments, says Bruce Robinson, M.D., a dermatologist in private practice in New York City and clinical instructor of dermatology at Lenox Hill Hospital. Over-the-counter creams may provide relief from the tingling and burning, but they aren’t the best option if you want sores gone fast.
The best way to treat cold sores is to start treatment early—in that prodromal stage—with a prescription oral antiviral medication like valacyclovir (which you probably know as Valtrex), says Lorraine Young, M.D., co-chief of dermatology clinical services at UCLA.
A common regimen is to take 2,000 milligrams in the morning and again later on in the day. This “decreases the virus from replicating, so then it will help it to heal faster,” says Dr. Young. It may even prevent the cold sore from erupting in the first place.
Preventing the virus from replicating prevents it from going through its normal course. The result? It can reduce the time it takes your blisters to heal—or even prevent them from appearing in the first place.
There’s even a newish way to get this medicine; there’s a form of acyclovir that you can put between your lip and gum on the side the cold sore is erupting on. It sits there and dissolves slowly throughout the day, offering your body a steady stream of the med to tame the virus.
2) Add a steroid cream.
A topical steroid cream (like cortisone) can help reduce the inflammation associated with the sores, which can make the pain, redness, and irritation feel a little bit better.
Important note: Steroid creams are only an option if you’re on the antiviral drugs. Remember the thing about steroids triggering breakouts? Steroids decrease your body’s ability to fight infections, so you have to be careful with them.
“If you just did the cream without viral therapy, you would be feeding the cold sore infection,” says Young. “But if you’re on the antiviral medicines, that could help decrease the symptoms.” Don’t put any kind of covering on top of the blister; air speeds the healing of these.
3) Make your own cold sore solution.
Dr. Robinson advises making a cold sore treatment solution with Domeboro, a powder available at drugstores that’s used to help with skin irritation (lots of people use it to soothe poison ivy rashes). Just dissolve the tablets or powder in about 12 to 16 ounces of water. You’ll notice some gunk at the bottom of the glass—that’s okay.
Then dunk a thin cloth, like a handkerchief or pillowcase, into the glass. Wring it out and lay it on the blistering area for about 15 to 30 minutes. Repeat two to three times a day until the sores dry out. (Make a new batch of the solution each time.)
“It sucks the moisture and water out of the blister,” says Dr. Robinson. “I can get someone who has an outbreak to scab within 3 days using that—which otherwise might take a week to 10 days.”
Once it’s dry, stop the soaks and keep the area moist with a topical antibiotic ointment like Neosporin. This helps prevent secondary bacterial infection—meaning it keeps any opportunistic bacteria from jumping into the broken skin and causing you more trouble—and aids the healing process. Also keep those bacterial infections away by not trying to pop the blister. “People pick at anything on their skin, so it can be tempting to do that,” says Dr. Young. If you get an additional infection, that not only makes the sore stick around longer; it can also lead to scarring.
4) Use cold compresses.
Reduce swelling and irritation with a cool, wet towel. The American Academy of Dermatology recommends using a cold compress for 5 to 10 minutes several times a day while you’re waiting for blisters to heal. Avoiding particularly acidic foods like tomatoes and oranges helps keep irritation to a minimum, too.
5) Consider lysine.
This amino acid comes in pills and ointments, and there’s some evidence that it’s useful for chasing cold sores. But it’s not for everyone—it can cause stomach pain and diarrhea, and it can change how your body takes up calcium, so don’t use this amino acid and calcium at the same time.
6) Try aloe vera.
While it won’t zap cold sores overnight, aloe vera has been found to reduce the pain associated with cold sores. It also contains vitamins A, C, and E, which may help to expedite the healing process.