Understanding Cold Sores: Treatment

Medically Reviewed by Melinda Ratini, MS, DO on August 11, 2025
2 min read

To see if you have the herpes simplex virus (HSV), which causes cold sores, your doctor may simply examine the cold sore or take a culture from it.

Your doctor may also test blood for antibodies to the virus.

A positive antibody test only proves that you have the virus; it does not tell you if the virus is active or when you were infected.

You can't cure HSV or a cold sore, but you can ease the pain it causes by: 

  • Avoiding spicy or acidic foods 
  • Applying ice
  • Using over-the-counter remedies

Look for medicines that contain numbing agents such as: 

  • Phenol 
  • Menthol to reduce cracking and soften scabs 
  • Abreva. This over-the-counter topical remedy can help speed healing and keep your pain at a minimum. But you must use it many times a day to speed the healing.

If your cold sore is especially painful or irritating, your doctor may prescribe an anesthetic gel to ease discomfort. They can also give you an antiviral oral medication to speed healing or stop your cold sore from coming back. 

The antiviral medicines available for treatment include: 

  • Acyclovir (Zovirax) 
  • Famciclovir (Famvir) 
  • Valacyclovir (Valtrex) 
  • Penciclovir (Denavir), which also comes in a topical form.

Acyclovir, famciclovir, and valacyclovir are oral medications. They work better if you start taking them within the first 48 hours of your outbreak. (Acyclovir also comes as a topical form.) Valacyclovir may cost more, but your digestive tract absorbs it better, so it's more reliable. 

It's important to keep your cold sore clean because bacteria can infect your sore. Clean and gently wash your sore with soap and water as needed to prevent infection.

 

  • Wash your hands after touching a cold sore.
  • Don't rub your eyes after touching your cold sore; you could get an ocular herpes infection, which may lead to blindness if left untreated.
  • Don't touch your genitals after touching your cold sore; you could get genital herpes.
  • Replace your toothbrush after your cold sore heals.
  • Don't kiss someone who has a cold sore or use that person's utensils, towels, or razors.
  • Apply sunscreen to the face and lips before prolonged exposure to the sun.
  • Replace your lipstick or lip balm after your sore goes away.