There are a variety of effective cold sore creams that either help reduce pain and itching associated with cold sore outbreaks or work as topical antiviral medications to reduce the extent of viral infection and hopefully shorten the duration of the outbreak. The best way to choose a cold sore cream is to combine methods from both families. It’s best to first apply an antiviral cold sore cream at the first sign of an outbreak and then apply a cream that works as a local anesthetic and can reduce pain and itching.
Cold sores are the result of an infection with a herpes simplex virus. Most of the population has been infected with this highly contagious virus, although not everyone gets cold sores. After the initial infection, the virus lies dormant in the nervous system, occasionally causing cold sores in response to infection, stress, or exposure to sunlight.
Some topical antiviral cold sore creams act on the virus itself by interfering with DNA production by the virus, preventing it from replicating itself. This family of drugs includes acyclovir, penciclovir, and valacyclovir. Each of these cold sore creams is available only by prescription and must be applied at the first sign of infection to be most effective. These preparations are also available in oral tablet or pill form and can be used either to treat cold sores as they occur or as a preventive measures in people who experience frequent outbreaks.
If a person prefers an over-the-counter (OTC) cold sore cream or is unable to see a doctor for a prescription cream quickly enough, there are several OTC alternatives that have similar anti-viral properties. Docosanol cold sore cream is widely available in drug stores and online. This ointment works by making changes to the cell membranes of healthy, uninfected cells that make it difficult for the virus to take over the cell. Another cold sore cream, resveratol, is one of the beneficial compounds found in red grapes and has been shown in one study to be as effective as acyclovir against cold sore infections.
Some cold sore ointments help relieve the pain and itching associated with herpes simplex infection. Lidocaine and benzocaine are both OTC topical creams that relieve the pain and itching associated with cold sores and can be applied after one of the antiviral creams to alleviate discomfort. Zinc and lysine are other substances available as creams that may be effective at shortening the duration of an outbreak and helping with discomfort.