I’ve suffered with cold sores since I was a child. I don’t know who exposed me and I don’t remember when I got my first cold sore, but I’ve had periodic outbreaks of swollen, painful blisters on my lips going back possibly as far as my preschool years. I haven’t really known life without this embarrassing condition that is impossible to hide. The majority of people in the U.S. have been infected with this virus, although only about 20-40% of people who carry the virus actually get cold sores. Trust me: that is not a fun lottery to win, and the fact that we sufferers are a relatively small group can make us feel alone and unfairly ashamed.
There is no cure for cold sores. Because I’ve been dealing with cold sores for most of my life, I’ve had a lot of time to experiment and figure out the best ways to cope with and treat these nasty little things. There are plenty of over-the-counter treatments for outbreaks that don’t really help (including some that cost a lot of money). I’ve also discovered the potential benefits of including certain foods in my diet to help prevent outbreaks. In particular, though, I’ve learned about prescription antiviral pills, which are far and away the most successful and practically life-changing cold sore treatment I’ve ever used.
Keep reading to learn about the single most effective thing I’ve done to treat cold sores.
Cold sores on the lips, also known as herpes simplex type 1, are part of the same family of viruses that cause genital herpes, chicken pox, and shingles. These viruses are latent, meaning they lie dormant and hide in your body and can recur again after your initial infection. For people who have had chicken pox, it means they are prone to get shingles later in life. With cold sores or genital herpes, it means another outbreak of blisters can be triggered at any time. With these viruses, you are literally a walking time bomb.
Sometimes I get several cold sores a year, or I might go a couple of years between outbreaks. I can often pinpoint what caused a specific outbreak — an illness or a stressful event (things that both weaken the immune system), or, less often, spending all day outside in bright and windy conditions. But that doesn’t mean those situations always trigger my cold sores, so it’s a burden I bear with a great deal of uncertainty, never sure when I’ll next feel those telltale blisters forming. Once I feel a cold sore coming on, it’s a matter of trying to treat it in a way that shortens its duration and reduces how big and ugly it gets.
Things I Tried that Didn’t Work
Over-the-Counter Creams. Through my high school years, I muddled through cold sore outbreaks using over-the-counter “remedies” such as Blistex or Campho-Phenique. I slathered these products liberally on my swollen, scabby lips, and they never seemed to help much except to maybe numb my sores. They didn’t clear up my cold sores any faster.
Lysine Supplements. When I was in college and dealt with several cold sores during one particularly difficult year, I began taking lysine supplements on the recommendation of some friends. Lysine is an amino acid that may interfere with herpes viral replication, but it hasn’t been definitively proven. Lysine didn’t reduce the frequency or severity of my outbreaks. I still take lysine occasionally as an extra precaution, especially if I’ve recently been ill or am going through an acutely stressful period, but I don’t rely on it to prevent cold sores or shorten outbreak duration.
Abreva. After college, I started seeing ads for a new over-the-counter cream called Abreva that claimed to dramatically shorten the duration of cold sore outbreaks. At around $20 per small tube, it cost a lot more than other over-the-counter creams that I usually paid less than $5 for. If it worked, though, it would be worth it. Unfortunately, it did nothing to noticeably reduce the length or severity of my cold sore outbreaks.
What Actually Helped My Cold Sores Go Away Faster
I was in my early thirties by the time I discovered a cold sore remedy that truly makes a difference. I was desperate to do all I could not to pass this miserable virus on to my young children. When I woke up one morning to feel those familiar blisters forming on my lip, I posted on social media about how frustrating it is to deal with cold sores. A good friend shared that she is also a longtime cold sore sufferer, and she recommended I get a prescription for Valtrex from my doctor. She discovered this antiviral pill a couple of years earlier when she had several outbreaks in a short time span and brought it up with her doctor. My friend claimed it quickly cleared up her cold sores whenever she got them.
Valtrex is an antiviral, which means it slows certain viruses from growing and replicating. It does not cure cold sores and the virus still lives in your body, ready to attack again another day. However, it greatly reduces the severity and duration of a cold sore outbreak.
I called my primary care doctor that same day and soon had a prescription in hand for valacyclovir, the generic equivalent of Valtrex. With insurance, valacyclovir cost me only $5 for a bottle of pills that gets me through a couple of outbreaks. I kept the pills in my purse so I’d always have them with me whenever a cold sore decided to strike. The recommended dosage is to take two pills (two grams) at the first sign of a cold sore, and then take two more pills (2 grams) about 12 hours later, so it’s a pretty simple treatment regimen.
The first time I took valacyclovir for a cold sore, I was amazed at how well it worked. Instead of having blisters grow large and remain full, swollen, and painful for days on end, my blisters dried up and moved to the scabbing stage within about two days. The blisters stay smaller and my entire lip does not swell up nearly as bad, and my cold sore is less noticeable overall. It can still take more than a week for my lip to fully heal and return to smooth, healthy skin, but the cold sore is definitely smaller and less conspicuous. I feel much less self conscious about having a cold sore when I have my supply of valacyclovir on hand. Some people claim that taking medication early enough prevents blisters from even forming, but I haven’t been that lucky.
One important note: it is essential to take antiviral medication at the very first sign of a cold sore. I’ve learned that if I wait even an hour or two, it greatly reduces the efficacy of the medication, and in some cases I’ll go on to develop a full-blown cold sore like I haven’t taken any medication at all. That’s why I always make sure it’s with me in my purse, and I always bring it along when I’m traveling.
I get my prescription from my primary care physician, but it’s possible your dentist may also be able to prescribe it. My dentist is a fellow cold sore sufferer and Valtrex or its generic equivalent is his go-to recommendation for cold sores.
Also of interest, Valtrex or valacyclovir may be prescribed to reduce the severity and shorten the duration of painful shingles outbreaks, too, as I learned when a family member got shingles a few years ago and got the same medication I take for cold sores.
Bonus: What Might Help Prevent Cold Sore Outbreaks
While antiviral pills are great at shortening the duration and reducing the severity of cold sore outbreaks, they don’t necessarily reduce the number of outbreaks you might experience. I appreciated having prescription medication when I had multiple cold sores during an especially bad year, but I was tired of getting so many outbreaks and did some research to see if I could make any dietary changes to help reduce my cold sore frequency.
Some people suggest limiting foods that contain arginine, such as certain nuts (pistachios are often blamed). I haven’t found that to make much difference for me.
I found some indications that eating yogurt and probiotics might help prevent outbreaks, and one particular study indicates probiotics might fight herpes. I figured it didn’t hurt to try eating some yogurt on a regular basis, and probiotics can help boost overall immune system health. I began eating yogurt cups several mornings a week for breakfast. I started with flavored yogurt such as strawberry, or sometimes I ate skyr. These days, I often eat plain yogurt sweetened with a little honey and mixed with granola and fruit such as strawberries. Plain yogurt with a swirl of jam or lemon curd is also good. Some people prefer to take probiotic supplements in pill form, but because supplements aren’t regulated by the FDA, I like to stick with getting probiotics from food sources when I can.
It may be subjective, but in my experience, I’m pretty sure yogurt has helped me reduce the number of cold sore outbreaks I have. After my year of frequent outbreaks, I started eating yogurt on a regular basis and didn’t get another cold sore for three years, which was a record for me.
Final Advice: Don’t Wait Any Longer
If you suffer with cold sores that are painful and make you want to hide from the world, talk with your primary care doctor or possibly even your dentist. I found antivirals like Valtrex (valacyclovir) to be my best bet in reducing the severity of cold sores and shortening the length of outbreaks. Generic antivirals for cold sores are affordable, especially if you have insurance, and the prescription is easy to fill in your local pharmacy. This prescription is the single best thing I’ve ever done to deal with my cold sores.
In the meantime, also give yogurt with live probiotics a try. It can’t hurt, and it might help.