The 5 Best OTC Cold Sore Treatments of 2024 - Health.com

Cold sores are quite common, and many people have a cold sore outbreak a few times a year. Itchy, painful, irritated, and sensitive cold sores are caused by the herpes simplex virus type 1 (HSV-1) and, less commonly, HSV 2. According to the World Health Organization, an estimated 3.7 billion people globally have an HSV-1 infection at a given time, which is the main cause of cold sores.

Most cold sores go away within a few weeks without treatment. However, multiple over-the-counter (OTC) ways to treat cold sores can help speed healing without needing to see a healthcare provider. Many people use oral treatments for prevention or treatment, explains Allison K. Truong, MD, a board-certified dermatologist in Beverly Hills, CA. These can reduce symptoms to seven days or prevent the cold sore from forming if you catch it early enough.

We surveyed 28 participants to find out which OTC cold sore treatment they tried, how effective it was, and why they liked it. The below over-the-counter cold sore treatments may help speed up healing time and can also help relieve symptoms like itching, pain, and redness. A dermatologist from our Medical Expert Board has also reviewed the contents of this article for medical and scientific accuracy.

• Form: Cold sore treatments come in three forms: creams, gels, or patches, depending on individual preferences and needs.
• Healing timeframe: Cold sores usually heal on their own within 2–4 weeks, but OTC treatments can speed it up if applied frequently.
• Targeted symptoms: Most cold sore treatments target discomfort, dryness, and inflammation. Addressing these factors can greatly improve the appearance and irritation of cold sores.
• Contagious timeframe: Cold sores are highly contagious during the blistering stage, lasting up to two weeks until they heal completely.
  

Our Experts recommended a variety of ingredients for managing cold sores, focusing on both alleviating symptoms and speeding up the healing process.

• Docosanol: An antiviral ingredient that speeds up healing and shortens the lifespan of a cold sore. 
• Camphor and phenol: These ingredients have antiseptic properties to prevent the spread of a cold sore and can also numb the area to prevent pain and itching. Camphor provides a cooling sensation that can help relieve the heat and discomfort caused by cold sores and dry them out.
• Glycerin: This is sometimes used in cold sore treatments to moisturize the area and prevent excessive dryness. 
• Lidocaine: Lidocaine is used in some cold sore treatments to help numb the area and minimize pain, discomfort, and itching. 
• Hydrocolloid: This thickening agent can absorb pus from a pimple; this ingredient is also used in some patches that can minimize the appearance of cold sores and protect them from outside aggressors. 
• Lysine: According to Geeta Yadav, MD, a board-certified dermatologist and founder of FACET Dermatology, Lysine helps soothe and hydrate cold sores. While some studies have suggested that taking daily lysine might prevent cold sores, the evidence is limited.

It's important to note that Jeannette Graf, MD, a board-certified dermatologist and Assistant Clinical Professor of Dermatology at Mount Sinai School of Medicine, advises against using multiple over-the-counter cold sore treatments together due to potential ingredient conflicts and recommends consulting a dermatologist before combining products.

Best Overall

 Amazon

Why We Like It

Our overall winner was the Abreva Docosanol 10% Cold Sore Treatment, which was praised for helping to relieve symptoms, reduce itching and burning, and, in some cases, actually reduce the length of the cold sore. Docosanol can be an effective antiviral ingredient that targets the virus that causes cold sores, explains Jeannette Graf, MD, a board-certified dermatologist and Assistant Clinical Professor of Dermatology at Mount Sinai School of Medicine.

Applying this product can effectively reduce the pain caused by cold sores. It also helps shrink the size of a cold sore, particularly if you use it at the first sign of its development, such as a tingling sensation on your lip. We love that it feels cooling upon application; it helps alleviate any burning, itchy, or tingling that often comes with a cold sore, and the cream formula makes it easy to apply.

It's Worth Noting

• The price is pretty steep at $23 for a 0.07 oz. pump and it doesn't blend well into the skin. This ointment might leave a visible white film on your lip while it works its magic. 

Product Details:

• Form: Cream
• Active Ingredients: Docosanol 10% 
• Usage: Five times a day, 10 days maximum

Best Budget

Amazon

Why We Like It

Available at most drugstores nationwide, Campho-Phenique Cold Sore Treatment Gel is a great budget option. The formula contains camphor and phenol, which work together to essentially numb the area on and around your cold sore, as well as stop the pain and itch. According to Dr. Graf, it also helps to prevent the development of external cold sores and fever blisters. This formula works overtime to really dry out your cold sore. It heals cold sores fast and, because it's a gel formula, might be less visible than other types of cold sore treatments on the market. 

It's Worth Noting 

• It stings right when you apply it to the affected area—but don't worry, this is normal and will go away after a few seconds.

Product Details:

• Form: Gel
• Active Ingredients: Camphorated phenol
• Usage: One to three times a day

Best for Pain Relief

Amazon

Why We Like It

True to its name, we really love how quickly this formula works—apply it to the area as soon as you feel that tingle. This gel-based Abreva Rapid Relief Cold Sore Treatment works fast to reduce the size of a cold sore and diminish the pain associated with said cold sore. You can thank the extra-strength lidocaine, 20% glycerin, and cooling menthol for helping to reduce pain and dry up the cold sore fast. In addition to having antiviral properties, this also helps to reduce pain and discomfort using topical lidocaine while also containing ingredients like glycerin to nourish the skin, explains Marisa Garshick, MD, a board-certified dermatologist at MDCS Dermatology. This helps to minimize pain even with the first application. 

It's Worth Noting

• This formula does not taste very good, and the top cap is a bit difficult to remove. 

Product Details:

• Form: Gel
• Active Ingredients: Glycerin, lidocaine hydrochloride
• Usage: Three to four times a day

Best Patch

Target

Why We Like It

Like hydrocolloid patches for acne, these Burt's Bees Cold Sore Patches use a hydrocolloid to protect and conceal cold sores from external elements. We were amazed by how much these little patches sped up the healing process on cold sores. This patch helps to create a protective barrier to minimize further irritation to the cold sore and helps to encourage faster healing, explains Dr. Garshick. It's easy to apply the clear patch and can be left on your cold sore for up to six hours. After applying the patch, you can also apply makeup if preferred.  

It's Worth Noting

• We wish the patches came in different sizes as they might be too big for smaller cold sores on the lips.

Product Details:

• Form: Patches
• Active Ingredients: Hydrocolloid
• Usage: One patch for up to six hours
  

CVS

Why We Like It

This Orajel Cold Sore Treatment quickly treats cold sore pain and speeds healing. According to Dr. Graf, this product contains benzalkonium chloride, a topical antiseptic, and benzocaine, a topical anesthetic, that works together to numb any pain and itching from the cold sore. We like that this is a touch-free application and features a mini applicator that you can brush the formula onto your cold sore directly—this keeps it clean and prevents the spreading of bacteria, too. Since it's a gel formula, it might not be as noticeable on your lips as a cream. This may be preferred by some over a white-looking cream.

It's Worth Noting

• This product may cause a slight burning sensation during application. Also, it contains only four treatments, so you can use it four times before purchasing another set.

Product Details:

• Form: Gel
• Active Ingredients: Benzalkonium chloride, benzocaine
• Usage: Three times a day

In order to find out which treatment is most effective for cold sores, we conducted a survey with 28 individuals who have previously experienced cold sores. We asked them about their experiences with over-the-counter cold sore treatments and gave them 15 different treatments to rate based on these attributes:

• Effectiveness: Did it help reduce any tingling, soreness, or itching/burning around your lip? 
• Texture: What was the texture of the formula like? Was it a cream, gel, ointment, or something else? 
• Feel: How did the cold sore medicine feel on your skin? Was it cooling and soothing? Smooth? Moisturizing or drying?
• Length of time of cold sore: How effective was the medication in making the cold sore go away at least a day sooner? 
• Recommend: How likely was each participant to recommend the products they tried? 

We also interviewed four dermatologists for their best recommendations for cold sore treatments. These experts include: 

• Marisa Garshick, MD, a board-certified dermatologist at MDCS Dermatology
• Geeta Yadav, MD, a board-certified dermatologist and founder of FACET Dermatology
• Jeannette Graf, MD, a board-certified dermatologist and Assistant Clinical Professor of Dermatology at Mount Sinai School of Medicine
• Allison K. Truong, MD, a board-certified dermatologist in Beverly Hills, CA
  

If the cold sore is not improving, is painful, or continues to recur, Dr. Garshick recommends seeing a healthcare provider. Additionally, if you're not sure if it is a cold sore or if you are immunocompromised, it is good to see a healthcare provider for proper evaluation, she explains. 

Although there are multiple over-the-counter cold sore treatments, in many cases, a prescription like Valtrex is the most effective way to treat a cold sore, says Dr. Truong. "The data for over-the-counter cold sore treatment is limited and mixed—it has to be compared to a treatment that we know works well, which is a prescription oral medication called Valacyclovir (Valtrex)." She suggests taking Valacyclovir at the first onset of tingling to help reduce symptoms to seven days or prevent the cold sore from even coming up. 

Daley Quinn is a freelance journalist, specializing in beauty and health, who has contributed to numerous publications, such as Elle, Real Simple, Allure, The Cut, WWD, and more. She also writes for her blog, The Daley Dose. For this story, Daley used her own experience with cold sore medicines, as well as survey results and recommendations from dermatologists, to create this list of best OTC cold sore treatments.