Cold sore treatment

Cold sores are small, fluid-filled blisters that appear on or around the lips. They are caused by the herpes simplex virus (HSV), most commonly HSV-1, and affect around 1 in 5 people. Around 70% of people are infected with HSV by the age of 25. Many people can live with the HSV-1 virus and not know it, as they do not show any symptoms.

The first symptom of a cold sore is normally a tingling, itching, or burning feeling on your face, usually around the lips and mouth. Some early symptoms you may experience are:

• sore throat
• swollen glands
• bad breath
• fluid-filled blisters
• blister clusters

When sores first appear, they look like small, fluid filled bumps surrounded by red, swollen skin. As time goes on, the blisters will start to burst and crust, which can cause:

• oozing
• crusting
• scabbing

Cold sores usually start to heal within 10 days, but this can vary between people.

There are a number of treatments for cold sores, both over-the-counter and on prescription. Some over-the-counter treatments for cold sores include:

• antiviral creams such as Zovirax, which can shorten the length of the outbreak, should be used at the first sign of tingling
• pain relieving gels and creams
• patches that are used to protect and help the skin heal
• electronic devices, which are sold at some pharmacies, and use light or lasers to treat cold sores, but there is limited evidence to confirm how well they work

Some prescription treatments for cold sores include:

• oral antiviral tablets, including valaciclovir and aciclovir, which can be helpful for severe or frequent outbreaks
• creams, your doctor may prescribe stronger antiviral creams that usually contain aciclovir

Cold sore tablets

Asda Online Doctor has 2 cold sore treatment options available. Valaciclovir and aciclovir are both oral antiviral medications. Valaciclovir comes in 500mg tablets, and aciclovir comes in 400mg tablets.

How do cold sore tablets work

Both valaciclovir and aciclovir work by stopping the HSV-1 virus from multiplying. This allows your immune system to effectively deal with the infection and reduces the severity and length of the outbreak. Cold sore tablets do not kill or cure the virus, but help to reduce the severity and duration significantly.

How to take cold sore tablets

To take valaciclovir, you should swallow one 500mg tablet twice a day for 5 days with plenty of water. You should leave at least 12 hours between each dose. We recommend drinking plenty of water to reduce side effects, especially if you are 65 years of age or older or have kidney problems.

If you are taking aciclovir, you should swallow one 400mg tablet 3 times a day for 5 days with plenty of water. Aciclovir can also be used to prevent outbreaks and is recommended for people who have 6 or more outbreaks in a year. For this type of treatment, 400mg is taken twice a day for 6 to 12 months. If you find it difficult to swallow tablets, you can dissolve them in a small glass of water. Make sure to drink all the liquid to get the full dose.

They can be taken with or without food, but taking them with food can help to reduce some side effects.

Cold sore tablets should, ideally, be taken within 24 hours of the first symptoms starting.

How effective are cold sore tablets

Valaciclovir and aciclovir are both highly effective treatments for cold sores and can make cold sores go away 1 day sooner.

A study has found that when compared to a placebo, valaciclovir:

• reduces the number of visible cold sores
• decreases the amount of positive lab tests
• helps to relieve pain from cold sores much sooner, 3 days instead of 6

A study looking at aciclovir found that at a higher dose (400mg, 5 times a day for 5 days), it helped to reduce symptoms in 8.1 days.

All medications, including cold sore tablets, can cause some people side effects. Some common side effects of valaciclovir and aciclovir include:

• feeling sick (nausea)
• headache
• fatigue
• diahorrea
• dizziness
• rashes
• being sick (vomiting)

Other common side effects of aciclovir include:

• stomach (abdominal) pains
• fever

Rare side effects include:

• confusion
• effects on blood and urine tests
• increased liver enzymes
• fits (seizures)
• unconsciousness
• slow, slurred speech
• unsteadiness when walking

In some cases, cold sore tablets can lead to an allergic reaction. You should call 999 straight away if you experience symptoms of an allergic reaction. These include:

• difficulty breathing
• flushing, itching skin
• swelling of the lips, face, throat, and neck
• low blood pressure causing collapse

For a full list of side effects for valaciclovir and aciclovir please read the patient information leaflets.

How to manage the side effects

Most side effects of cold sore tablets are mild and temporary and can be treated easily at home. You can treat:

• dizziness and headaches by staying hydrated, getting plenty of rest, and taking over the counter pain relief like paracetamol or ibuprofen
• nausea and vomiting by avoiding strong smells and flashing lights, staying hydrated, and eating small, frequent, bland meals
• itching and rashes by applying a cool, wet cloth to the affected areas, applying gentle, fragrance-free moisturisers, and avoiding scratchy fabrics

If you are finding any of the side effects persistent or difficult to manage, speak to your doctor or pharmacist for more advice.

Many cold sore treatments can be purchased over the counter and online. Treatments such as creams, gels, and patches can be bought over the counter from most pharmacies. Prescription-only tablets can be requested online from trusted online doctor services, or you can make an appointment with your GP to get a prescription on the NHS.

Can you buy cold sore tablets online?

Yes, you can request the cold sore tablets, valaciclovir and aciclovir online from Asda Online Doctor. To buy with us online, you will first need to complete a short online health assessment for one of our doctors to review, you can then place your order. From there, if:

• Your order is approved – it will be dispatched and sent to your home address in discreet packaging, or you can choose to collect it from your local Asda Pharmacy 4 hours after a doctor’s approval.
• Your order isn’t approved – one of our doctors will contact you via your account with alternative treatment options.

Buying cold sore treatment online with Asda Online Doctor can ensure that you get treatment quickly, which is important as the sooner you treat cold sores, the more effective the treatment is.

Is cold sore treatment available over the counter?

Yes, some cold sore treatments, such as gels and creams, as well as patches are available over the counter from many pharmacies.

The best time to take cold sore tablets is as soon as you experience the first signs of an outbreak. You should take the tablets within 24 hours of any tingling or itching for it to be most effective. This can help to prevent blisters from forming at all or help them to heal quicker.

There are several things you can do at home to help relieve cold sore symptoms. These include:

• drinking plenty of fluid to stop dehydration
• taking paracetamol or ibuprofen
• eating cool and soft foods
• using a cold compress
• avoiding cold sore triggers, including stress, fatigue, and sunbeds
• using sunblock lip balm when you are in the sun
• avoiding picking the blisters to prevent infection
• strengthening your immune system by eating healthily, getting enough sleep, and exercising

Cold sores are mainly caused by the HSV-1 virus, but they can also be caused by HSV-2, the main cause of genital herpes. The virus is spread through skin-to-skin contact, such as kissing and sex, and remains inactive until activated. Cold sores can be triggered by:

• stress
• illness
• skin trauma
• hormonal changes
• sunlight

There are 5 main stages that a cold sore will go through. Please note that time frames of the stages can vary from person to person.

Here is the overview of the different stages:

Stage 1 – Prodrome

This stage can last from a few hours to 2 days. You may experience tingling, itching, or burning where a cold sore will appear. This is the best stage to treat a cold sore.

Stage 2 – Blisters

This happens around 12 to 24 hours after the first symptoms appear. This is when small, fluid filled blisters are seen, and the area may be swollen and painful.

Stage 3 – Weeping

During this stage, the blisters burst and leave open weeping sores that usually last 2 to 3 days. The sores are very easily spread (contagious), and you should avoid touching them to help prevent the virus from spreading.

Stage 4 – Crusting

This happens around days 5 to 8, and the sores start to dry, and a yellow or brown scab or crust forms over them. This stage may cause itching or pain, but you should not pick or scratch the area, as this can slow down healing.

Stage 5 – Healing

This happens around days 8 to 10, when the scabs fall off, and new skin appears. As the skin continues to heal, the redness will fade. Cold sores should be healing by day 10.

Cold sores usually last around 7 to 10 days. The healing process can be sped up with the help of antiviral medications. If you have a cold sore that has not started to heal within 10 days, you should speak to your doctor.

Some things you can do to prevent cold sores include:

• avoiding triggers such as stress and sun exposure
• taking medications such as valaciclovir daily
• avoiding physical contact with other people who have open sores
• taking care of your general health

Yes, cold sores can come back as the virus that causes them stays inactive in your body and can be triggered again in the future. Cold sore treatments treat the symptoms of cold sores and not the cause. There is no cure for cold sores, so once you have been infected with HSV, it will remain in your body for life.