Online Cold Sore Treatment

Many typical recurrent cold sores can be assessed online. The clinician will review where the lesion is, whether you have had similar episodes before, how long symptoms have been present, how severe they are, your medical history and any current medicines.

Eye involvement, severe or widespread infection, significant immune suppression, diagnostic uncertainty or unusually persistent lesions may require face-to-face assessment.

No. Treatment is supplied only where symptoms are consistent with herpes labialis and the selected antiviral is clinically appropriate. Some mouth ulcers, impetigo and other facial lesions can resemble cold sores.

Topical aciclovir is often suitable for uncomplicated cold sores, particularly when started early. Oral aciclovir may be considered in selected patients where systemic treatment is clinically appropriate, for example with more significant or recurrent herpes simplex infection.

A cold sore is a herpes simplex virus infection, usually affecting the lips or surrounding facial skin. It often begins with tingling, itching or burning before small fluid-filled blisters appear.

Tingling, itching, burning or tenderness can occur before a visible blister develops. Starting antiviral treatment during this early prodromal stage may provide the greatest benefit.

Cold sores commonly heal within about 7 to 10 days without complications, although the duration can vary. Persistent, severe or repeatedly worsening lesions should be reviewed.

Yes. Cold sores are contagious from the first tingling symptoms until the lesion has fully healed. Avoid kissing and avoid sharing items that contact the mouth while a cold sore is active.

Yes. Herpes simplex virus can be transferred from an active lesion to other sites, including the eyes. Wash your hands after touching the area and avoid touching your eyes.

Aciclovir 5% cream is a topical antiviral used for herpes simplex infections of the lips and face. It works by interfering with viral replication in infected cells.

Apply a thin layer to the affected and immediately surrounding skin five times daily at approximately 4-hour intervals during the day, omitting the night-time application.

Treatment is usually continued for 4 days. If healing has not occurred, treatment may be continued for up to 10 days. If the lesion is still present after 10 days, medical review is recommended.

Start treatment as soon as possible, ideally when tingling, itching or burning begins or when the first lesion appears. Treatment can still be started at the blister stage.

Wash your hands before and after applying the cream. Apply a thin layer to the affected area and immediately surrounding skin without rubbing excessively.

No. Cold sore cream is intended for external skin use. Do not apply it inside the mouth or nose or in or near the eyes. Suspected herpes infection involving the eye needs urgent clinical assessment.

Possible local effects include mild burning, stinging, dryness, flaking, itching or redness. Seek advice if you develop a significant or persistent reaction.

Cold sore cream is not recommended for immunocompromised patients without medical advice. More significant herpes infections can occur in people with weakened immune systems and may require systemic treatment or specialist assessment.

Aciclovir tablets are systemic antiviral medicines used to treat herpes simplex infections of the skin and mucous membranes. They may be considered for cold sores where oral antiviral treatment is clinically appropriate.

Current product information lists 200 mg five times daily at approximately 4-hour intervals, omitting the night-time dose, for 5 days. The prescriber will confirm whether this regimen is appropriate for you.

Oral treatment should be started as early as possible after symptoms begin. For recurrent infection, treatment is preferably started during the tingling or burning prodrome or as soon as lesions appear.

Good hydration is important while taking oral aciclovir, particularly in older adults and people with kidney problems. Follow the prescriber's advice and drink adequate fluids unless you have been told to restrict your fluid intake.

Dose adjustment may be needed in people with impaired kidney function and in some older adults. The clinician will review kidney health, age and other relevant factors before prescribing.

Possible side effects include headache, dizziness, nausea, vomiting, diarrhoea, abdominal discomfort, rash, itching and tiredness. Serious reactions are uncommon but require prompt assessment.

Avoid kissing while a cold sore is active, do not share lip products, razors, cutlery or other items that contact the lesion, and wash your hands after touching the affected area.

No. Picking or squeezing can irritate the lesion, delay healing and increase the chance of spreading the virus or introducing bacterial infection.

You may use a suitable lip moisturiser for comfort, but avoid sharing it and avoid contaminating products that will be reused. Apply medicines according to their specific directions.

Triggers vary between individuals and can include illness, stress, strong sunlight, fatigue and local skin trauma. Using lip sun protection may help people whose outbreaks are triggered by sunlight.

No. Antiviral treatment can reduce viral replication during an episode but does not remove herpes simplex virus from the body. The virus remains latent and can reactivate later.

No. Severe, extensive, very frequent or complicated herpes simplex infection may require oral antiviral treatment or further medical assessment rather than topical treatment alone.

Do not combine treatments unless a clinician has advised you to do so. Treatment should be selected according to the severity and clinical context rather than automatically using both formulations.

Antiviral medicines are most useful when started early. They do not make the lesion disappear immediately, but may shorten or lessen an episode in suitable patients.

If a cold sore has not healed after the recommended treatment period, or remains present beyond about 10 days, seek clinical review. Persistent lesions may require reassessment of the diagnosis or treatment.

Frequent or particularly troublesome recurrences should be discussed with a clinician. The diagnosis, triggers and whether suppressive antiviral treatment is appropriate can then be considered.

Urgent assessment is needed for eye pain, a red eye, light sensitivity or suspected herpes around the eye. Severe widespread infection, significant immune suppression, neurological symptoms or serious systemic illness also require prompt medical review.

Herpes simplex can infect the eye and may damage the cornea. Eye pain, redness, blurred vision, light sensitivity or a lesion very close to the eye should be assessed promptly rather than treated as a routine cold sore.

Marked swelling, increasing pain, spreading redness, pus or fever may suggest secondary bacterial infection or another diagnosis. Seek clinical review.

Pregnancy and breastfeeding should be disclosed during the consultation. Aciclovir may be used in some circumstances, but the appropriate formulation and treatment decision should be made after considering the individual clinical situation.

Repeat treatment may be appropriate for typical recurrent cold sores when the diagnosis and previous response are clear. A change in appearance, severity, frequency or medical history may require further review.

If treatment is clinically approved, the medicine will be supplied with directions for use and relevant patient information. Follow the dispensing label and product leaflet carefully.