Cold sores are painful clusters of blisters that appear on or near the lips. Also called fever blisters, these sores are caused by the herpes simplex virus, and even without treatment, often go away within a few weeks. After the initial tingling or burning that signals a cold sore is on the way, unsightly blisters appear -- and these blisters tend to pop on their own after a few days. While you may be tempted to pop them before they naturally rupture, doing so can cause more pain, risk the spread of the infection, and may even delay healing. According to the American Academy of Dermatology (AAD), there are better ways to speed up the healing process.
Step 1: Antiviral Medication
At the first sign of a cold sore, which is when you feel the tingle or burn, apply an antiviral cream directly to the area. This cream is most effective when treatment is started before the blister appears or ruptures, and when reapplied according to package directions. Over-the-counter (OTC) docosanol (Abreva) cream, or prescription acyclovir (Zovirax) cream, have been shown to hasten the healing of a cold sore by at least a few days, and can minimize the size of the blister. They work by slowing the replication of the herpes simplex virus. If you get repeated cold sores, talk to your doctor to understand if oral antiviral medications may work better for you.
Step 2: Cold Compress
Apply a cold compress to the lip, for 5 to 10 minutes, at the first sign of a cold sore, and reapply several times each day until healed. Cold therapy helps to manage pain, reduce redness and shrink swelling. A popular home remedy is to apply ice directly to the cold sore, which is claimed to not only shrink swelling but to interfere with replication of the virus. Research is not available to confirm ice prevents, shrinks or helps pop a blister, but cold therapy can help with swelling and pain relief. If you apply ice, prevent frostbite by placing the ice in a plastic bag or wrapping in a thin cloth first, and applying just long enough to numb the area.
Step 3: Keep Lips Moist
After the cold sore blisters pop, ulcers appear, which scab over as the healing process begins. Do not pull the scab off early or allow the scab to crack, since this slows the healing process and can increase the risk of infection. To facilitate healing, keep the lips moist by using a lip balm that contains petroleum jelly or cocoa butter. When the sores are healing, it's also important to protect your lips from the sun. The AAD recommends using a lip <ahref="https: www.aad.org="" public="" diseases="" contagious-skin-diseases="" cold-sores#treatment"=""> </ahref="https:>balm with SPF of 30 or higher. In fact, the use of sunscreen may also prevent cold sores, since strong sunlight can be a trigger for these viral outbreaks.
Step 4: Prevent the Spread
The fluid from cold sores is highly contagious, especially after the blisters pop or rupture. Try to avoid touching your infected area, and do not engage in kissing or other direct contact until the sores are completely healed. Always wash your hands before and after applying lip medication or balm, or after inadvertently touching your cold sore, to reduce the risk of acquiring a bacterial infection or spreading the infection to others -- or to new sites on your own body. Always wash or discard any items that come into contact with a cold sore.
Things You'll Need
Antiviral medication, OTC or prescription
Cold compress or ice (wrapped in a thin cloth)
Lip balm, containing petroleum jelly or cocoa butter and sunscreen
Pain relievers such as ibuprofen and acetaminophen
Popping cold sore blisters is not a recommended strategy for managing herpes simplex virus outbreaks. If your blister is painful and does not rupture on its own, consider seeing your doctor. However, if you choose to pop your cold sore blister, take steps to prevent infection. Use clean hands, a sterilized lancing device, and sterile gauze to soak up the liquid that comes out of the blister. Carefully clean away the pus and fluid that drains away from the sore, and wash your hands with soap and water.
If you have severe pain from your cold sore, you may get relief from OTC pain relievers such as ibuprofen and acetaminophen. You can also try OTC pain-relieving lip gels or ointments which contain benzocaine, lidocaine, dibucaine, or benzyl alcohol. If you suffer from recurrent cold sores, ask your doctor about treatment options. Also see your doctor if you have a cold sore that is not getting better or appears to be spreading.
Reviewed by Kay Peck, MPH RD
- Merck Manual: Herpes Simplex Virus (HSV) Infections
- American Academy of Dermatology: Cold Sores: Diagnosis, Treatment and Outcome
- Canadian Family Physician: Treatment and Prevention of Herpes Labialis
- JAMA Internal Medicine: The Treatment of Herpes Simplex Infections An Evidence-Based Review
- Journal of Esthetic and Restorative Dentistry: Treatment of Herpes Labialis: Comparison of Two OTC Drugs and Untreated Controls