A cold sore treatment can help reduce the appearance and shorten the duration of the appearance of cold sores, which are blisters formed on or around your lips and caused by the herpes simplex virus.
These cold sore blisters can be painful and embarrassing, but the right treatment can help shrink their appearance and banish them from your face sooner rather than later.
Not all supplemental treatments for cold sore are created equal, though. To get rid of cold sores, you need a high-quality treatment and you need to apply it as soon as possible once a cold sore starts to appear.
We’ve reviewed and ranked the ten best treatments for cold sores on the market according to their effectiveness.
1. Abreva Docosanol
Abreva uses the saturated fatty acid docosanol to attack the virus that causes cold sores, and it’s one of the few compounds that’s been FDA-approved as an effective treatment for cold sores.
Clinical research has found that this fatty acid can decrease the duration that a cold sore appears on your lips.
While this along makes Abreva a fantastic choice, it may work best when combined with other cold sore treatments that use additional ingredients to treat cold sores—docosanol is the only active ingredient in this cold sore treatment.
Serex is a multi-ingredient balm that uses a broad range of herbal ingredients to treat not just your cold sore, but the conditions of your skin and lips.
By using skin emollients like aloe vera gel and collagen boosting compounds like hyaluronic acid, Serex improves the underlying integrity of your facial skin and lips. This might actually prevent cold sores from happening in the future, because a breakout can occur as a result of damaged skin or lips.
This places Serex high in the rankings, because it’s the one of the few choices that could actually prevent cold sores in the future versus treating them in the present. The fact that it includes zinc is even better, as zinc is a proven treatment for active cold sores.
3. Quantum Health Super Lysine+
Quantum Health Super Lysine+ uses a diverse range of ingredients to soothe cold sore pain and speed recovery.
It’s got several of the best treatments for cold sores, including zinc oxide, lysine, echinacea, and vitamin A.
These ingredients help banish cold sores quicker, while the menthol helps to relieve pain. With this versatile range of efficacious ingredients, it’s an excellent choice.
4. Basic Organics L-Lysine Ointment
Basic Organics makes a lip balm that has a high concentration of the amino acid L-lysine, which is proven to help prevent cold sores.
On top of this, it has vitamins A, D, and E to improve skin and lip health, plus menthol and camphor to relieve itching and pain from already-active cold sores.
Thanks to this broad-spectrum approach, it is a very effective way to prevent cold sores in the future.
5. Eve Hansen Tea Tree Oil
Tea tree oil is one cold sore treatment that’s under-utilized in many products. There is good clinical research supporting its use as a treatment for reducing the duration of cold sores and for treating the symptoms, but since it needs to be applied in a highly concentrated form, it tends not to get blended in with other active ingredients.
Of your options for tea tree oil, Eve Hansen’s is the best: it uses pure, steam-distilled tea tree oil that’s certified organic. It makes an excellent addition to your cold sore treatment routine.
6. Releev 1 Day
Releev 1 Day uses a mixture of benzalkonium chloride, which directly attacks the virus that causes cold sores, along with echinacea, an herbal extract that’s thought to have anti-viral and immune system boosting properties.
While it doesn’t have all of the most effective cold sore treatments, many people nevertheless find it a useful treatment for their breakouts.
7. Urban ReLeaf Lemon Balm Blister Soothing Care
Urban ReLeaf Lemon Balm focuses its treatment on lemon, tea tree, and peppermint essential oil, but given that this lip balm is supplied in a heavy beeswax and shea butter base, these essential oils might not be present at a high enough concentration to be as effective as possible.
Still, some users find it useful, given that it’s easy to carry around and apply multiple times during the day.
8. Orajel Touch-Free
Orajel makes a cold sore treatment that’s primarily focused on symptom relief. It uses benzalkonium chloride to kill the virus on the skin, and uses a lidocaine-like derivative to numb the skin so you don’t get the itching and burning pain from your cold sore.
Unfortunately, while this brings symptomatic relief, it doesn’t actually speed recovery very much.
Campho-Phenique works to soothe cold sore pain with camphor, but there’s nothing in this cold sore treatment that will actually speed up treatment. Since it’s for symptomatic relief only, it ends up at the bottom of the rankings.
10. Blister Balm
Blister Balm uses a patented ester preparation based on jojoba oil, a common skin moisturizer and cosmetic ingredient. While the company claims that this is a more effective treatment than competing cold sore treatments, there isn’t any clinical evidence to back up this assertion.
As such, you should opt for a different treatment that’s been proven in independent research first before trying this cold sore treatment.
Cold sore treatment benefits and side effects
Cold sore treatments reduce the appearance and shorten the duration of blistering breakouts on your face and lips.
These breakouts, called cold sores in common parlance or herpes labialis in medical terminology, are caused by an underlying viral infection that periodically flares up and causes a blister on your skin.
These breakouts can be in response to stress, ultraviolet light exposure, or physical damage to your skin or lips. These blisters are embarrassing and cause itching, burning, and pain.
A number of potential treatments for cold sores are available that can both soothe the pain caused by cold sore breakouts and actually shorten their duration. A subset of these treatments might even be able to prevent future breakouts from happening.
Docosanol cream can shorten healing times by almost a day. Docosanol is a relatively simple molecule that seems to be particularly disruptive to the virus that causes cold sore breakouts.
A clinical trial published in 2001 in the Journal of the American Academy of Dermatology tested the effects of docosanol on adults who had frequent cold sore breakouts (1).
Half of the subjects were given a 10% docosanol cream, while the other half was given a placebo cream. The subjects were instructed to apply the cream five times per day when they had breakouts, and recorded how long each breakout lasted. For more robust results, the researchers conducted the trial simultaneously at two different locations.
After the trials had concluded, the researchers found that the docosanol treatment had decreased the duration of cold sores by about 18 hours (from about five days down to about four) when comparing the placebo group to the docosanol group.
Topical zinc can speed healing and reduce the symptoms of a cold sore. Taking a zinc supplement has been shown to boost your immune system and reduce the duration of upper respiratory infections caused by viruses, like the common cold, so it’s reasonable to hypothesize that zinc would be an effective treatment for cold sore breakouts as well, because they are likewise caused by viral activity.
A study published in Germany in 1995 tested this hypothesis using a clinical trial design (2). The researchers found that a gel containing zinc sulfate was able to reduce the duration of cold sore symptoms, as well as decrease symptom severity.
Other research published in the journal Alternative Therapies in Health and Medicine had similar results (3). In this study, using a zinc-based topical cream (using zinc oxide and zinc glycinate in this case) was associated with a reduction in cold sore duration by 1.5 days.
Patients who used the placebo cream had cold sores that lasted for an average of 6.5 days, while patients using the zinc cream had symptoms that lasted only 5 days.
Tea tree oil may boost recovery from a cold sore breakout. Tea tree oil has consistent antiviral activity when tested against a wide variety of viruses (including herpes simplex, the virus that causes cold sores) on a petri dish, so testing this efficacy in real people was a logical extension of this finding.
A small pilot study suggests that these benefits work in real life as well as in a test tube—ten subjects who had cold sore breakouts were given either a 6% tea tree oil ointment or a placebo gel, and their blisters were swabbed to test for viral activity (4).
Though this study was small, the results did indicate a trend towards a decrease in levels of the virus, as well as a decrease in symptom duration.
L-lysine may prevent the occurence of future cold sores. L-lysine is an amino acid that appears to inhibit the activity of the virus that causes cold sores, and as a result, researchers hypothesized that it may be useful for treating or preventing cold sore outbreaks.
A clinical trial published in Acta Dermato-venereologica tested whether L-lysine was effective at either treating or preventing cold sore breakouts (5). A group of patients with frequent cold sores was randomly assigned either an L-lysine supplement or a placebo, and was followed for 12 weeks.
The groups were then switched later on for greater statistical power. Unfortunately, the results showed no effect of L-lysine on the duration or severity of any of the symptoms of cold sores.
However, when the subjects were using L-lysine, they went longer between cold sore breakouts, indicating that L-lysine could be useful for preventing cold sores in the future, even if it’s not very effective at treating them after they’ve occurred.
Since cold sores involve an open wound or blister on the skin, it should be expected that almost any treatment may involve localized side effects like stinging, burning, or irritation.
This was the case in the clinical trials mentioned earlier that tested zinc-based cold sore treatments—these occasionally caused localized skin reactions.
Herbal-based treatment like tea tree oil carry the additional risk of skin irritation due to allergies or sensitivities in the plant material the oil is derived from; indeed, one of the ten subjects in the first pilot study on tea tree oil withdrew from the study because of adverse effects from the treatment.
Docosanol, while it’s been established as an effective treatment, also has a tendency to cause headaches. While these tend to be mild, they do tend to occur in around 10% of people who use the cream.
When applying a topical treatment for cold sores, frequent application is best. All clinical trials instruct their subjects to apply their cold sore treatments at least three times a day, and most require five daily applications.
This means applying the gel or cream every two to three hours. This is necessary to keep a high concentration of antiviral compounds in contact with the cold sore, as eating, drinking, and sweating will otherwise quickly wash them away.
Better adherence to this protocol likely means better results, so look for a cold sore treatment that’s easy to carry around and frequently be reapplied on a regular basis.
For extra sun exposure, using a good lip balm will also help prevent breakouts.
Cold sores can be both unsightly and irritating, but with the right combination of cold sore treatments, you can reduce symptoms, speed recovery, and possibly even prevent cold sores from recurring in the future.
Cold sore treatments that contain docosanol, zinc, or tea tree oil all appear to be effective at reducing symptom duration, and you can expect the cold sore to last about one to 1.5 days less than if you hadn’t applied the cold sore treatment.
For preventing cold sores in the future, using L-lysine appears to be effective, so if you regularly get cold sores, this treatment might decrease the frequency of a breakout. While many cold sore treatments have mild side effects, these usually disappear after you stop using them.
When you follow the standard treatment protocol of applying a cold sore treatment every two to three hours when you have a breakout, these treatments appear to be an easy and effective way to boost your recovery and decrease your symptoms when you have a cold sore breakout.