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.
2. Dalinex Cold Sore Treatment
Dalinex Cold Sore Treatment uses a range of herbal ingredients, including L-lysine, which is known to combat the cold sore virus. Dalinex is a good choice for all around lip treatment thanks to secondary compounds that soothe skin that’s been damaged by cold sores.
This might actually prevent cold sores from happening in the future, because a breakout can occur as a result of damaged skin or lips.
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. While blister balm could help heal skin, it doesn’t have the heavy weaponry that the other products on this list have for fighting the virus that causes cold sores.
Who should buy a cold sore treatment?
Cold sores are painful, irritating, blistering sores that appear on your lips if you are infected with the herpes simplex virus. Cold sores can appear at random, but may be more common if you are stressed or if the function of your immune system is compromised.
For unknown reasons, cold sores are more of a problem for some people than others. Many people have the herpes simplex virus in their system, but never get cold sores. Others might get a cold sore once or twice a year, while others are plagued with frequent and often multiple cold sore outbreaks.
If you are in these latter two categories, a cold sore treatment is a great investment. While cold sore treatments can’t instantly make a cold sore disappear, there is solid scientific research that demonstrates that over the counter cold sore treatments can significantly reduce the duration of a cold sore.
If you are tired of waiting for a week or more for your cold sores to go away on their own, you should definitely get a cold sore treatment. Even if you only get cold sores a couple of times a year, it pays to have a cold sore treatment on hand, because their efficacy is improved if you start applying the treatment as soon as a cold sore starts to form.
Not all cold sores respond to a given treatment, so if you have not had success with cold sore treatments in the past, it’s worth giving a different product a shot. Treatments that are based on docosanol, for example, work very differently than treatments that are based on tea tree oil.
How we ranked
Our rankings of cold sore treatments were based on published clinical research on effective ways to treat cold sores. We specifically sought out products that had either been tested and proven against a placebo in clinical studies on people with cold sores, or at least contained ingredients that had a track record of proven results in clinical research.
This meant that we selected products containing docosanol, an FDA-approved molecule that attacks the herpes simplex virus, the mineral zinc, which boosts immunity and fights cold sores, L-lysine, or tea tree oil.
All of these key compounds have good scientific work supporting their ability to fight cold sores, either by attacking the virus directly, or by improving the body’s ability to clear the virus.
When a formulation itself was tested and approved by the FDA, like Abreva (which is based on docosanol), we rated it higher than a product that merely contained some compounds that are active against the herpes simplex virus.
That’s because when an entire product is clinically tested, you know that it is delivering an effective dose and that there is no interference from other ingredients on its overall efficacy.
A secondary evaluation criteria was whether the cold sore treatment provided any ingredients that soothe the pain and irritation that cold sores can cause. Ingredients like camphor, menthol, peppermint oil, and lidocaine can achieve this effect. While these ingredients won’t speed up recovery, they do help with symptomatic relief.
We also evaluated whether the candidate cold sore treatments provided moisturizers or lip balms that help reinforce the natural barrier of the skin on your lip.
Again, these may not directly attack the cold sore virus, but they can help rebuild and reinforce the integrity of your skin, which will help with healing the damage done to your lips by a cold sore.
After considering all of these criteria, we ranked the remaining supplements, putting the most weight on the clinical efficacy of the ingredients. Our final results represent the best cold sore treatments that you can buy over the counter.
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 occurrence 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.
Q: What cold sore treatments can you use at home?
A: Some of the best cold sore treatments for use at home are based on docosanol, tea tree oil, zinc, or L-lysine. These compounds have been demonstrated to be effective ways to directly combat the herpes simplex virus that causes cold sores.
Docosanol in particular is approved by the FDA as a standalone treatment to shorten the duration of cold sores when they break out. Plenty of research also backs the use of tea tree oil, zinc, and L-lysine.
Q: What cold sore treatments work the fastest?
A: If you are looking to get rid of a cold sore as fast as possible, you want to use a treatment that attacks the virus directly.
That means a product that includes docosanol, tea tree oil, zinc, or L-lysine, as these compounds have been proven to attack or inhibit the activity of the herpes simplex virus.
While there are other treatments that can help soothe the pain and irritation associated with cold sores, or improve the integrity of your skin to help aid your ability to repair the damaged tissue in your lip, these other options aren’t as useful for rapidly eliminating cold sores from your lips.
Q: How do you heal a cold sore?
A: The best way to heal a cold sore is to apply a high quality cold sore treatment as soon as symptoms start appearing. High quality products will include ingredients that have been proven effective against cold sores in scientific research, like docosanol, L-lysine, or tea tree oil.
Healing can be assisted by secondary ingredients that help heal the skin, but in terms of actually removing the crusting and blistering from a cold sore, you’ll want something that’s proven effective.
Q: How long do cold sores last?
A: Without treatment, a cold sore will last anywhere from one to two weeks. In the clinical literature, treatment can cut this down to about four days. Unfortunately, we still don’t have a treatment that stops a cold sore dead in its tracks, but with proper treatment, you can get rid of them right away.
Importantly, for maximum treatment benefits, you should start applying a cold sore treatment as soon as possible once you start feeling one appearing.
Often, you’ll feel tingling or burning in a localized spot on your lip prior to the appearance of a blister on your lip. If you start applying a treatment early, you’re far more likely to see a quick remission of a cold sore.
Q: Do cold sores mean you have an STD?
A: Cold sores are caused by the herpes simplex virus—technically, herpes simplex virus type 1, or HSV-1 for short. In contrast, genital herpes (which are sexually transmitted) are most often caused by herpes simplex virus type 2, or HSV-2.
These are genetically distinct viruses, so it’s not correct to call cold sores an STD in the same way that genital herpes are an STD. Nevertheless, it’s important to realize that cold sores are contagious, so you shouldn’t engage in any sexual activity when you have an active cold sore.
Q: How do you get rid of a cold sore in 24 hours?
A: Unfortunately, it is not possible to get a full remission of a cold sore within 24 hours of it appearing in all cases. With rapid and effective treatment, you can significantly speed the recovery time from a cold sore, but in the scientific literature, cold sores—even when attacked right away with the best treatments—still take around four days to go away, on average.
Now, there is a lot of individual variability in recovery time, so it’s very possible that some cold sores can go away faster, possibly even within 24 hours. But on average, it does take a few days. To keep your recovery time to an absolute minimum, though, you should still follow best practices. Begin treatment with a proven cold sore treatment as soon as possible after symptoms start to appear.
Q: Does toothpaste remove cold sores?
A: Toothpaste is an old folk remedy for cold sores, but it doesn’t contain any active ingredients that fight the cold sore virus. However, part of the reason for this persisting as a home remedy probably has to do with the fact that toothpaste usually contains peppermint, spearmint, or other herbal extracts that are sometimes used in cold sore treatments to relieve the pain and irritation associated with cold sores.
You’ll often see peppermint oil or menthol included in cold sore treatments for similar reasons: they can numb and cool some of the pain from a cold sore. Unfortunately, toothpaste won’t address the root problem, which is the cold sore virus. We recommend one of our top ranked cold sore treatments instead.
Q: How do you use a cold sore treatment?
A: Cold sore treatments are applied directly to your lips, and as a consequence, they need to be re-applied several times per day.
The exact frequency depends on the product, but three to five applications per day is pretty typical. You’ll want to keep applying treatment as long as you have symptoms to get the quickest resolution of a cold sore.
Q: What herbs are effective for cold sores?
A: Among herbal compounds for treating cold sores, by far the best choice is tea tree oil. Tea tree oil has been demonstrated to be biologically active against the herpes simplex virus in scientific studies, and that is the virus that causes cold sores.
Tea tree oil has also been demonstrated effective in clinical research, at least in small pilot studies (6). Other herbs, like peppermint oil, can be useful for treating the pain and irritation from a cold sore, though they may not contribute to fighting the virus directly.
Finally, even simple oils from herbal sources, like jojoba oil or argan oil, may be incorporated into a cold sore treatment for their skin protecting effects. Still, tea tree oil is the most effective herb when it comes to actually fighting the virus that causes cold sores.
Q: How long does a cold sore last without treatment?
A: Without treatment, a cold sore can last for between seven and ten days, on average. Very stubborn cold sores can stick around for up to two weeks.
If you are experiencing a cold sore that lasts much longer than that, you should talk to your doctor to make sure there isn’t a different underlying problem that’s masquerading as a cold sore.
The relatively long natural course of cold sores when untreated is all the better reason to start treating it right away: research shows you can substantially shrink the duration of a cold sore with proper treatment in a timely manner.
Q: Is Carmex better than Abreva for treating cold sores?
A: Carmex and Abreva are both big-name brands when it comes to lip balms to treat cold sores, but they do not perform equally well. Our research team thinks that Abreva is the far better choice, thanks to the inclusion of an FDA-approved agent (docosanol) that is proven to fight against the herpes simplex virus.
Carmex only includes a lidocaine derivative to numb the pain from a cold sore: its ability to attack the virus itself is nowhere near what you’ll get with Abreva.
Abreva is also supported by clinical research that has demonstrated a significant decrease in the duration of a cold sore when its active ingredient is applied right away; the same is not true for Carmex. For these reasons, Abreva should be considered the superior choice.
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.
For BodyNutrition‘s #1 cold sore recommendation, click here.