Get early treatment. The earlier you treat a cold sore, the better. In fact, the best time to start treatment is as soon as you feel the tell-tale tingle. The standard treatment is aciclovir cream, applied five times a day for 5 days. If your cold sore is on the lips, you may have to reapply the cream after eating or drinking. Aciclovir cream contains an antiviral drug that prevents the virus from multiplying and speeds up healing. You can buy it from pharmacies without a prescription. (Another antiviral cream, penciclovir, is available, but requires a doctor’s prescription in the UK and needs to be applied more frequently than aciclovir. It can be purchased through online pharmacies without prescription.)
Of note, many cold sores may also clear up without treatment within 7–10 days. Antiviral creams and tablets can just hasten this process.
Do not expect miracles from the cream. If you start treatment early enough, it may shorten the attack length. If you often get recurrences, it makes sense to ensure that you have a supply of antiviral cream in readiness, so that you can start treatment promptly.

Be hygienic. Hygiene is important because you do not want a bacterial infection to move in.

• Try not to touch the sore with your hands.
• If you apply any cream or oil to the sore, use a new cotton-wool bud each time.
• To wash the area, dab it gently with a moistened tissue. Do not apply any disinfectant, because this may be too harsh for the damaged skin.

Protect your eyes. Herpes simplex can cause a nasty eye infection, so take care.

• Be careful when applying eye make-up – it is easy to touch your cold sore without realizing it.
• Wash your hands very thoroughly before putting in contact lenses (this is one reason why you should never use saliva to moisten contact lenses).
• If your eye does become sore, see your doctor straight away.

Do not infect anyone who is vulnerable. Although herpes simplex is not normally a damaging virus, it can cause serious problems in people whose immune system is poor.

• Keep away from babies.
• Do not kiss anyone who is unwell for any reason, or who is pregnant, old, or has eczema (herpes can cause a nasty infection in skin already affected by eczema).
• Do not share your toothbrush or eating utensils with anyone (because the virus can be passed in saliva).
• Do not give oral sex to anyone until the sore has healed completely, or you could be giving them genital herpes.

First published on: embarrassingproblems.com
Reviewed and edited by: Dr Anna Cantlay
Last updated: October 2020