About one-third of adults are afflicted with recurrent cold sores. Tingling, itching and burning are followed by sores on the border of the lip that progress to crusting and healing. The whole unsightly misery takes 10 days.
Prescription antiviral medications shorten the symptoms by 1-2 days and are pricey, plus you have to buy a trip to the doctor.
So, what's available over the counter and how well do these treatments work?
Abreva is the only FDA-approved over-the-counter medication approved for healing cold sores. It works about as well as the prescription topical antiviral medications (shortens the illness by 0.5-1 day) and causes less resistance. Abreva, like the prescription topicals, has to be applied five times a day, but the price is right ($15 for a 2 gram tube. Shop around!)
Lysine has been a popular treatment for preventing cold sores for many years and there is modest science to support its effectiveness. In one small study, patients taking 1000 mg of lysine three times a day for six months had 2.4 fewer occurrences than those taking a sugar pill. There is also some evidence that similar doses of lysine may shorten cold sore outbreaks. Potential side effects of oral lysine include diarrhea and abdominal pain.
Dr. Mohler has practiced family medicine in Grand Junction for 38 years. He has a particular interest in pharmaceutical education. Phil works part-time for both Primary Care Partners and Rocky Mountain Health Plans.