Last week I talked about recurrent herpes labialis (cold sores and fever blisters) and several factors that can trigger an outbreak.  Now, let’s look at treatments that can help.  Unfortunately, there is no known cure for the herpes virus that causes the lesions.  There are no standard treatment protocols, but many products and medications have been utilized with good results. 

Over the counter remedies are palliative in nature.  They relieve the symptoms, inhibit the continued development of the lesion, promote healing or possess properties that interfere with the development of the cold sore.  Over the counter remedies require multiple applications to be effective.  Numbing agents include Campho-Phenique (www.bayer.com) and Orajel MouthAid.  Those agents that limit sore formation include Herpecin-L (www.chattem.com), Pure Lip Solution pack (www.purelip.com), zinc and tannic acid.  Moisturizers include Abreva (www.abreva.com) and Carmex (www.carma-lab.com).  With all over-the-counter products there will be varied results.

Herbal remedies include tea tree oil and nutritional supplements such as Herpetrol tablets (www.alvaamco.com) and VIR-L-Lysine (lysine).  Some people have found relief from a diet high in lysine and low in arginine.  Studies have found that the amino acid arginine is required by the herpes virus to replicate.  Sine lysine competes with arginine for intestinal transport, a diet rich in lysine (brewers yeast, legumes, wheat germ, fish, meat and dairy) and low in arginine (chocolate, peanuts and almonds) may have an antiviral effect for some.

Home remedies include rubbing ice on the area to drop the temperature and lower the area’s metabolic rate to hamper the sores development.  Some people also have found luck with tea bags (tannic acid in tea) and petroleum jelly.  Many patients have expressed frustration at having tried so many different over-the-counter, herbal and home remedies with little or no success.

I often tell patient’s that if something works for them, great!  If not, we can pull out the big guns as there are some excellent prescription medications for cold sores that work very well.  Many of my patients have had very good results with systemic oral medications such as Valtrex (valcyclovir) and Famvir (famcyclovir).  These medications work better when they are taken early in an early stage of the outbreak.  If taken in the prodromal stage before the sore actually develops (that stage when your lip begins to tingle), it will often eliminate the outbreak completely.  Topical prescription creams such as Zovirax (acyclovir) and Denavir (pencyclovir) also work well, but must be applied several times a day for four to five days.  Newer medications such as Viroxyn (Quadrex Pharmaceuticals) that disrupt the coating of the virus to kill it on contact look very promising and function during any stage of the outbreak.

Remember, cold sores are very contagious.  You should avoid touching the lesion or kissing anyone while you have an active outbreak.  Many people don’t understand that a cold sore is a herpes virus and therefore very contagious.  A person can actually self-inoculate and spread the virus to other parts of their body.  If you do touch the lesion, be sure to thoroughly wash your hands before doing anything else.  Also, replace your toothbrush after an outbreak and utilize disposable razors during the time there is a sore present.

Now that you are armed with some of the latest information on ulcers and cold sores you can limit their outbreaks and feel better quicker when they do appear.