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Cold sores are small, painful blisters that typically appear on or around the lips, caused by the herpes simplex virus type 1 (HSV-1). Many people confuse cold sores with canker sores. Cold sores are caused by a viral infection and appear on the outside of the mouth as fluid-filled blisters, whereas canker sores are non-contagious ulcers that develop inside the mouth and are not caused by a virus.
Cold sores can cause uncomfortable symptoms such as tingling or burning before the blister appears, painful fluid-filled blisters, crusting and scabbing as they heal, and occasional fever or swollen lymph nodes during the first outbreak.
Getting the right treatment plan for cold sores can help speed up healing, reduce pain, and decrease the frequency of future outbreaks.
With LifeMD, you can get immediate help and treatment online without an in-office appointment. Prescription antiviral medications can help cold sores heal faster and provide relief from discomfort, especially when started at the first sign of an outbreak.
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Acyclovir is an antiviral medication that works by stopping the herpes simplex virus from multiplying, which helps reduce the severity and duration of cold sore outbreaks. It's most effective when started at the first sign of symptoms like tingling or burning. Acyclovir can be taken as oral tablets (typically five times daily for five days) or applied as a topical cream to the affected area. It can also be used as suppressive therapy taken daily to prevent frequent outbreaks.
Valacyclovir is an antiviral medication that converts to acyclovir in the body but requires less frequent dosing, making it more convenient. It works by inhibiting viral replication to shorten healing time and reduce pain during cold sore outbreaks. It's typically taken twice daily for one day at the first sign of an outbreak, or as a single high dose in some cases. For people with frequent outbreaks, it can also be taken daily as suppressive therapy to reduce recurrence.
Famciclovir is an antiviral medication that works by blocking the replication of the herpes simplex virus, helping to speed up healing and reduce the duration of cold sore symptoms. It's particularly effective when started early in an outbreak and requires less frequent dosing than acyclovir. It's typically taken as a single-day treatment (three doses in one day) at the first sign of symptoms, making it a convenient option for managing outbreaks quickly.
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Cold sores typically last seven to 10 days without treatment, going through several stages from initial tingling to blistering, bursting, crusting, and finally healing. The timeline can vary depending on whether it's your first outbreak or a recurrent one. First outbreaks tend to be more severe and may last up to two weeks or longer. With antiviral treatment started early, cold sores can heal in as little as three to five days. The contagious period lasts from when you first feel tingling until the sore is completely healed and the scab has fallen off.
Yes, cold sores are always caused by the herpes simplex virus, usually type 1 (HSV-1), though occasionally type 2 (HSV-2) can cause them as well. Once you're infected with the virus, it stays in your body permanently in a dormant state and can reactivate periodically, causing cold sore outbreaks. Not everyone infected with HSV-1 develops visible cold sores. Some people carry the virus without ever having symptoms. Having cold sores means you have oral herpes, which is extremely common and affects a large portion of the adult population.
Yes, cold sores are highly contagious, especially when blisters are present. The virus spreads through direct contact with the sore, saliva, or the fluid from the blister, as well as through kissing or sharing items like utensils, lip balm, or towels. You can spread the virus even before the blister appears if you're experiencing tingling or burning, and you remain contagious until the sore is completely healed.
You can also spread the virus to other parts of your own body, particularly your eyes or genitals, by touching the sore and then another area, so hand washing is essential during an outbreak.
Online cold sore treatments typically involve a virtual consultation with a licensed healthcare provider. During the consultation, you can discuss your symptoms, provide your medical history, describe when you first noticed symptoms, and share photos of the affected area to help your provider confirm the diagnosis.
You'll then receive a personalized treatment plan based on your needs, with antiviral medication recommendations and any necessary prescriptions. Your healthcare provider may also discuss trigger avoidance and preventive strategies to help reduce the frequency of future outbreaks.
It's important to be open and honest during your consultation to help your healthcare provider determine the best treatment approach. Be sure to provide your doctor with detailed information, such as:
• Your symptoms and when you first noticed them
• Whether this is your first outbreak or if you've had cold sores before
• How frequently you get outbreaks and any triggers you've identified
• Underlying health conditions, current medications, or any allergies
The more information you can provide, the better your doctor can assess your situation, prescribe the most effective treatment, and help you develop a plan to manage future outbreaks.
LifeMD offers online cold sore treatments and can provide you with the prescriptions you need. You can have these sent to your local pharmacy, where your medication will be prepared for pick-up.
When it comes to treating cold sores, antiviral medications work best when started at the first sign of an outbreak, ideally during the tingling stage before blisters appear. If started early, you may notice that the cold sore is less severe, heals faster, and causes less pain.
Most people see improvement within 24 to 48 hours of starting treatment, with complete healing typically occurring within three to five days instead of the usual seven to 10 days without medication. For suppressive therapy taken daily to prevent outbreaks, it may take a few weeks to notice a reduction in outbreak frequency.
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