10 Home Treatments for Cold Sores | The Survival Doctorby James Hubbard, MD, MPH

Okay, maybe a cold sore, also called a fever blister, isn’t the worst thing you can have when you can’t get to a doctor, but it can be downright irritating. And I’ve seen my share of cold sores that had become bad enough to affect proper eating and increase the risk of dehydration. Also, if a secondary infection develops, it could turn into something potentially dangerous.

So, in this post I’ll delve a little into prevention and home treatments for cold sores—and what makes some of us prone to get them while other people never do.

What Causes Cold Sores

Cold sores are caused by the herpes simplex virus. You get the virus by direct contact of mucous membranes or broken skin from someone already infected.

And they can give you the virus even if they’ve never had a blister in their life. That’s because, once a person has the virus in their body, it’s there for life.

Usually it just hides, or “sleeps,” next to one of the nerves. But even so, it replicates. One single virus becomes two. Two become four, etc. Soon there are thousands.

At some point many of these shed into the air and onto the external skin. If there’s no blister or sore, there’s no way the person knows when. But, if your mucous membranes (inner lips, nostrils, head of the penis, vaginal lips) or broken skin comes in direct contact, the virus on board.

Cold sores are usually caused by herpes simplex 1. For some reason, this type likes living in the facial nerves, so the breakouts are usually around the lips or nose.

Genital herpes is usually caused by herpes simplex 2, which likes nerves below the belt—in the genital, buttock, lower back, lower abdomen, and upper leg region.

Herpes simplex 1 and 2 are very similar, with most of their differences related to where they prefer to locate. I say prefer because herpes 1 can live below the belt, and herpes 2 around the mouth. It’s always been that way, but we’re seeing more crossover in the last few years, presumably because of the increased popularity of oral sex.

10 Home Treatments for Cold Sores | The Survival DoctorWhy Do Some of Us Get Cold Sores and Some of Us Never Get Them? (It’s All in Our Genes)

It’s estimated that about 80 percent of us have herpes simplex. We can tell that because when we test our blood, 80 percent of us have antibodies that have formed to fight it. And yet, only 30 percent of people with the virus ever break out with a sore or blister.

It’s also estimated that about 20 percent of us have herpes simplex 2 antibodies, but not all of those people have ever broken out either.

Why do some people never get sores? We think it might be genetic. Several genes have been isolated in our DNA that seem to account for whether we’re susceptible to breakouts. The exact whys are yet to be discovered, but the bottom line is some of us are genetically prone to fever blisters and some of us are not.

How to Prevent Cold Sores

The Survival Doctor's Guides to Wounds and BurnsTo prevent catching the virus, obviously avoid direct contact with a blister or sore. Also, no sharing eating or drinking utensils, creams or ointments, towels, bath cloths, etc.

If you already get cold sores, to prevent breakouts, avoid triggers. Different people have different triggers. Some of the common ones are:

  • Direct sunlight. You can cover up or use a sunscreen. Zinc oxide on the areas most likely to break out is a great protectant.
  • Stress—a pretty big one during disasters.
  • Fever or a cold.
  • Menstrual cycle.
  • Certain foods, such as chocolate in some people (not all, by any means).

There are also prescription medicines you can take every day to decrease your outbreaks.

>> Home treatments for life-threatening problems: The Survival Doctor’s e-books.

Over-the-Counter and Home Treatments for Cold Sores

Nothing cures herpes. There’s no prescription or home remedy that’s going to get rid of the virus for good. But fortunately, there are treatments that can cut down on outbreaks—or at least the amount of pain or time.

The most effective treatment to reduce the duration of a cold sore is prescription medicine. At least one comes in generic form. Nothing works as well. But there are some home remedies that can help if you don’t have one of these meds.

With any treatment, start as soon as you feel the first sign a cold sore is coming on. When applying creams or ointments, use a cotton-tip applicator and throw it away.

The herb lemon balm.

Some people use the lemon balm herb to treat their cold sores.

The following will reduce the pain:

  • An NSAID, such as ibuprofen (Advil) or naproxen (Aleve).
  • Acetaminophen (Tylenol).
  • A topical numbing medicine.
  • An ice pack with a cloth around it applied to the cold sore for about ten minutes every two hours.
  • A cool, moist cloth applied for about twenty minutes every two hours.

To shorten the duration, you could try:

  • Abreva (docosanol), an over-the-counter medicine.
  • Any drying medicine. One of my Facebook fans swears by Bactine (which contains both drying and numbing medicines), followed by Carmex to counteract the dryness.
  • The supplement L-lysine—500 to 1,000 mg daily on an empty stomach. Or get it from high-lysine foods such as yogurt, fish, or potatoes.
  • Avoiding foods high in L-arginine, including many types of nuts.
  • The herb lemon balm, which can be made into a tea to drink and to apply directly to the fever blister, or which can be bought in a topical solution (containing at least 1 percent of the extract).

Keep the area clean with soap and water. If you use a cloth and towel, use it on the affected area last, then wash it in hot water.


A herpes infection in the eye is rare, but can cause permanent damage, so if you have an outbreak and your eye gets red or scratchy, make extra effort to see a doctor right away if possible.

Another complication can be a secondary bacterial infection that may need oral antibiotics.

People with low immune systems—those who are elderly, are taking chemotherapy, have HIV, etc.—can have serious herpes infections, even meningitis.

What’s been your experience? Have you ever had complications? Do you have further tips for prevention or home treatment?

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Lips photo: Flickr/Coblat. Cold-sore photo: Flickr/Oblivion999. Lemon balm photo: Flickr/Kendiala.

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