Cold sore creams


Cold sore (Herpes labialis) is also known colloquially as fever blisters. It is an infection with the Herpes simplex virus type Icausing sore small blisters around the nose and mouth, but other areas such as the eyes or cheeks may also be affected. Cold sores begin with a tingling sensation in the affected area and after a few hours a blister filled with clear liquid forms, which eventually bursts and crusts. Antiviral creams or gels should be used immediately at the first symptoms in order to contain the infection as quickly as possible and to stop the fever blister from blooming.

Which are there?

There are now a large number of cold sore creams available on the market. One of the most well-known drugs for cold sores is one Acyclovir. Creams with the active ingredient aciclovir are available, for example, from Ratiopharm (Aciclovir-ratiopharm®), Dermapharm (Elac®) or Stada (Aciclostad®) and promise one rapid relief of complaints. Fenistil Pencivir® contains the antiviral drug Penciclovir, which stops the cold sore from spreading and ensures quick healing of the painful sores. Erazaban® cream contains the active ingredient docosanol and can be used to treat the early stages of cold sores, which accelerates the healing of the cold sore. Foscarnet-containing Triapten® is an antiviral cream, but experts advise against using it for cold sores, as the ingredients can cause skin irritation and the active ingredient may be carcinogenic.Tromantadine (Viru-Merz® Serol) is an antiviral agent that is used for recurrent herpes simplex infections, whereby treatment should only be carried out in the early stages of cold sores.

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There are also cold sore creams available vegetable based. Lomaherpan® from Lomapharm contains natural lemon balm extract. Early treatment when symptoms first appear is intended to stop the virus from spreading, but so far there have been no studies that prove its effectiveness. Ointments containing zinc can also be used to treat cold sores.

More information can be found here: Homeopathy for cold sores

What active ingredients are there?

The therapy of cold sores is carried out with substances that inhibit the multiplication of viruses, so-called Antivirals. The most commonly used cold sore creams contain acyclovir as an active ingredient. It is an antiviral agent that is particularly effective against herpes viruses by inhibiting the metabolism of infected cells and thereby preventing the viruses from multiplying. Penciclovir stops the infection from spreading by also stopping new viruses from forming in infected cells. The active ingredient docosanol inhibits the virus from penetrating the cell and thus prevents the herpes viruses from multiplying.

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Which cream works best?

The most important substances for the therapy of cold sores are Acyclovir and Penciclovir and are recommended for self-medication. In addition to being highly effective, both active ingredients are also very well tolerated. Acyclovir was used as the first active ingredient in the modern therapy of herpes simplex diseases and is now available under many trade names. In order to have a positive effect on the course of the disease, the use of acyclovir should already be in early stagebefore the actual blistering occurs. Penciclovir, on the other hand, can also be used at a more advanced stage, when a cold sore has already formed, and can lead to faster healing.

In general, however, all antiviral drugs work via a similar mechanism and can only stop the virus from multiplying, but not kill it. Nevertheless, therapy with acyclovir and penciclovir promises rapid pain relief and accelerated crust formation. Since 2008, the prescription in Germany Foscarnet Sodium which prevents viruses from entering the cells. However, therapy with this active ingredient is only recommended for patients who do not respond to treatment with the proven antivirals.

Different creams to treat cold sores:


Zovirax® contains the antiviral acyclovir. The cream is used for the local therapy of cold sores. Zovirax® combats itching and can shorten the duration of the infection if used early enough. Zovirax® contains the active ingredient Acyclovir in combination with propylene glycol, a penetration accelerator. Thanks to this formula, the lip cream is quickly absorbed into the deep layers of the skin, where it inhibits virus replication in the affected cells.

For a successful treatment of the cold sore, it is important that the cream is already in early stage is applied. Zovirax® should be applied to the infected area several times a day every four hours. The treatment period is usually five days. Zovirax® is considered to be well tolerated and redness or allergic skin reactions only occur very rarely.


The drug Pencivir® contains the patented active ingredient penciclovir, an antiviral drug that is supposed to inhibit the multiplication of viruses after the outbreak of cold sores. Pencivir® can be used at the first sign of an outbreak of infection and relieves pain and itching. Several clinical studies have shown that Pencivir® shortens the natural healing process and accelerates crust formation. The cream is spread over a large area over the affected area every two hours throughout the day and should be applied at least 6 times a day. The treatment is continued for four days. Pencivir® can be used for the first tingling sensation and for fever blisters that have already opened and is also available as a tinted lip cream. Compared to acyclovir, penciclovir has the advantage that it can still be used successfully when the disease is more advanced.


Acic® contains as an active ingredient Acyclovir and is used to relieve itching and pain in herpes infections of the lips and in the genital area. In addition, Acic® can be used as a precaution against infections with the Herpes simplex virus be used. Acyclovir prevents the virus from spreading further and thus leads to faster resolution of symptoms and faster healing.


The drug Elac® contains the antiviral as an active ingredient Acyclovir and is used to treat common cold sores. By fighting the viral replication, the progression of the infection is stopped, the itching and pain relieved, and the natural healing process accelerated.


Fenistil® Gel has a cooling and moisturizing effect on burning and itchy skin. Fenistil® inhibits histamine, a substance produced by the body that causes itching. The cream does not contain antivirals, however, and applying it at the first symptoms of a cold sore will not prevent the outbreak. Fenistil® is therefore not suitable for the treatment of cold sores.

Zinc ointments

Zinc ointment such as Virudermin® Gel are well tolerated and can be used to treat cold sores. The zinc sulfate contained in it inhibits the penetration of viruses into the host cell and promotes wound healing. A therapy with zinc ointment is only successful in the early phases of the herpes outbreak.

How long does therapy with a cream last?

If left untreated, a cold sore usually lasts between 9 to 14 days, beginning with the first symptoms and ending with the crust falling off. If the treatment is started early, the healing time with antivirals is between 6 and 7 days, whereby the pain can be significantly alleviated and the crust formation accelerated. Most creams are designed to be applied over a treatment period of four to five days.

Read more at: Duration of cold sores

Is there a prescription for a cold sore cream?

For self-medication of cold sores, creams are available 2 g acyclovir or. 2 g penciclovir Available without a prescription in any pharmacy, but larger tubes require a prescription. Forscanet creams generally require a prescription.

Cream or plaster - which is better?

Besides creams there are also Band Aid, so-called Patches, against cold sores. The advantage of these patches is that they are clear and only need to be changed every 8-10 hours, whereas most creams need to be applied every two hours during the day. By masking, the patches also protect against the spread of the infection. In general, however, it is true that neither plasters nor creams can eliminate viruses that are dormant in the body. Both offer pain relief and slightly accelerate the healing process.