Treatment for Oral Herpes

Oral Treatments

Acyclovir (Zovirax), valacyclovir (Valtrex), and famciclovir (Famvir) -- the anti-viral pills used to treat genital herpes -- can also treat the cold sores associated with oral herpes. In addition, acyclovir is available in topical form (see below), as is penciclovir (a related drug).

Topical Treatments

These ointments or creams help shorten healing time and duration of symptoms. However, none are truly effective in eliminating outbreaks.

• Penciclovir (Denavir) heals HSV-1 sores on average about half a day faster than without treatment, stops viral shedding, and reduces the duration of pain. Ideally, the patient should apply the cream within the first hour of symptoms, although benefits have also been noted with later application. It is continued for 4 consecutive days, and should be reapplied every 2 hours while awake.
• Acyclovir cream (Zovirax) works best when applied early on (at the first sign of pain or tingling).
• Docosanol cream (Abreva) is the only FDA-approved non-prescription ointment for oral herpes. It is applied five times a day, beginning at the first sign of tingling or pain. Studies have been mixed on it benefits.
• Over-the-counter topical anesthetics may provide modest relief. They include Anbesol gel, Blistex lip ointment, Campho-phenique, Herpecin-L, Viractin, and Zilactin.