Cold Sore Remedies: Natural Treatments, Triggers, and When to See a Doctor

Uh-oh. You have been hanging out in the hot sun and now there is a red, painful blister making itself at home on your lip. Cold sores, also known as fever blisters, are caused by the herpes simplex virus type 1. The virus, which is most often picked up during childhood, usually lies dormant, waiting for the body to be weakened by stress or illness, and sometimes the heat of the summer sun, to push it back to the surface. What can you do to relieve the pain of a cold sore and shorten the outbreak?

The short answer: catch it during the tingling stage, hit it with ice, and stack two or three of the remedies below. Most people can cut a 10-day outbreak down to 5 or 6 days with a careful routine, and the right diet keeps the next outbreak weeks or months further out. For a clinical reference, the U.S. National Library of Medicine’s MedlinePlus cold sores fact sheet is the best plain-English primer.

Cold Sores vs Canker Sores?

Cold sores are often confused with canker sores, but they do not affect the same areas. Cold sores generally form around the mouth or nose, though they can appear, less frequently, on the gums or roof of the mouth. Canker sores, which are not caused by a virus at all (most are linked to minor mouth trauma, stress, or food triggers), usually form on the inner cheeks or tongue. Canker sores also look different from cold sores. They appear as small, round, white areas surrounded by a red halo. It is important to know the difference, because cold sores are contagious, while canker sores are not.

More Common Than You Think

It is estimated that 80% of Americans have been exposed to the virus that causes cold sores, though many of those who are infected never develop a visible outbreak because their immune systems suppress the virus before it reaches the surface. The roughly 20% who do get cold sores tend to be the people whose bodies cycle through more stress, illness, or sun exposure than average. Pregnancy, dental work, fever, sunburn, and serious sleep deprivation are the four most common adult triggers.

Cold Sore Remedies

While there is no cure for the virus that causes cold sores, the sores themselves generally clear up on their own within a week or two. In the meantime, there are steps you can take to reduce the pain, shorten the outbreak, and prevent further ones:

• Echinacea can help fight the virus and support the immune system. See our guide to natural ways to treat a fever for more immune-support ideas that overlap.
• Exercise will strengthen your immune system, promote healing, and reduce stress to help prevent further outbreaks. A daily 20-minute walk has measurable effects on HSV recurrence.
• Ice can help to numb the pain and reduce the inflammation. Apply a cold compress to the area during the earliest stage of development, usually marked by a tingling sensation. Catching it here is the single biggest lever; an ice pack at the tingle stage can shrink a 10-day outbreak to under 5.
• Lysine, an essential amino acid found in many foods we regularly eat, can help to contain the spread of cold sores. You can increase your lysine intake by taking a supplement (1,000 mg, three times a day) or applying a lysine ointment to the site of the outbreak. The benefits of lysine are offset by arginine, another amino acid found in foods like chocolate, peanuts, almonds, grain cereals, peas, gelatin, and beer. For best results, avoid these foods for the duration of your outbreak.
• Lemon balm, an herb that looks like mint, when applied to the site of a cold sore as a cream or steeped tea poultice, has been shown to cut recovery time in half in some people and can also help to prevent future outbreaks. See our birth month herbs piece for lemon balm’s wider uses.
• Peppermint oil, applied to the site of the sore (diluted 1:1 in a carrier oil), will help to fight off the virus. External use only.
• Vitamin B deficiency has been linked with cold sore outbreaks. There are actually eight distinct vitamins in the B family (thiamine, riboflavin, niacin, pantothenic acid, pyridoxine, biotin, folic acid, and cobalamin), which are responsible for promoting a strong immune system and healthy cell growth. Take a B-Complex supplement at least once daily.
• Witch hazel can help to dry out the sore, which will allow it to heal faster and prevent oozing. Dab a small amount on a cotton swab and apply two or three times a day.
• Zinc can bind with the virus to promote healing and prevent the sores from spreading. Apply a water-based zinc solution several times a day, or take a 25 mg zinc supplement.

Other Cold Sore Tips

• Use a petroleum-based ointment or lip balm to keep the infected area moist. This can help to contain the infection, protect it from sun and wind, and keep the area soft to prevent cracking.
• Don’t touch, rub, or scratch the sore, as this can spread the infection to yourself and others. If you must touch it, be sure to wash your hands immediately. Keep the area clean with gentle soap and warm water.
• Avoid salty or acidic foods, which can irritate the sore and stretch the healing window.
• Replace your toothbrush after the sore crusts over; the virus can survive on the bristles for several hours.
• Wear SPF 30 lip balm whenever you are outdoors for more than 20 minutes, especially in summer.

When to See a Doctor

Most cold sores clear on their own and never need a clinic visit, but a few situations warrant a call to your provider. See a doctor if a sore lasts more than 14 days, if you have more than six outbreaks a year, if a sore appears near or in the eye (rare but serious, can threaten vision), if you have a weakened immune system from another condition, or if a sore is spreading instead of crusting over. Prescription antivirals like acyclovir, valacyclovir, or famciclovir, taken in the first 24 hours of the tingling stage, can stop the outbreak from progressing entirely.

Preventing the Next One

Once you have HSV-1, the goal shifts from cure (impossible) to suppression (very doable). The three biggest prevention levers, in rough order of effect: keep sun off your lips (SPF balm, brim hats, mid-day shade), sleep at least seven hours most nights, and run a daily lysine supplement during high-trigger months. Together those three reduce the average outbreak frequency by roughly half in most people.

Cold Sore Remedies FAQ

For more home remedies, browse our witch hazel guide and the Best Days calendar for traditional timing of natural treatments.

Jaime McLeod

Jaime McLeod is a longtime journalist who has written for a wide variety of newspapers, magazines, and websites, including MTV.com. She enjoys the outdoors, growing and eating organic food, and is interested in all aspects of natural wellness.

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