cold sores, recurrent cold sores

Q. I have always suffered from recurrent cold sores as far back as I can remember. I am especially vulnerable in the summer when I spend a lot of time outdoors. Even with lip balm that has a sunblock I am frequently in pain.

These sores are incredibly ugly and people always stare. That makes me even more self-conscious about them. What can you recommend to prevent cold sores or speed healing once they occur? I have heard that lysine might be good but I know nothing about this stuff. What is it and how well does it work?

A. Cold sores, also called fever blisters, can be painful and look yucky. Some people have outbreaks once or twice a year. Others seem to have recurrent cold sores every few weeks. Once our bodies are infected with this herpes virus it remains forever. Why some people are more vulnerable to attacks than others remains mysterious. Clearly our immune systems play an important role in this process. Sun exposure can bring on an outbreak. So can a trip to the dentist (presumably because of mild trauma associated with such procedures).

Although we are enthusiastic about lysine (more about this supplement in a minute) we would be remiss if we did not mention that there are effective anti-viral agents for type 1 (HSV-1) herpes infections that cause cold sores. Zovirax (acyclovir) and Denavir (penciclovir) are available in cream form. Your doctor could alsp prescribe oral anti-virals as Famvir (famciclovir), Valtrex (valacyclovir), and Zovirax.

If you prefer a more natural and affordable approach, you may want to seriously consider lysine. The arginine/lysine theory of cold sore management remains somewhat controversial within the medical community. It goes something like this. The amino acid arginine is essential for herpes viruses to replicate and multiply. Arginine is high in nuts (such as almonds, Brazil nuts, peanuts, walnuts, etc), pumpkin and squash seeds, sesame seeds, red meat and some cereals (oatmeal for example). People are advised to cut back on high arginine-containing foods and add lysine supplements to their regimen (1000 to 1500 mg total daily dose). Lysine is supposed to make it harder for the herpes virus to replicate.

We were somewhat skeptical of this approach as there were been both negative as well as positive studies with lysine. Most of the research was with small numbers of patients and seemed inconclusive to us. Nevertheless, some of the double-blind, placebo-controlled trials lasted from 12 to 52 weeks and reported significant reductions in cold sore outbreaks among the lysine groups.

What has convinced us that something positive was happening with lysine has been the outpouring of letters from dental professionals and our readers. We have received so many anecdotal reports of success that we are convinced something is going on here We share just some of the lysine success stories with you:

One oral surgeon wrote to say his patients do well on a preventive regimen of one 500 mg tablet of l-lysine daily. If they develop a sore, increasing to four tablets a day seems to help it heal faster. A reader said, “I suffered from cold sores since I was a little boy and my doctor prescribed acyclovir, which wasn’t any help. My pharmacist suggested lysine, and I have been taking 500 mg of this amino acid for two years now. I am free of fever blisters and that’s a great relief.”

Q. When you wrote recently about home remedies for cold sores, why in heavens name didn’t you tell peple about l-lysine?

For 50 years I would develop fever blisters every time I went out in the sun. About 4 years ago a pharmacist told me about l-lysine. Since then I have taken it for a week before I know I’ll be exposed to sunshine. I have not had a cold sore since.

A. We were flooded with letters like yours praising the power of l-lysine. One young woman writes, “my boyfriend got these sores constantly, and as a last resort we went to the health food store to see if there was anything that could help. He was told to take lysine and the sores have never returned.”

Another reader reports suffering from nasty fever blisters that lasted 3 or 4 weeks. She was told by a friend to take lysine, and when she was skeptical the friend said, “then live with them if you’re stubborn.”

She now takes l-lysine whenever she feels a cold sore coming on or if she is in the sun more than usual. She says, “it quickly nips them in the bud. Doctors and druggists don’t seem to believe this, but I know it works.”

Judging from our mail bag, l-lysine does help many people. Though it may not work for everyone, this amino acid may be worth a try.

We would love to hear your story (positive or negative). Share your experience with l-lysine below in the comment section.

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  1. Kristen

    I take Zovirax and L-lysine and Abreva and essential oils for the lesions I regularly get in my right nostril (a couple times per month depending on stress levels and sun exposure). When I get them my glands swell up on that side of my jaw and neck. I am exhausted and achy, and I often get migraines on that side of my head, and my vision on that side gets blurry. It’s an ongoing struggle for my health. I wish I had more answers but even doctors do not have answers so I continue to stay on an anti-inflammatory diet and work hard to get plenty of sleep. However, one thing that I have discovered that helps the lesions go away faster and helps the pain is Calamine Lotion. When I looked up the ingredients I realized why. It contains Zinc oxide and and Ferric Oxide that dry out the blisters and reduce pain and itching. Also zinc has many healing properties. So just an fyi – maybe it can help you too.

  2. blanquita

    Hi: I feel for you. I’ve had to deal with the same pesky thing for years. The most terrible news is that it’s a virus called herpes SIMPLEX. Note the difference with plain herpes. That stays with you for life and is contagious. You can get it by drinking from an infected person’s glass. I love straws! and always ask for them.

    I’ve heard that one contracts it as a child, and there are millions of kids in that situation. It remains dormant until certain things awaken it: stress, stomach ailments, cold weather. I’ve been able to control mine when I’m in the sun by applying generous layers of high UV protection chap stick. In addition, I extend the application to all areas around my mouth (like a clown). I don’t see why it wouldn’t work in cold weather as well. There is medication that really expedites healing and relieves pain. It’s available in cream or pill presentation I can’t mention names here. I prefer the cream.

    Good luck, and be brave! Accept the fact that you’ll have to live with it for life. Help yourself by avoiding the above causes. Go see your Dr. to consult on the matter. He or she might even prescribe the cream for you.

  3. Jean

    Wonderful chance here for discussion. Thank you. I have had cold sores and sties in my eyes since age 3. I’m 59 now. They says it’s a form of herpes, but I have never ever had them in the nether regions.

    Back when my sisters and I were young we had the same doctor who delivered us. He even came over once in a while. I remember a picture of me with a patch over my eye and some sort of salve on it. My cold sores didn’t have to be directly on my lips or in my mouth. They could be above my top lip, even over to the side. Unfortunately Doctor Lawther retired. The new doctor simply said it a virus and was environmental. Why on Earth can’t doctors ever tell you where it derived from? They continue to simply place a bandage on a problem that’s probably some kind of warning of something bigger about to happen.

    I’m all about healthy habits and healthy food. Was it the vaccines they gave us, the fluoride, the metal, Mercury, lead, that we breathe everyday with the pollution and pesticides on our crops? I need straight answers. I think we all do. I think we have a right to know.

  4. Mags

    I too suffer from this dreadful ailment can I take antiviral meds WITH they Lysine tabs? Anyone know if it’s a waste of should I take the lysine AFTER the sore has cleared up

  5. Steve
    Tamworth NSW Australia

    Dang, I got the stress, dry climate, am nut addict (smoked almonds are droooool bacon for almost all vegetarians). Am 36 too. It seems that coffee, for many, is an addiction at this age. Less energy? Perhaps. I find that an acyclovir l-lysine combo at the first tingle stage turns it into a scab before a McMassive blister on the face. I only ever get them at festivals, sharing ciggies and drinks. No, I don’t smoke or drink, and I get them every month.
    So am:
    – cutting almonds.
    – reducing coffee

  6. sammy
    detroit mich

    I’m 44 now and have been getting cold sores since a child. used to get them every 6 months or so but recently I’ve been getting them every month since I started a new job with terrible hours. having to wake up at 5am 3 days a week and its taking a toll on my sleep cycle. I’m assuming that’s a big trigger because I wake up half the night and are very sleepy at work. I’ve tried everything, acyclovir and abreva and lysine 500mg daily and still get them. I wonder if there are any clinical trials for a cure going on? I wonder if the 40 minutes of aerobics I do daily worsens it? because I’m assuming exercise helps the immune system. also my white blood count is always one point under the range, does that mean my immune system is weak?

  7. Lisa F.

    I’m only saying this because nobody knows me. When I feel one coming on, and I get the tingling which I thought everyone got (but just learned that not everyone does), I have no idea who told me to do it but I have put ear wax on the cold sore. I don’t get the ear wax in my mouth at all. I normally just lightly dampen my finger, put it in my ear then right on the cold sore, and like I said it never has a chance. When I know I have it on the sore I don’t touch it and let the ear wax do its work.

  8. Osca

    I’ve been getting a cold sore one after another,for the past 2 months. Nothing really works for me, not even lysine or any other creme. My last resort is to burst them and dry them out with acetone. That’s my only cure cause nothing really works for me. I’m 38 years old, and I’ve been getting these nasty things since I was a kid. I’m getting them more often now that I’m older, twice a month. It sucks that nothing seems to work for me.

    • Robin

      OMG, Osca! Don’t DO that! ‘Bursting’ a cold sore causes pain right in the area where the virus resides which makes it worse, the virus digs its heels in increasing the healing time, and can easily cause additional eruptions elsewhere around the mouth. And think about the toxicity of the acetone, in an open lesion, no less. Just buy Cold Sores Begone Stick, looks like chapstick, has lysine and other herbal ammunition that kills the infection when you feel the early symptom, for me, a tingle. I apply it then, the tingle stops, the sore doesn’t develop, and you’re good to go. Testimonials all over Amazon and on product website,

    • blanquita

      Zovirax or acyclovir works best for me. In addition a drop of campho phonique (sp? in a small green bottle, sold over the counter) that does heal at the start, during and after the outbreak. The thing is to avoid the triggers and attack it as soon as one feels one coming.

  9. Lisa
    New Zealand

    I definitely feel the pain! I have been a coldsore sufferer since I was a child, and its an awful thing to go through. I don’t get them as badly as I used to, but triggers for me are dry lips, sunburn and windburn. If I am feeling a little run down I can also get them. Interestingly enough, I came across this feed as I just had a coldsore go away, only to find myself traveling for work, and two starting to appear in its place. I have two days of intense meetings. I am stressed out for fear that these are going to get out of control. In preparation for the onslaught (I couldn’t find lysine this late at night), I have dolloped on Zovirax (which doesn’t usually work), taken ibuprofen, taken turmeric tablets (3x the dose), Exectuive Stress B tablets (2 x the dose) and garlic oil tablets (2 x the dose). Will keep you posted, feeling the tingle and have a little swelling but hoping my concoction will help me out.

  10. Rocky

    Vitamin B12 causes cold sores for me, have to avoid it.

  11. Bobbi

    When I feel that tale-tale tingling that almost always comes just prior to the cold sore I immediately begin taking L-lysine in megadoses, I also apply Campho Phenique gel many, many times a day which drys the lips, so I follow those applications with Carmex. Since I began this regimen, I rarely get them.
    btw – if my lips get very chapped, a cold sore usually follows, or tries to!

  12. Les Green
    Atlanta, GA

    Nothing works..believe me. When I catch a virus or a cold, i get huge cold sores all over my face…multiple ones too. I have tried everything and nothing has worked.

  13. Kay
    Napa, CA

    I’d like to add something bizarre. Ha. So… I’ve had cold sores since I can remember. I’m 29. And I get them multiple times a year, religiously. However, I thought it was interesting that during my pregnancy, and the 2 years after that I breastfed, I did not get ONE outbreak. Once I stopped breastfeeding, they began to return in the usual frequency. I’m curious if it was related to my hormones/immunity.

    • Robin L Barr

      That’s interesting. I know one of the most common triggers for a cold sore (and canker sores) are hormonal changes – menstruation, pregnancy, menopause.

  14. Kay
    Napa, CA

    I use L-lysine the second I can tell one is coming, and it doesn’t seem to help with me. I still use it, though. Ha. Hoping to ask for an anti-viral oral medication soon. I seem to hear that those work well. None of the over the counter topicals ever work for me. But, again, I still use them. So who knows, maybe they lessen my symptoms.

    • Liz

      Did you stop drinking during that time? Maybe alcohol or something you do when only not pregnant.

  15. Ruby

    I started suffering from them as a little child and I think it was due to the big sloppy kisses my mother and grandma used to give me even when they had cold sores. I do wish people wouldn’t kiss children on the lips as they do not know if they are carriers or not. For some reason I hadn’t had an outbreak for 5 years then last year whilst on holiday in the sun I didn’t protect myself properly on the first day and got 2 on my lips, I had to bear these unsightly things for my holiday and yes people are rude enough to stare, if I had known I would have taken a bell and rang it and shouted clear the beach the infected monster is here.

    Anyway, I had no more until the past month then 2 and now another 2 and what did I do to deserve them? eat nuts! Thanks to all the people on the internet that bought my attention to that, otherwise I would have never known that they were the cause. I will look into the cold sore machine from Boots chemist it is said to be very effective and as a five year guarantee if its prescribed by your GP.

  16. Andy

    You guys all need to look up the electronic cold sore healing machine. It is sold here in Boots in the UK.

    If I feel a cold sore coming on, I zap it with the machine, and 70% of the time it won’t appear. If it does appear, they only last a few days if I use the machine, and don’t leave me with the yucky feeling.

  17. sally

    I have had these aggravating cold sores or fever blisers for years. Yes, I did have chicken pox as a child and I understand this makes you vulnerable. Once, I had one that would not go away and I do believe it got infected. It lasted a month and I was extremely depressed, couldn’t go anywhere. Never had one that bad since.

    A friend told me to get Llisine and never forget to take it. Everytime I do forget or go out in the sun, I’m sure to get one! Anyone recomment a good sun block for lips or the fever blisters, bring it on! I hate these things!

  18. Aindreas Scholz

    I have been suffering from recurrent cold sores for the past 10 years. Over the years, I have tried many things to either prevent or minimise the symptoms. Personally speaking, I found Acyclovir 200mg capsules to be very effective. In fact, since taking the capsules I experience less and less cold sore attacks per year. In addition, I noticed that electric dry shaving increases my chances of developing cold sores. I now only wet shave. Hope this helps. Andreas

  19. Coco

    Lysine is the only thing that can stop a coldsore for me. I start taking it every 4 hours once I feel one. Never thought to continually take it but now I may add it to my daily vitamin regimen!

  20. Carole
    New Jersey

    What lysine brand do you recommend??

  21. Megan

    I am desperate for recommendations or if anyone suffers from cold sores as badly as I do. This fall i started getting them on and around my mouth. I started taking valtrex and went without one for about a month. However, Since November I have literally suffered with a cold sore EVERY WEEK. I have tried 4 different anti-virals in pill form, zovirax cream, abreva, campho, and when all of those stopped working I started taking 1000 mg of lysine 3 times a day but I am still suffering. It is a mystery. My doctor said I likely have a compromised immune system as she and my dermatologist have never heard of anything like it..I try taking vitamins, milk, but nothing is stopping these awful things. Not only are they embarrassing but painful! If anyone has any sort of idea or recommendation please let me know.

    • TARA

      I am with everyone on this board. I have been suffering with fever blisters(herpes 1 virus) my whole life. I am 42 year old female. I have shingles (herpes 3 virus) 1 month now they are going away but very very slow. Now I just woke up today and have fever blisters under my nose. This is where I usually get them every time on right side and the right side of my neck gland swells. My lymph node swelled under my armpit on left side where I have these shingles. Take lysine everyday. Watch what I eat nuts,chocolate,grains etc.. I get stressed easily and I know this contributes to these fever/shingles virus! I hate the fact there is nothing that can be done to rid these forever? The prescribed valcyclovir pills & denavir creams just don’t work for me. I have started taking oil of oregano and using that on the blisters it’s an antiviral & antibacterial supplement. I am just at my wits end. It seems I am riddled with this virus inside me? It’s just so frustrating

      • Anita H

        I am the same. Searching for answers. I too had chicken pox as a child. I didn’t know that made you more susceptible to the hsv1 virus. Something that is different for me is that I basically get a new one or two every single day. Sometimes I will have 4 or 5 tingling and wanting to break through. As long as I put the lysine ointment on them they don’t get out of control but still take around 3-4 days to be gone.

        And by then I have new ones starting. This constant recurring has been going on for over a year now and I am so desperate to have it stop! I started taking l-lysine by mouth as well. I have heard that it could take up to a year of taking it before the symptoms lessen. So sad that dealing with this is going to be lifelong. Before this past year I only got one every few months. The only thing I can think of that is different is that we moved from California to Arkansas. I am wondering if it has something to do with the climate change.

        • Danielle

          I get bad cold sores. About 10 years ago I went through a stint where they were so bad I was getting them again just after they went away for close to 6 months. Big and angry. My doc put me on a 6 month dose of the medication they give people who have genital herpes (!)

          She said the medication occupies the space where the virus lies dormant so that it cannot awaken. I was cold sore free for close to 18 months after that. Now I take lysine to manage the odd outbreak, but they are starting to get bad again so I’m thinking of doing it again. Anyway, thought I would mention it.

    • BPC

      Have you found something that has worked for you? I am in the exact same scenerio. I have had them my whole life but it was usually just 1-2 times a year. Now it is more like once a week. Even started taking valtrex once an day and still got them.

    • Kylie

      Hi Megan, I know you seem to be getting these more regularly than every month, but please make sure that you try to avoid any medication containing naproxen, which is used in some period pain medicines . I can’t explain explain the link but I used to experience terrible coldsores every month and eventually found that for some reason the naprogesic I was taking was triggering attacks. I stopped taking it and didn’t have a cold sore for more than 15 years. It may not be of any help but, just in case I thought best to share this

    • Ruby

      If you eat nuts you should give them up for a couple of weeks and see if it helps.

    • Laura

      Megan, I’m having the same issues. I’ve had cold sores (fever blisters) for 30 years. I’ve been taking Acyclovir for about 7 years, and it helped for the little bit, and now has stopped. I have tried campho, abreva, lysine, home remedies (online), but haven’t tried the electronic cold sore device – have you? I have had 3 in the last month and once one ends, another starts (and in all different places – bottom lip, lower left; then bottom lip lower right; then top). I feel your pain – so ugly, annoying, and super super painful at times. If you have had any luck – would love to know. Thanks, Laura

  22. angel

    I have been getting cold sores irregularly since I was infected about 7 years ago. In the last 2 and a half years I’ve had less than five outbreaks except the last week I’ve had 6 cold sores. I am attributing this to taking olive leaf extract (it destroys viruses within the body and temporarily worsens symptoms) so my body is working over time.

    Triggers for me include extreme stress and being run down/ill although I had a recent infection and never got a cold sore. My daily regime is: 1000mg vitamin c and zinc, copper, vitamin b and 1000mg l-lysine, an olive leaf in the morning then another one in the evening with my meal then a garlic oil before bed. I sometimes take reishi mushroom extract too 1 a day just during my current outbreak.

    I also follow a relatively balance/low arginine diet and balance meals, however these last few weeks I’ve crept up to 3 coffees a day from my usual 2 which seems to have had an impact and triggered my cold sores. I treat with sudacrem (zinc oxide) and lysine ointment works a charm. My 6 cold sores never came up and blistered just remained flat and are almost healed (2 at the start of the previous week that quickly went and the last 4 about 36 hours of having them so far)

  23. Jessica L
    Marianna FL

    I had 1 fever blister when I was 15 after getting a sunburn on my face and apparently my lips, 1 fever blister at age 24. Now I’m 36 and in the last 2 years I have started getting them regularly. It started every couple months and now every month.

    I read on another site to try Lysine and it said to take 1000 mg every 6 hrs during an outbreak. It said it only takes 5 hours for the pill to go from your stomach to your lip tissue to stop the replication of the virus and it was right. I found that article at 8am with a small cluster of new blisters and by the next morning it was completely flat and didn’t hurt, on the 2nd day it was completely gone.

    It was about 32 hrs from the first sign to gone, it had erased it completely. I went from the 4 pills a day to 3 pills a day and then 2, 1000mg pills a day within 4 days of starting. Now this morning I awoke to a new cluster on a different place on my lip.

    My new strategy is to start the 4 pills a day and keep taking the 4 pills for a full week this time before weening down to 3 and then 2 and then hopefully some day just one a day. If anyone else first this be aware that one site said large doses for long periods (they said long periods being 5 years) can cause kidney inflammation and to cut back on dairy because lysine can make you absorb too much and cause gallstones. I don’t know if it’s true just thought I would mention it so if you try this and all of a sudden get kidney pain or discomfort you can stop taking it.

    I will say that the only thing I have changed since starting to get fever blisters often is I started DRINKING COFFEE. I never made the connection until reading this thread. All of the other triggers that were mentioned I don’t believe trigger mine because I gave not increased the eating of nuts or chocolate BUT coffee I started drinking lots more of after I had my son because having a baby is exhausting. I will stop drinking coffee and see what happens.

    • Dori

      Vitamin C will give me a cold sore. For some reason if I take 1000mg of C I get a cold sore. So try taking less vit C to see if it will help. I just do not take vitamin C.

    • Maggie

      I don’t think it’s the coffee at all. I never drank coffee up until about 6 years ago. I had them long before that so I don’t see a connection there.

  24. Laura

    Milk. Something about the amino acids or proteins. No chocolate or peanuts (I still eat other nuts and it doesnt seem to make the outbreak worse). Lots of milk and lysine. And milk.

  25. Valerie

    This virus is highly contagious, be very careful not to spread it to the rest of your body, especially into your eyes. I got infected 8 months ago by taking a sip from my friend’s bottle at a summer festival. We both forgot she had a small cold sore on her lip when she passed me her cider. I developed a cold sore almost the next day and the virus has been torturing me ever since. I’m 29, healthy and athletic, with a pretty strong immune system, I used to think. From having 4 outbreaks in the past 8 months, I’ve learned my triggers are stress, menstruation, and alcohol.

    After the first two outbreaks, one right after the other, I started taking Trilex supplement from Natural Wellbeing with lysine (+other natural extracts) and it worked!! I didn’t have another outbreak in 5 months until I decided to take a break from lysine. Going through my second cold sore this month, I’ve realized I absolutely have to:
    -take lysine for the next few months
    -alternate it with elderberry extract
    -start coconut oil pulling
    -try immediate icing at the first signs of a cold sore (it seems to work for many people)

    It could be just me, but Abreva or acyclovir cream do not help at all.
    To speed up healing this new cream Aubio works for me, it’s a little overpriced though. After applying it every 2 hours to a freshly developed cold sore, I have a brown scab the next day. Then I apply tea tree oil so that the scab dries out and falls off over the next couple of days.

    Before using Aubio, my healing period was 7-10 days, which is now cut in half. Hopefully, the right diet (NO coffee, almond milk, nuts, and seeds), lysine and elderberry supplements, oil pulling, and vitamin C will keep me cold sore-free. It’s also very important to relax, and try not to stress out. Good luck to all of us!

    • Jay

      I got cold sores from sharing drink question is how you maintain daily hygiene and routine..thanks for any comment

  26. Lora

    I have gotten cold sores since I was a child…am now 40 and getting the a lot…I never knew that nuts could contribute! I have been eating tons of nuts lately…that might be the reason. It’s a bummer to stop eating them, but I will try and am going to add lysine.

  27. Lynn

    I am 66 and am getting a cold sore about every couple of months.I use to get one once or twice a year.
    I thought cold sores lessened as you got older.Any answers as to why it has increased for me? I am a very healthy woman, but wondering it could be a suppressed immune system.

  28. Little Lumatic
    Victoria BC

    I get terrible fever blisters every 4 months, about 3 or 4 at a time. It’s awful! I work in dental too, so my patients often give me weird looks. Maybe I’ll try the I Iysine thing. I’ll try Anything at this point.

  29. Sam

    Nothing has really worked for me either. This year has been the worst year for me. I actually did a lot of detoxifying treatments such as iodized foot baths and 2 colonics and I got outbreaks right after treatments. My guess was that my body was doing just that…detoxifying…but, unfortunately in the form of herpes. I’ve been getting them since early childhood. So does my sister mom aunts and uncle. They have all pretty much found what works for them and me…I get them the worst and most frequently of everybody. Triggers are definitely stress, disrupted sleep routine, SUN, dry climate, chapped lips, thinking about them( just kidding) I apply ice right away and that has works a few times, but I swear these things have their own agenda. I have had a very bad hot rash up my back the first time I ever started taking prescription acyclovir with l-lysine supplements . At the same time while taking vitamin B. I like the method of drying them out. Alcohol, tea tree oil, peppermint oil, carmex, l-lysine ointment (which used to work great, but now just doesn’t like abreva) when I was a kid living by the ocean, the sea water used to do wonders…now I live in the dessert and I swear the dry climate is killin me….well anyway..good luck to all. Hope you find what works for you.

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