Many people report that L-lysine, an amino acid, works quite well at preventing or shortening a cold sore outbreak. Not everyone has success with this approach, however. Sometimes a prescription drug such as valacyclovir is the solution for frequent or very painful outbreaks, as these readers discovered.
Valtrex (Valacyclovir) for Cold Sores:
Q. You wrote about valacyclovir for cold sores and I’m glad you did. My dermatologist prescribed it about ten years ago and the drug changed my life. I’d suffered with horrid cold sores since I was a little girl.
Now I keep two valacyclovir pills in my purse. That way, I have them handy at the first “tingle,” which I’ve learned to recognize. If I take them immediately, I literally have zero cold sore. It’s a miracle drug for me.
A. Thank you for sharing your experience. Valacyclovir (Valtrex) and similar antiviral drugs can be highly effective against herpes simplex infections. In one study, researchers found that young athletes at a Minnesota wrestling camp were able to avoid most cases of herpes gladiatorum by taking Valtrex daily (Clinical Journal of Sport Medicine, July 2016).
Another Reader Testimonial:
Q. I had cold sores for 30 years before I found a solution. You recently mentioned L-lysine, but it didn’t work for me. Summer sunburns, icy cold winters and a stressful job all brought cold sores on frequently.
Many dermatologists over the years prescribed things that did not work. When I complained to my internist, he said you need Valtrex. It’s usually prescribed for genital herpes and the generic name is valacyclovir.
For the last ten years, I have taken Valtrex when I feel a tingling coming on. I’ve not had a cold sore since getting that prescription.
Cold Sores and Herpes Medicine:
A. Cold sores (herpes labialis) are caused by a virus, herpes simplex virus type 1 (HSV-1). That’s why a prescription medicine like valacyclovir that treats genital herpes (HSV-2) is also quite effective for cold sores. Thank you for sharing your success.
There are several other medications that should also work. Those include the prescription drugs acyclovir (Zovirax) and famciclovir (Famvir). Acyclovir is available as a topical cream as well as pill form. In the US, all these medications require prescriptions, but in New Zealand, famciclovir is available over the counter (Journal of Clinical Virology, Jan. 2012).
There is even an OTC cream that is approved in the US to help cold sores heal faster. It is docosanol (Abreva). It’s not clear if it would work equally well as valacylovir for you, however. In one head-to-head comparison with another topical nonprescription treatment, benzalkonium chloride (Viroxyn), it was less effective.
Non-Drug Cold Sore Remedies:
We have been surprised that people report success with sauerkraut juice. One woman rubbed this on her upper lip whenever she felt a “familiar bubble” starting to form. She reported that within a couple of days healing took place.
This remedy turns out to be very popular against canker sores which form inside the mouth. We first heard about this approach from D.W. in Garland, Texas. His mom was a dental technician during the 1930s. The dentist she worked for recommended a mouthful of sauerkraut juice swished around for a minute or so. The patient was to do this a couple of times a day and swallow one tablespoon. One physician who was plagued by incredibly painful canker sores doubted it would work but became a believer after it was the only remedy that actually cleared up the sores.
By far the most popular cold sore remedy on our website is this amino acid.
Mike in Calgary, Canada had a very different experience from the one at the top of this page:
“I have had cold sores since I was a small child when our grandmother kissed me and my four sisters. I’m a PT and golf instructor and I am outside for 8 months a season and used to get several outbreaks per season.
“I spent hundreds on Abreva and Valtrex. What a waste of money. I take L-lysine every night and haven’t had a breakout in over two years. Knock on wood. L-lysine is rather cheap compared to all the prescription meds. It works for me.”
Kate in Australia found a combo helpful:
“I too have never found lysine to be helpful but I was also taking Valtrex, which was a godsend!
“I kept getting frequent outbreaks however so went to a new doctor for help. He prescribed acyclovir tablets which I now take daily. I have only had 2 coldsores in the 8 months I’ve been taking this medication. I was getting multiple cold sores every week beforehand. Much cheaper than Valtrex and I’m a new person.”
A surprising number of people report that ice is helpful. Here is just one:
Jim in British Columbia, Canada likes ice:
“L-lysine works great, BUT, you don’t take it everyday or the effects will fade overtime. What you do is take it as soon as you feel the tingling of the sore under the skin.
“I take 400-600mg in capsules with a glass of water. Then place an ice cube in a paper towel and place the exposed side against the skin at the location of the sore and hold it there until the skin is numb. Wait until after the burning cold feeling goes away. I have been doing this for the past three years now and have not had one cold sore since! Not one.”
What we have learned over the years is that no one thing works for everyone. Some people love antiviral drugs like valacyclovir. Others think L-lysine is the magic remedy against HSV-1 infections. We encourage people to see what works best for them and stick with it until the benefits fade. Then try something else.
You will find a bunch of other approaches in our book, The People’s Pharmacy Quick & Handy Home Remedies.