Health Guide — Cold Sores (Oral HSV‑1)
Cold Sores — Treat Early, Heal Faster, Protect the Eye
Start oral antivirals at the tingle/burn stage for the biggest benefit (e.g., valacyclovir 2 g, repeat in 12 hours). Avoid kissing/oral sex and sharing items until healed. If you have eye symptoms or lesions near the eye, seek urgent in‑person care.
What is a cold sore?
A cluster of small blisters on the lip border (vermilion) caused by herpes simplex virus‑1. After the first infection, the virus becomes dormant in the nerve and can reactivate with UV exposure, stress, illness, or fatigue.
Best timing & regimens
At prodrome (tingle/burn): antivirals shorten symptom duration the most.
Valacyclovir (typical): 2 g now, 2 g in 12 h (one‑day regimen) or 1 g BID x 5 days if started later.
Famciclovir: 1500 mg once at onset or 750 mg twice in one day.
Acyclovir: effective with more frequent dosing if cost coverage is needed.
Stand‑by prescriptions & prevention
If you get frequent flares or travel often, ask for a stand‑by antiviral to keep on hand.
Use SPF lip balm daily, avoid trigger sun/wind exposure, manage sleep and stress, and wash hands often.
Don’t share lip balms, utensils, towels during an outbreak.
When not to self‑manage
Eye involvement (pain, redness, photophobia, vision change) or rash on the nose tip/near eye — could signal ocular HSV; seek care urgently.
Immunocompromised state or ≥6 recurrences/year — discuss suppressive therapy with your clinician.
Atypical lesions or spreading facial cellulitis.
Comfort care
Cool compresses, petrolatum to keep lesions moist, avoid picking to prevent bacterial superinfection. OTC topicals may ease symptoms but lack the speed of oral antivirals.
How TeleDirectMD helps
We confirm typical HSV‑1 by video/photos, rule out eye involvement, and send same‑day antivirals with clear instructions. For frequent flares, we discuss suppressive options with your PCP/derm.
Internal links
Shingles treatment online → /treatments/shingles-online-treatment
Eczema treatment online → /treatments/eczema-online-treatment
Common Cold (URI) guide → /health-guides/common-cold-uri-symptoms-relief
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