Adult Cold Sore Treatment in Texas
MD-only online cold sore evaluation for adults in Texas with guideline-based antiviral treatment when appropriate. $49 flat-fee video visit, no insurance required.
Cold sores are viral (herpes simplex). Antibiotics do not treat cold sores. Antiviral medication works best when started early, ideally at the first tingling or burning.
- Assessment for cold sore vs canker sore vs bacterial skin infection
- Antiviral prescribing when clinically appropriate
- Contagiousness guidance and prevention tips
- Adults only (18+)
What Is a Cold Sore?
Cold sores, also called herpes labialis, are caused by herpes simplex virus and most commonly appear on or near the lips. Many adults carry the virus and may have periodic outbreaks. A typical outbreak starts with tingling, burning, or tightness, followed by clustered blisters that can break open and crust over.
Cold sores are contagious, especially when blisters are present or weeping. TeleDirectMD provides adult-only, MD-only online care in Texas focused on accurate recognition, antiviral treatment when appropriate, and clear guidance about prevention and when in-person care is safer.
Cold Sore Symptoms and Red Flags
TeleDirectMD evaluates the lesion pattern, timing, recurrence history, immune status, and any eye symptoms. This helps confirm the diagnosis and identify situations that need urgent in-person evaluation.
| Symptom or pattern | What it suggests | Telehealth appropriate? | Red flag requiring urgent in-person or ER care |
|---|---|---|---|
| Tingling or burning on the lip, then small clustered blisters | Typical herpes labialis outbreak | Often yes | Eye pain, light sensitivity, or vision changes |
| Crusting sore on the lip after blisters | Healing cold sore | Often yes | Rapidly spreading facial swelling |
| Thick honey-colored crust with increasing redness | Possible impetigo or secondary bacterial infection | Sometimes | Fever, rapidly spreading painful redness, or severe tenderness |
| Single painful ulcer inside the mouth | Canker sore (aphthous ulcer) more likely | Often yes | Inability to swallow fluids, dehydration signs |
| Frequent severe outbreaks or widespread lesions | Higher risk course, consider immune factors | Sometimes | Immunocompromised with extensive lesions or systemic symptoms |
| Lesions near the eye or on the eyelid | Possible herpes eye involvement risk | Often no | Any eye symptoms, urgent same-day evaluation |
Conditions That Can Mimic a Cold Sore
Several conditions around the mouth can look similar. Your TeleDirectMD physician uses lesion appearance, location, and symptom timing to guide the diagnosis.
Canker Sore
Usually inside the mouth. Ulcer is not a cluster of blisters and is not caused by herpes.
Impetigo
Bacterial infection that can cause honey-colored crusting and spreading redness, often needs antibiotics.
Angular Cheilitis
Cracking at the corners of the mouth from irritation or mixed infection, not classic blister clusters.
Contact Dermatitis
Irritation from lip products, toothpaste, or fragrances causing redness and scaling rather than clustered blisters.
Shingles
Can cause painful grouped blisters, usually in a band-like pattern on one side of the face.
Cellulitis
Warmth, expanding redness, and significant pain can indicate deeper skin infection needing urgent care.
When Cold Sores Can Be Managed Through Telehealth
TeleDirectMD is best for adults with typical cold sores who are stable and do not have eye symptoms or signs of severe infection.
When a Video Visit Is Appropriate
- Adult 18+ with typical tingling then clustered blisters on or near the lip.
- Symptoms started recently, especially within 24 to 48 hours.
- No eye pain, vision changes, or lesions near the eye.
- No fever or rapidly spreading painful redness.
- Physically located in Texas at the time of the visit.
Red Flags Requiring In-Person or ER Care
- Eye pain, light sensitivity, blurred vision, or lesions near the eye.
- Severe facial swelling or rapidly spreading redness.
- High fever, severe weakness, or dehydration.
- Immunocompromised with extensive lesions or systemic symptoms.
- Severe pain out of proportion to skin findings.
How TeleDirectMD Treats Cold Sores in Adults
Cold sore care focuses on early antiviral treatment when appropriate, symptom relief, and reducing spread to others. Antivirals work best when started at the first sign of an outbreak.
Antiviral Treatment
- Valacyclovir is commonly used for episodic treatment.
- Acyclovir is an alternative option when appropriate.
- For frequent outbreaks, suppressive therapy may be discussed based on history and risk factors.
Symptom Relief
- Petrolatum barrier to reduce cracking and promote healing.
- Cold compresses for discomfort.
- Avoid picking or peeling scabs to reduce scarring and bacterial infection risk.
Preventing Spread
- Avoid kissing and oral contact until fully healed.
- Avoid sharing cups, lip balm, towels, or razors during outbreaks.
- Hand hygiene after touching the area.
Medication Table for Adult Cold Sores
These are common adult regimens for herpes labialis. TeleDirectMD individualizes recommendations based on timing, kidney history, immune status, and overall presentation.
| Medication | Dose | Duration | When used |
|---|---|---|---|
| Valacyclovir | 2000 mg by mouth 2 times daily | 1 day | Episodic treatment started early, ideally within 24 hours of onset. |
| Acyclovir | 400 mg by mouth 3 times daily | 5 days | Alternative episodic regimen when appropriate. |
| Famciclovir | 1500 mg by mouth once | Single dose | Alternative episodic option when clinically appropriate. |
| Docosanol | 10% cream, apply 5 times daily | Until healed | Over-the-counter option for early lesions, modest benefit for some patients. |
| Petrolatum | Apply thin layer as needed | Until healed | Barrier support and comfort, reduces cracking. |
TeleDirectMD does not prescribe controlled substances for cold sore visits. If eye involvement is suspected, urgent in-person evaluation is required.
Home Care and Prevention
Most cold sores heal within 7 to 10 days. Early antiviral treatment may shorten the course. Good barrier care and trigger management can reduce recurrence.
Home Care Checklist
- Start antiviral medication as soon as symptoms begin, if prescribed.
- Use petrolatum to keep the lesion moist and reduce cracking.
- Use cold compresses for discomfort.
- Avoid picking or peeling scabs.
- Use lip sunscreen if sun is a trigger.
When to Recheck
- Lesions are not improving by day 10.
- Increasing redness, warmth, pus, or fever.
- Any eye symptoms or lesions near the eye.
- Outbreaks are frequent or unusually severe.
TeleDirectMD Cold Sore Care: What to Expect
TeleDirectMD provides MD-only virtual urgent care for adults for $49 flat-fee video visits in 25+ states. Your physician reviews symptoms, timing, recurrence history, immune status, and red flags such as eye involvement. When appropriate, we prescribe antiviral treatment and provide guidance to reduce spread and recover safely. No controlled substances are prescribed.