Dr. Michael Lee graduated from Stanford University with honors and received his medical degree from the University of Chicago in 1996. Dr. Lee completed his internal medicine residency at Mount Auburn Hospital, a Harvard Medical School teaching hospital.

Cold Sore Therapy Tips [Cold Sores]

About a third of adults suffer from recurrent outbreaks of cold sores which usually occur on the border of the lip, begin crusting in 3-4 days, and completely heal in 10 days.

Topical antivirals (penciclovir) or OTC (over-the-counter) Abreva decrease the duration of cold sores by a day.

Oral antivirals like acyclovir, famciclovir (Famvir), and valacyclovir (Valtrex) decrease the duration of cold sores by 2 days. Famciclovir seems like a good deal if you have insurance or are paying cash. It’s 500mg, 3 tablets taken together at one time ($7 at Costco). Remember, these medicines need to be started ASAP within 48 hours of symptoms (lip tingling, itching, burning), hours count so it’s good to get a supply to keep on hand.

Patients with frequent outbreaks may consider taking famcyclovir 500mg twice daily. The same regiment can also be used before periods of sun exposure or dental work.

If it’s your first time with an outbreak, the recommended dosage is 500mg twice daily for a week ($31 at Costco).

You can improve this by half a day by using OTC 1% hydrocortisone cream five times daily.

Cold Sore Relief (a lemon balm) should be applied as well two to four times daily at the first symptom until healed. This may shorten healing time, prevent spread, and reduce symptoms of recurring cold sores.

Try to reduce triggers such has prolonged sun exposure and stress. If you notice that you get outbreaks after eating sweets and nuts, you might try avoiding these foods.

Cold sores sure aren’t fun but hopefully this will help.


  1. j Said,

    June 29, 2011 @ 11:14 pm

    thanks for even giving the prices at costco! such a thorough doctor!

  2. drmikelee Said,

    June 30, 2011 @ 9:41 am

    Thanks j! Today, I was prescribing Famvir for someone who was paying cash and wondered if there might be a more convenient pharmacy to use. But as you can see from the prices below, there’s a reason to make the trip to Costco.

    Famvir 500mg tablets 30 tablets
    Costco $66.57
    Target $152.47
    Sam’s Club $202.88
    Wal-mart $246.78

  3. Rennifer Said,

    July 3, 2011 @ 5:03 pm

    Tip top stuff. I’ll epxcet more now.

  4. E. Keith Owens Said,

    July 4, 2011 @ 8:52 am

    Instructions I didnt regularly get cold sores maybe 3-5 a year but when I got the they were HUGE right below my lip on the corner of my mouth. Friday December 12 2008 9 02 PM.Country of Remedy usa.Name carolyn.Ingredients Extra Strength H-Balm .Ice.Lysine.Apple Cider Vinegar.antibacterial neosporine.Instructions Hi Lately I have been getting massive cold sores and have tried many of the remedies on this website.

  5. Vivienne Hoppe Said,

    July 14, 2011 @ 8:46 am

    I was surprised and pleased to find this info on your site today. I have recurring cold sores, one right now, and have found that if I apply Abreva at the first sign of a cold sore I avoid the pain, swelling and burning completely. I reapply three to four times a day for two to three days. I carry Abreva in my purse always!

  6. zac Said,

    April 2, 2013 @ 10:57 am

    L- Lysine amino acids is one of the best ways not only to help with recovering from an out break but also to not have outbreaks as often I take 1 1000mg tablet a day and outbreaks occur less often when I do have a outbreak I take 5000mg and it almost completely stop then out break. It truly is a magical drug for cold soars!!!!!!!

  7. dev.pvv.ntnu.no Said,

    September 12, 2014 @ 4:42 pm

    Everything is very open with a precise description of the issues.
    It was really informative. Your site is very useful.
    Thanks for sharing!

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