Acyclovir Cream or Ointment for Cold Sores and Genital Herpes
If you get cold sores or genital herpes, you have probably seen acyclovir offered in more than one form. Acyclovir is an antiviral medicine for herpes outbreaks, and it comes as a cream, an ointment and tablets. The cream and the ointment sound alike, but in the US they are approved for different jobs.
Acyclovir cream, sold under the brand name Zovirax, is approved for cold sores that keep coming back in adults and teens aged 12 and older.[1] Acyclovir ointment is approved for a first outbreak of genital herpes.[2] For genital herpes in general, the CDC recommends antiviral tablets.[3] While there is no cure for herpes, there are several treatments that work well,[3] and whichever kind of herpes you have, Starfish.com has a prescription for it. A licensed clinician reviews your answers to choose the treatment that fits.
Acyclovir Cream vs Ointment at a Glance
| Acyclovir cream | Acyclovir ointment | Antiviral tablets (acyclovir or valacyclovir) | |
|---|---|---|---|
| Approved use | Cold sores that keep coming back, ages 12 and up[1] | A first outbreak of genital herpes, and some herpes skin infections in people with a weak immune system[2] | Genital herpes and cold sores[3][5] |
| What it does | Helps a cold sore heal sooner[1] | Shortened healing time in studies of first genital outbreaks[2] | Shortens outbreaks, and taken daily means fewer of them[3] |
| Where it goes | On the cold sore. Not on the genitals[1] | On the skin sores. Not in the eyes[2] | Swallowed as a tablet[3] |
What Acyclovir Cream Does Well
Acyclovir cream works by stopping the herpes virus from spreading in the body.[4] Used on a cold sore, it helps the sore heal sooner.[1] It goes straight onto the sore, so there is no tablet to swallow.
It is also gentle. In its trials, skin reactions where the cream was applied were reported by 5% of people using it, compared with 4% of people using a cream with no medicine in it.[1] It works best when you apply it at the very beginning of a cold sore, at the first tingle or itch.[4]
The cream’s label says it should not be used in the eye, inside the mouth or nose, or on the genitals.[1] So for genital sores, the ointment or tablets are the options.
When Acyclovir Ointment Is Used
Acyclovir ointment has its own label. It is approved for a first outbreak of genital herpes, and for some herpes skin infections in people with a weak immune system.[2] In studies of first genital outbreaks, it shortened healing time, and in some cases it eased pain and shortened the time the virus could be passed on.[2]
Its label also sets out its limits. In people with a healthy immune system, studies of herpes that kept coming back, on the genitals or the lips, showed no clear benefit.[2] The most common side effect is mild burning or stinging where it is applied.[2]
We offer a topical acyclovir option for both cold sores and genital herpes. When you request it, the clinician may prescribe acyclovir ointment when it is the better treatment for you.
Treat Genital Herpes With Tablets
Request acyclovir or valacyclovir tablets, or let the clinician choose. If treatment is right for you, we send the prescription to your pharmacy.
Why Tablets Lead for Genital Herpes
The CDC’s treatment guidelines say antiviral creams and ointments offer little benefit for genital herpes and are discouraged.[3] Tablets are the standard treatment instead. The CDC recommends three: acyclovir, valacyclovir and famciclovir.[3] They can be used two ways.
For each outbreak. A short course helps an outbreak heal sooner. The CDC says it works best if you start within 1 day of a sore appearing, or during the tingling that comes before some outbreaks.[3]
Every day. Daily treatment, called suppressive therapy, cuts outbreaks by 70% to 80% in people who get them often.[3] Daily valacyclovir also lowers the chance of passing herpes to a partner.[3]
This applies to whichever virus causes your genital herpes. HSV-1, the virus behind most cold sores, causes a growing share of genital herpes.[3]
Getting Acyclovir Online for Any Kind of Herpes
For cold sores, you can request acyclovir cream on its own, acyclovir tablets for cold sores, or valacyclovir for cold sores.
For genital herpes, you can request acyclovir for genital herpes or valacyclovir for genital herpes. Either one can be taken for each outbreak or every day. You can also add a topical option, and the clinician may prescribe acyclovir ointment.
You answer an online questionnaire instead of booking an appointment. A licensed clinician reviews your answers. If treatment is right for you, we send the prescription to the pharmacy you chose, usually within 1 to 2 hours. You pay for the medication at the pharmacy, the same way you would with a prescription from your own doctor.
When to See a Clinician in Person
You have genital sores for the first time. The CDC advises confirming genital herpes with a lab test of the sore.[3] That needs an in-person visit.
A sore is near your eye. See a healthcare provider in person.[6] Neither the cream nor the ointment goes in the eye.[1][2]
A cold sore lasts longer than 2 weeks, or your immune system is weakened. These also call for an in-person visit.[6]
You are pregnant. Please contact your obstetrician. We do not treat anyone who is pregnant.
FAQ
Is acyclovir ointment the same as acyclovir cream?
No. Both contain 5% acyclovir, but they are different products with different US labels.[1][2] The cream is approved for cold sores that keep coming back.[1] The ointment is approved for a first outbreak of genital herpes.[2]
Can I use acyclovir cream for genital herpes?
No. The cream’s US label says not to use it on the genitals.[1] For genital herpes, the CDC recommends antiviral tablets,[3] and the ointment is the topical approved for a first outbreak.[2]
Can I get acyclovir cream or ointment online?
Yes. With Starfish.com, you request a topical acyclovir option through a private online questionnaire, with no appointment to book. A licensed clinician decides between cream and ointment and, if treatment is right for you, sends the prescription to your pharmacy, usually within 1 to 2 hours.
How much faster does a cold sore heal with acyclovir cream?
In the trials on its label, cold sores treated with the cream healed in about 4.5 days, compared with about 5 days without it.[1] Starting at the first sign gives it the best chance to help.[4]
Get the Right Acyclovir for Your Herpes
Cold sores or genital herpes, start with a short questionnaire. A licensed clinician reviews your answers and, if treatment is right for you, sends the prescription to your pharmacy within 1 to 2 hours.
References
- U.S. National Library of Medicine, DailyMed. “Zovirax (acyclovir) cream, for topical use.” Human prescription drug label. https://dailymed.nlm.nih.gov/dailymed/fda/fdaDrugXsl.cfm?setid=125dbe4e-94ba-45bd-a714-f9c4b8e8b5c2
- U.S. National Library of Medicine, DailyMed. “Acyclovir ointment USP, 5%.” Human prescription drug label. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=d2d4fb8b-cd9d-45a3-90cd-3805a9441240
- Centers for Disease Control and Prevention. “Genital Herpes Simplex Virus (HSV) Infection.” Sexually Transmitted Infections Treatment Guidelines, 2021. https://www.cdc.gov/std/treatment-guidelines/herpes.htm
- U.S. National Library of Medicine, MedlinePlus. “Acyclovir Topical.” Drug information. https://medlineplus.gov/druginfo/meds/a606001.html
- U.S. National Library of Medicine, DailyMed. “Valtrex (valacyclovir hydrochloride) tablet, film coated.” Human prescription drug label. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=b2d1c6ad-e2ef-6b0d-e053-2a95a90a8d09
- U.S. National Library of Medicine, MedlinePlus. “Oral herpes.” Medical Encyclopedia. https://medlineplus.gov/ency/article/000606.htm
