How Long Do Cold Sores Last? Healing Time With and Without Antivirals
If you can feel a familiar tingle on your lip, or a blister has already appeared, the first thing you probably want to know is how long cold sores last. Without treatment, most clear up on their own in 1 to 2 weeks,[1] although some take up to 3 weeks.[2]
Cold sores are caused by the herpes simplex virus, usually type 1 (HSV-1). There is no cure for the virus, but prescription antiviral medicine can help a cold sore heal sooner and hurt less, especially when you start it at the very first sign.[1][3] With Starfish.com, you can request cold sore treatment online, and if it is right for you, a licensed clinician sends the prescription to your pharmacy, usually within 1 to 2 hours.
The Stages of a Cold Sore
| Stage | What you notice | Starting an antiviral now |
|---|---|---|
| Tingling | Itching, burning or tingling around the lips, often for a day or so before anything appears[2] | The best time to start. Antivirals work best before blisters develop[1] |
| Blisters | Small, fluid-filled blisters, often along the border of the lips[2] | Less certain. The benefit of starting valacyclovir after a sore has formed has not been established[3] |
| Weeping and crusting | The blisters merge, burst, ooze and then crust over[2] | Benefit not established[3] |
| Healing | The crust falls away and leaves pink skin, usually with no scar[1][2] | Not needed. The sore is already healing |
What an Antiviral Does for a Cold Sore
Antiviral medicine helps a cold sore in three ways.
- It heals sooner. Valacyclovir, sold under the brand name Valtrex, is an antiviral tablet used to treat cold sores. In the clinical trials behind its FDA label, people who started it at the first symptom had cold sores that cleared about 1 day sooner on average than people who took a placebo.[3]
- It eases the symptoms. MedlinePlus notes that antiviral medicines help reduce pain and make your symptoms go away sooner.[1]
- It can mean fewer contagious days. A cold sore is most likely to spread while the blisters are oozing,[2] so a shorter outbreak can also mean less time being careful around partners, family and friends.
Taken together, that means a shorter, more comfortable outbreak, and the earlier you start, the better your chance of getting that benefit.[1][3] Our clinicians can prescribe valacyclovir for cold sores or acyclovir, another antiviral tablet for cold sores. Acyclovir 5% cream is an antiviral cream for recurring cold sores, and some people add acyclovir cream to a tablet to treat the sore directly.[4]
Treat a Cold Sore at the First Tingle
Start your request as soon as you feel it. If treatment is right for you, we send the prescription to your pharmacy, usually within 1 to 2 hours.
Why Timing Matters So Much
An antiviral works by stopping the virus from multiplying. That is why the label advises starting at the earliest symptom, such as tingling, itching or burning, and why the benefit of starting after a sore has formed has not been established.[3]
If you get cold sores regularly, you probably know the warning signs. Requesting treatment online means you do not have to wait for an appointment while the tingle turns into a blister. Once the clinician approves it, the prescription goes to the pharmacy you choose. You pay for the medication at the pharmacy, the same way you would with a prescription from your own doctor.
What Can Bring a Cold Sore Back
Antivirals treat an outbreak but do not cure cold sores,[3] so the virus stays in the body and can flare up again. Mayo Clinic lists these common triggers:[2]
- A viral infection or fever
- Hormonal changes, such as a menstrual period
- Stress and fatigue
- Sun or wind exposure
- Changes in the immune system
- An injury to the skin
Knowing your own triggers can help you spot an outbreak early. If cold sores come back often, say so in your questionnaire, so the clinician knows your history when deciding on treatment.
When to See a Clinician in Person
Contact a healthcare provider in person if:
- the cold sore has not healed within 2 weeks[1][2]
- you have sores or blisters near your eyes, or eye pain or grittiness[1][2]
- your symptoms are severe[1]
- you have a weakened immune system[1]
We do not treat anyone who is pregnant, so if you are pregnant, contact your obstetrician.
FAQ
How long do cold sores last with valacyclovir?
In the trials behind its label, valacyclovir shortened a cold sore by about a day on average, when people started it at the first symptom.[3] Most cold sores clear in 1 to 2 weeks without treatment.[1]
How long is a cold sore contagious?
A cold sore spreads most easily while the blisters are oozing, but the virus can also spread when there is no sore at all.[2]
Should I use tablets or acyclovir cream?
Tablets showed the larger effect in their trials, about a day shorter, compared with about half a day for the cream.[3][4] Some people use both. You can request tablets, the cream or both, or let the clinician choose.
Can herpes be cured like a bacterial STD?
No. Antibiotics can cure bacterial STDs, but there is no cure for herpes. Antivirals help an outbreak heal sooner, and the virus stays in the body.[1][3]
Can I get a prescription before a sore appears?
Yes. The tingling stage is the best time to start an antiviral, so request cold sore treatment as soon as you notice it.
Get Cold Sore Treatment Today
Ask for valacyclovir, acyclovir or acyclovir cream, or let the clinician choose.
References
- U.S. National Library of Medicine, MedlinePlus. “Oral herpes.” Medical Encyclopedia. https://medlineplus.gov/ency/article/000606.htm
- Mayo Clinic. “Cold sore: Symptoms and causes.” https://www.mayoclinic.org/diseases-conditions/cold-sore/symptoms-causes/syc-20371017
- 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, 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
