Cold Sore Treatments

This service is NOT suitable for you if:

• You are requesting this treatment for another person (that is a person other than the named person on this account)

• You are pregnant (or suspect you could be pregnant) or breastfeeding

• This is the first time you have had a Cold Sore

• You have new lesions that are not where your Cold Sore lesions usually occur

• You need a prescription for suppression therapy (a longer course of treatment to help prevent flares)

• You are feeling unwell / have a temperature

• You have severe kidney disease

• You are immunocompromised (have a weakened immune system because of certain medical conditions, or medications you are taking)
  Please book a video consultation or speak with your regular doctor as a more detailed clinical history is essential so appropriate treatment is provided; the required medication dose /duration is different to that available via this service.  

• Your lesions are located in areas other than lips/ mouth/ chin area
  If you have lesions on other areas of your face or inside your mouth, please book a video consultation or speak with your local GP.

If you have lesions on other areas of your face or inside your mouth, please book a video consultation or speak with your local GP.

If you have genital lesions, please use our genital herpes treatment service. 

IF YOU HAVE LESIONS ON/ AROUND YOUR EYE, PLEASE SEEK URGENT MEDICAL ASSESSMENT.

Cold Sores are caused by the Herpes Simplex Virus (HSV). This is a common virus and it is spread through direct skin-skin contact. It is very contagious. Most people are exposed to HSV during childhood (after kisses from a family member with the virus) and it is assumed that most adults carry this virus without necessarily having had a Cold Sore. This is called subclinical carrying and is harmless in itself.

Once you have been infected, you carry the virus for life, but may not be aware of it and may not have any further episodes/outbreaks.

There are 2 different types of HSV that cause Cold Sores, HSV type 1 and HSV type 2; HSV type 1 is responsible for more than 90% of Cold Sores.
HSV type 2 generally causes Genital Herpes, but if it infects skin around the mouth it can cause Cold Sores too.

HSV infections are mostly asymptomatic or unrecognised and can be spread, even if there are no Cold Sores/ blisters visible.
Some infections will cause blisters and sores ranging from mild to more severe.
Before Cold Sore lesions appear, they are often preceded by a sensation of pain, burning or numbness. Fluid filled blisters usually appear within 24 hours and weep until they scab over and heal. Episodes are usually mild and self limiting, settling on their own in 7-10 days.

Some people find that certain things/ situations trigger a Cold Sore to reappear including:

• Feeling unwell eg. with a viral infection or fever

• Exposure to sunlight & wind 
  (If you feel this is a trigger, apply a high SPF factor moisturising sun cream every day)

• Stress

• Fatigue

• Changes to the immune system

• Injury to the skin
  (try to avoid dry, chapped lips)

• Hormonal changes eg. at the start of your period

Cold Sores are contagious from the moment of the first tingle until they have completely healed. There are some things you can do to reduce the risk of spread to others, or to other areas of your own body:

• Try not to pick/ touch sores

• Avoid kissing / skin contact with others

• Avoid having oral sex (it can  cause genital herpes)

• Avoid sharing items that come into contact with the Cold Sore lesions: lip balm, towels, eating utensils and other personal items

• Keep your hands clean: wash your hands carefully before you touch yourself or other people

• Try to avoid triggers: the best way to avoid spreading Cold Sores is to avoid getting them

• If you get a warning sign, then act quickly: follow the advice above and consider treatment (creams or medication depending on your individual situation)

Please be aware that you should be especially careful around those who are immunocompromised (weakened immune system) when you have active Cold Sore lesions, until they heal completely as HSV infection can be potentially very serious for these people.

Extreme caution is required around babies who are at risk of neonatal herpes, a potentially life-threatening condition – do not kiss babies or young children if you have a Cold Sore.

In some cases, antiviral medication is required to manage a flare of Cold Sores, e.g. frequent, severe episodes or if exposed to predictable triggers.

This medication should be taken as soon as possible after the symptoms start,or when you get warning signs (e.g. tingling). 

It is not a cure for Cold Sores but it reduces the severity and duration of the outbreak by preventing the virus from multiplying. This also helps to reduce the spread of the virus.

We can arrange a prescription for antiviral medication for people who have previously been diagnosed with Cold Sores by a healthcare professional for:

• A current outbreak
• In preparation for the next recurrence 

This is subject to clinical suitability. 

If you require further information, please contact our team (info@webdoctor.ie)

Some of the side effects:

• Nausea/ vomiting, diarrhoea or stomach aches
• Headache
• Rash
• Photosensitivity (more sensitive to sunlight)
• Dizziness
• Fatigue

If you are concerned about any of these symptoms, or you develop other symptoms which you feel may be related to this medication, please speak with your doctor for advice. For full details of the potential side effects of this medication, please read the patient information leaflet (PIL) that comes with your medication.

Yes, you can buy a cream that contains antiviral medication over the counter (without a prescription) in your pharmacy. Many people find that if they start this treatment immediately when they feel the first signs of a Cold Sore, such as tingling, that it is very effective.

Please note, you will need a prescription for antiviral tablets.

There are some occasions when you should see a doctor face-to-face via a video consultation or your local GP:

• If you are pregnant
• If your lesions have been present for more than 10 days
• If you are concerned that your lesions are getting worse despite treatment
• If you develop lesions in a different location to where your lesions usually occur
• If you have lesions inside your nose/ mouth/ ears, or areas other than you face
  If you have lesions around your eye/ on your eye, please seek URGENT medical assessment 
• If you have a weakened immune system
• If you are feeling generally unwell (e.g. fever, headache, malaise)

These infections are potentially more complex to manage and require a more detailed assessment.