Cold sores are caused by the herpes simplex virus, and as such, you can control them with prescription medication. These come in two different forms: topical creams and antiviral tablets. Depending on your habits, lifestyle, and preferences, either one or both may work better for you. The guide below explores how each works, well-known brands for each, and which you should buy and why.

Creams

Cold sore creams are ‘topical’ creams—in other words, you apply them directly to the area in question. This helps the medication find the sore more quickly than it would through you taking a tablet. There are a number of different creams with different active ingredients. Some are more effective than others. Creams often speed up recovery, or prevent cold sore from spreading.

Pros & Cons:

Creams are an excellent choice for a number of reasons.

• Creams are non-invasive. If you’re not a fan of swallowing pills, using a cream or gel is no problem.
• Because they’re non-invasive, creams pose less of a risk of side effects.
• Creams are also much less likely to interfere with any other medication you may currently be taking.
• The medication in creams finds its way to the affected area more quickly than tablets. This is because you apply it directly. Tablets, by contrast, have to be digested first.
• Through ‘compounding’, your pharmacist can combine ingredients to create a perfect cream for you.
• You don’t have to take creams with water or food, like you do with tablets. If you forget to take a tablet with food and water, their efficacy is greatly reduced.

That being said, creams aren’t perfect. They can be messy, and you get it on your fingers and hands when you apply them. It’s also quite easy to rub the cream away if you aren’t careful. This is especially the case if you’re eating. And if your cold sore is on your lips, you may taste the cream—it’s not pleasant. All in all, you have to balance these pros and cons together to figure out what matters most to you.

Pills

Cold sore pills are an effective way to manage outbreaks on a consistent, long-term basis. You take them like any other pill, with food and water. They contain the same medications that creams contain. However, since the medication is absorbed through the gut, it takes longer for your body to get it to the affected area. Even so, they can be effective. They’re definitely worthy of consideration compared to creams.

Pros & Cons:

Pills are an excellent choice for a number of reasons, including:

• With pills, there’s no mess. You swallow the tablet and you’re done.
• Because pills are digested by your body, they’re available for longer than cream. Cream tends to rub off easily, whereas once you’ve swallowed a pill, it’s there to stay.
• You can easily take pills in public, whereas applying cream might be embarrassing or messy. They’re also easy to carry around.

That being said, there are a few drawbacks to taking pills, too. One is that you have to schedule them correctly. If there’s too much of a gap between taking one and taking another, they’re nowhere near as effective. That’s because the virus has time to replicate in the absence of medication. While the same applies to creams, it’s easier to use cream than take tablets. There’s also the fact that you have to remember to drink water and eat food before you take your tablet, too.

Well-Known Brands

There are three main cold sore prescription creams/pills available today (if you’d like to learn about Over The Counter pills and creams for cold sores please see this page).

1. Zovirax. Zovirax was one of the first antiviral drugs to treat herpes. It contains aciclovir, a compound discovered in the 1970s, and originally found in a Caribbean sponge. Aciclovir was such a breakthrough that the researcher who discovered it won a Nobel Prize. Today, further advancements mean that aciclovir has been further refined and improved. Zovirax is the best-known brand to still use aciclovir, and it’s available either as a cream or a pill.
2. Valtrex. Valtrex is an antiviral drug with the active ingredient valaciclovir. It was first made available in the U.S. in 2009, and is also marketed under the brand name Zelitrex. Valaciclovir is more ‘bio-available’ than regular aciclovir. This means that the body absorbs it more easily. Consequently, Valtrex contains less valaciclovir than Zovirax contains aciclovir. Again, Valtrex is available either as a pill or as a cream.
3. Denavir. Denavir contains penciclovir, another improvement on aciclovir that is also more bio-available. Denavir is available as a cream only.

Aciclovir, Penciclovir, and Valaciclovir are the best-known herpes medications available today. Other medications include famciclovir and ganciclovir. Each of these medications is effective, and none offer any common side effects. In around 1% of cases, patients experience nausea and diarrhea.

Which Should You Buy, And Why?

On the balance of the pros and cons above, neither creams nor tablets are a clear ‘winner’. Both can be effective, so long as you use them correctly. However, there are definitely people who would prefer one over the other. Consider the following points:

• Do you already take supplements or other tablets in the morning? If so, you would find it much easier to remember to take cold sore tablets.
• Do you find it difficult to swallow pills? If so, creams would be the better alternative.
• Do you rub, bite or lick your lips? If so, you would most likely get rid of any cream you put on and should take pills instead.
• Do you eat irregularly? For example, do you often forget breakfast, or eat your meals at different times each day? If so, taking tablets wouldn’t be very effective for you.
• Are your cold sores on the inside of your lips? If so, you wouldn’t be able to effectively put cream on them.

Take a look at the list of creams and tablets above to see if you recognize any of them. A friend or colleague may have told you about them before, in which case you could ask your doctor for them on their recommendation. If not, take a look at the blog posts below. There’s plenty more information on everything from cold sore creams and tablets to devices. Click the links below to find out more.