Cold sore home remedies: the cold compress at the first tingle

It announces itself before it appears: a tingle, a tightness, a small itch at the edge of the lip. Anyone who gets them knows the feeling, and knows what is coming.

French households had remedies for the days that follow. But the useful moment is the one before the blister, and that is where this page starts.

Before anything else, two rules

A cold sore is contagious, from the first tingle until the scab has come away on its own. Not until it looks better. Until it is gone.

Never kiss a newborn while you have one. In a baby under three months the herpes simplex virus can cause a severe, sometimes life threatening infection. This is not a precaution to weigh up: it is a rule. The same applies to anyone whose immune system is weakened.

And wash your hands after touching it. The virus carried to an eye causes an infection that can damage sight, and that is an emergency, not a home remedy situation.

The cold compress, in the first hours

This is the one to do, and the window is short.

At the very first tingle, wrap an ice cube in a clean thin cloth and hold it against the spot for five to ten minutes. Repeat several times over the first few hours.

Cold numbs the area and reduces the swelling that is beginning. Applied early enough, it sometimes keeps the blister smaller than it would have been. Applied on day three, it is only comfort.

Never put ice straight onto the lip.

Keep it dry, keep it clean

A cold sore heals better dry than moist.

• Dab it clean with a tissue and throw the tissue away.
• Do not pick the scab, however tempting. Picking is how it spreads to another spot on the lip and how it leaves a mark.
• Do not burst the blister. The fluid inside is full of virus.
• Use your own towel until it has healed.
• Replace your lip balm afterwards, and do not share it.

Lemon balm

Lemon balm is the plant with the most standing here, and it is a genuinely traditional French remedy for this exact complaint.

Steep a teaspoon of dried lemon balm in half a cup of hot water for ten minutes, let it cool completely, then dab it on with a clean cotton pad, several times a day.

NCCIH describes lemon balm as generally well tolerated for short term use and does not claim more than that. There is some research on it for cold sores; it is not conclusive. It is soothing, it is cheap, and it will not do harm.

Honey

A small dab of honey on the sore, several times a day, on clean skin.

It is soothing on skin that has cracked, and it keeps the area from drying to the point of splitting.

Never for a child under one year old, in any form.

Petroleum jelly on the crack, not on the blister

Once the scab has formed and the lip starts to split when you talk, a thin layer of petroleum jelly on the crack itself makes the day easier.

Apply it with a cotton swab rather than a finger, and throw the swab away. Dipping a finger into the tub and back onto the lip is how a jar becomes a reservoir.

The pharmacy option, and when it is worth it

An antiviral cream bought over the counter works best applied at the tingle stage, before the blister. Past that point its effect is small.

If you get them often, or badly, a doctor can prescribe tablets that do more than any cream. That conversation is worth having if this happens several times a year.

What sets them off

The virus stays in the body and reactivates. The common triggers are recognisable:

• strong sunshine, which is why a lip balm with sun protection genuinely prevents some of them
• a cold or a fever, hence the name
• a stressful or exhausting stretch, and what helps stress is relevant here
• hormonal changes
• cold wind and chapped lips
• a bad night, which lowers everyone’s resistance: see what helps insomnia

When to see a doctor

Go the same day, or to an emergency room, if:

• it is near or in the eye, or your eye becomes painful, red or light-sensitive
• you have a weakened immune system
• a baby under three months has been exposed
• the sore is spreading widely, or you have a fever with it

Make an appointment if:

• it has not healed after two weeks
• you get them more than five or six times a year
• the area becomes swollen, hot, and yellow-crusted, which suggests a bacterial infection on top
• you have eczema, which changes how this virus behaves on skin

A sore inside the mouth rather than on the lip is usually something else: see canker sores, which are not contagious and not viral.

FAQ

How long am I contagious with a cold sore?

From the first tingle until the scab has fallen off by itself. It is longest at the blister stage, when the fluid is full of virus, but it does not end when the sore stops looking dramatic.

Does toothpaste on a cold sore work?

No, and it is one of the most repeated pieces of bad advice there is. Toothpaste dries and irritates the skin and can make the crack worse.

Can I catch it from sharing a glass?

It is far less likely than direct contact, but do not share a glass, a towel or a lip balm while you have one. The rule that actually matters is the one about newborns.