The most effective thing to put on a herpes sore is a prescription antiviral medication, either taken as a pill or applied as a cream. But several over-the-counter topicals, natural options, and comfort measures can also speed healing or ease pain while you wait for an outbreak to resolve. What works best depends on whether you’re dealing with oral herpes (cold sores) or genital herpes, and whether the sore is in its early tingling stage or already open and weeping.
Prescription Antivirals: The Most Effective Option
Oral antiviral medications are the gold standard for herpes outbreaks. They work by mimicking a building block of DNA. The virus picks up the fake piece and tries to use it, which stops viral DNA from copying itself. Importantly, this process only activates inside infected cells, which is why antivirals cause relatively few side effects.
For a first genital herpes outbreak, the CDC recommends a 7 to 10 day course of oral antivirals. For recurring outbreaks, treatment courses are shorter, sometimes as brief as 1 to 3 days depending on the specific medication and dose. Starting the medication at the earliest sign of tingling or burning makes the biggest difference. If you wait until sores are fully formed, antivirals still help but the benefit shrinks considerably.
Prescription antiviral creams also exist, though they’re generally less effective than pills. They work best for cold sores when applied during the prodrome, that early tingling sensation before a blister appears. For genital herpes, oral medication is strongly preferred over topical creams.
Over-the-Counter Topical Cream
Docosanol 10% cream (sold as Abreva) is the only FDA-approved nonprescription antiviral for cold sores. Unlike prescription antivirals that interfere with viral DNA, docosanol works by blocking the virus from fusing with your cell membranes, preventing it from getting inside healthy cells in the first place. In a clinical trial of over 700 patients, docosanol reduced healing time by about 18 hours compared to placebo, bringing the median down to 4.1 days.
That may sound modest, but for cold sores that typically last a week or more, shaving off nearly a day matters. The key is applying it five times a day starting at the very first tingle. Once a blister has fully formed, the window for meaningful benefit has narrowed. Docosanol is approved for oral herpes only, not for genital sores.
Zinc Solutions
Topical zinc has shown promise for herpes sores. In a clinical study using a 4% zinc sulfate solution in water, all 18 patients experienced complete relief from pain, tingling, and burning within 24 hours. Crusting occurred within 1 to 3 days, and no adverse effects were reported. Zinc appears to have direct antiviral properties and also helps dry out weeping lesions.
You can find zinc oxide in many over-the-counter lip balms and ointments marketed for cold sores. Look for products listing zinc oxide or zinc sulfate as an active ingredient. Avoid applying concentrated zinc solutions to genital skin without medical guidance, as mucous membranes are more sensitive than lip tissue.
Honey
Medical-grade honey, particularly kanuka and manuka varieties, has been studied as a topical herpes treatment with surprisingly competitive results. One randomized controlled trial found that honey and acyclovir cream both had a median healing time of nine days for cold sores, with the trend slightly favoring honey. A smaller trial from the UAE found that multiflora honey healed cold sores an average of 3.3 days faster than acyclovir cream (2.6 versus 5.9 days).
Honey has natural antibacterial and anti-inflammatory properties, and it creates a moist wound-healing environment that may reduce crusting and cracking. If you want to try it, use medical-grade or raw honey rather than processed grocery store varieties. Apply a thick layer directly to the sore several times a day. This approach is reasonable for oral herpes but should not replace antiviral medication for genital outbreaks.
L-Lysine Supplements
L-lysine is an amino acid that competes with arginine, another amino acid the herpes virus needs to replicate. While not something you “put on” a sore directly, it’s one of the most commonly searched supplements for herpes management. For daily prevention, 500 to 1,000 mg per day is a reasonable dose. During an active outbreak, some people increase to 3,000 mg per day for the duration of the acute phase. Doses up to 3 grams daily are generally well tolerated, though higher amounts can cause nausea, cramps, and diarrhea.
The evidence for lysine is mixed but favorable enough that many people find it worth trying, particularly for reducing the frequency of cold sore recurrences. It works best as a complement to antiviral treatment, not a replacement.
Comfort Measures for Active Sores
Beyond treatments aimed at shortening the outbreak, several things can ease discomfort while sores heal:
- Ice or cold compresses: Applying a cloth-wrapped ice pack for 10 to 15 minutes can numb pain and reduce swelling, especially during the early blister stage.
- Petroleum jelly: A thin layer over crusted sores keeps them from cracking painfully. It won’t speed healing, but it protects the skin and reduces irritation from clothing or friction.
- Cornstarch or baking soda paste: Lightly dusting weeping genital sores with cornstarch can help absorb moisture and reduce irritation. Some people make a thin paste and dab it on, then let it dry.
- Warm salt water soaks: For genital sores, sitting in a shallow warm bath with dissolved salt can clean the area gently and relieve stinging.
- Topical lidocaine: Over-the-counter numbing gels or sprays containing lidocaine can temporarily relieve pain from both oral and genital sores.
What Not to Put on Herpes Sores
Steroid creams (hydrocortisone, triamcinolone, and similar corticosteroids) should not be applied to herpes sores. Steroids suppress local immune function, which can allow the virus to replicate more aggressively, spread to a wider area, and delay healing. This applies to both prescription and over-the-counter steroid creams.
Calamine lotion, while useful for many itchy skin conditions, should not be used on open sores or on genital or anal skin. Alcohol-based products, hydrogen peroxide, and harsh antiseptics can damage healing tissue and increase scarring without meaningfully reducing viral activity. Toothpaste, a popular home remedy, can irritate and dry out surrounding healthy skin while offering no antiviral benefit.
Avoid picking at or popping blisters. The fluid inside is highly infectious, and breaking the skin barrier increases the risk of bacterial infection on top of the viral outbreak. Let blisters break on their own, and keep the area clean with gentle soap and water.