Aciclovir (e.g. Zovirax Cold Sore Cream, Virasorb Cold Sore Cream and Soothelip) is the most commonly recommended pharmacy treatment for cold sores. It is an antiviral agent which works by inhibiting viral reproduction.[1,3]
It comes as a 5% cream which is applied to the affected area five times a day for five days.[1,3]
Aciclovir can be used at both the tingle and blister stages of the cold sore[3] but if the cream is used at the early ‘tingling’ stage, it can lessen the duration and severity of an attack, and speed up the healing process.[1,7,9]

Fenistil (Penciclovir) is a new type of antiviral agent, which is available OTC for the first time in the UK after it is switched by its manufacturer’s from a prescription only medicine to one which is available to buy in the pharmacy. Like other anti-viral agents, penciclovir works directly against the virus which causes cold sores.[11]

<PRACTICE POINT>
Look at the products containing aciclovir stocked by your pharmacy and note:
1. The dosage recommendations
2. Any other information that might be helpful to a customer.

Other cold sore treatments do not treat the cold sore but can help to relieve some of the symptoms such as pain, irritation and dryness. Local anaesthetics such as lidnocaine (e.g. Lypsyl Cold Sore Gel) can help soothe the affected area and relieve soreness, although their duration of action is short.[2,4,8]

Mild antiseptics and skin moisturisers can help to support the skin as it undergoes normal healing processes. Pain associated with cold sores can be treated with simple analgesics such as paracetamol and ibuprofen.

<PRACTICE POINT>
What products are available to customers suffering from cold sores that contain:
1. An anaesthetic
2. Antiseptic
3. Moisturiser

When to refer
In most cases, a cold sore is a self-limiting condition which can be simply and successfully treated OTC. People who experience very frequent or severe cold sores should be referred to the pharmacist for further advice.