What ointment heals cold sores fast? A guide to antiviral and OTC treatments

October 12, 2025 •

4 min read

Did you know that the herpes simplex virus type 1 (HSV-1), which causes cold sores, affects more than half of the US population by their 20s? For those affected, knowing what ointment heals cold sores fast can significantly shorten the duration of painful and embarrassing outbreaks.

Quick Summary

Antiviral ointments containing docosanol or prescription acyclovir are the most effective topical treatments to accelerate cold sore healing. Early application at the first sign of symptoms is critical for success.

Key Points

Start Early: The most crucial factor for quick healing is applying an antiviral ointment at the very first sign of a cold sore, such as tingling, itching, or burning.
Choose an Antiviral: Opt for an ointment with an antiviral ingredient, like over-the-counter docosanol (Abreva) or a prescription acyclovir cream, to directly address the viral cause.
Docosanol Blocks Viral Entry: Docosanol works by preventing the herpes virus from entering healthy skin cells, which helps limit the spread of the outbreak.
Prescription for Severe Cases: If you have frequent or severe outbreaks, a doctor can prescribe a stronger topical medication like acyclovir cream or a combination cream to speed healing.
Supportive Care Helps: Use cold compresses for pain and swelling, and keep the area moisturized with petroleum jelly once a scab forms to prevent cracking and aid healing.
Avoid Touching the Sore: To prevent spreading the virus and prolonging healing, wash your hands after applying ointment and avoid picking or touching the sore.

The Fastest Approach to Healing Cold Sores

When a cold sore, also known as a fever blister, appears, it's a frustrating and often painful event. The good news is that antiviral ointments can help accelerate the healing process by addressing the root cause: the herpes simplex virus (HSV). The most effective strategy hinges on one crucial factor: applying the medication at the first sign of an outbreak, often a tingling, itching, or burning sensation. Wait too long, and topical treatments become less effective because the virus has already replicated and spread.

Over-the-Counter (OTC) Antiviral Options

For many, the first line of defense is a topical ointment available without a prescription. The most prominent of these is docosanol, the active ingredient in Abreva and generic equivalents.

Docosanol (Abreva): This is the only non-prescription medication approved by the FDA to shorten cold sore healing time. Docosanol works by preventing the herpes virus from entering healthy cells, thereby limiting its spread. When applied five times a day at the first sign of a cold sore, it can reduce healing time by about 18 hours compared to a placebo, with some users healing in as little as 2.5 days.
Other OTC Creams: Many other products contain ingredients like menthol, camphor, or lidocaine to provide symptomatic relief from pain and itching, but they do not contain antiviral agents to shorten the healing time itself.

Prescription Topical Antiviral Creams

For those who experience frequent or severe outbreaks, a doctor may prescribe a stronger topical antiviral cream. These medications are generally more potent than their OTC counterparts and can offer faster results, especially if you can get the prescription filled and applied very early.

Acyclovir Cream (Zovirax): Acyclovir cream is a prescription antiviral medication that works by stopping the herpes virus from replicating its DNA. It is typically applied five times a day for four days to treat cold sores on the lips and face. For optimal results, it must be applied at the very first sign of an outbreak.
Penciclovir Cream (Denavir): Another prescription option, penciclovir, works similarly to acyclovir to inhibit viral replication. Studies have shown it can shorten healing time and reduce pain, but some research suggests its results may be only marginally better than placebo.
Acyclovir-Hydrocortisone Cream (Xerese): This is a combination prescription product that pairs the antiviral acyclovir with a mild steroid, hydrocortisone. The combination may help reduce inflammation and lower the risk of scabs forming.

Supportive Care and Home Remedies

While antiviral ointments are the primary way to speed healing, supportive care can provide comfort and aid the recovery process.

Cold Compresses: Applying a cold, damp towel or a cloth-covered ice pack to the sore can help reduce swelling and discomfort.
Pain Relief: OTC pain relievers like acetaminophen or ibuprofen can help manage pain.
Avoid Irritation: Steer clear of acidic or salty foods that might sting the sore.
Protect the Skin: Petroleum jelly (Vaseline) can prevent the sore from cracking once it has scabbed over and can offer a protective barrier.

Comparison of Fast-Acting Cold Sore Treatments


Treatment	Availability	Key Active Ingredient	Mechanism	Time to Healing	Best Timing for Use
Abreva (Docosanol)	OTC	Docosanol 10%	Prevents virus from entering healthy cells	~4.1 days (median)	First sign of tingling/burning
Acyclovir Cream (Zovirax)	Prescription	Acyclovir 5%	Inhibits viral replication	Shortens duration by about one day	First sign of tingling/burning
Acyclovir-Hydrocortisone Cream (Xerese)	Prescription	Acyclovir + Hydrocortisone	Antiviral + anti-inflammatory	May reduce risk of blistering	First sign of tingling/burning
Penciclovir Cream (Denavir)	Prescription	Penciclovir 1%	Inhibits viral replication	Shortens duration by about one day	First sign of tingling/burning

Important Considerations for Treatment

Regardless of the ointment you choose, adherence to proper application is key. Always wash your hands before and after touching the cold sore and applying cream to avoid spreading the virus. Using a cotton swab or a gloved finger for application can also help. Most importantly, resist the urge to pick at the sore or the developing scab. This can prolong healing, increase the risk of scarring, and spread the virus to other areas of your body or to other people.

Additionally, some triggers can set off an outbreak, including stress, illness, sun exposure, and fatigue. A lip balm with sun protection can help prevent sun-induced cold sores.

Conclusion

For anyone looking for what ointment heals cold sores fast, the answer lies in using an antiviral treatment as early as possible. Over-the-counter docosanol (Abreva) is a highly effective, accessible option for most people. For those who experience frequent or severe outbreaks, prescription-strength antiviral creams like acyclovir offer another potent solution. While no topical treatment can heal a cold sore overnight, consistent and early application of these ointments, along with good self-care, is the most reliable way to minimize symptoms and shorten the healing time significantly.

For more in-depth information, you can consult sources like the MedlinePlus Cold Sore page for guidance on symptoms and treatment options.

Frequently Asked Questions

No, it is not possible to heal a cold sore overnight. While starting an antiviral treatment at the first sign of symptoms can significantly shorten the overall healing time, it cannot make a cold sore disappear completely in 24 hours.

When used at the very first sign of a cold sore, Abreva can heal it in as little as 2.5 days for some users, with a median healing time of 4.1 days, according to the manufacturer.

For those with frequent or severe outbreaks, prescription acyclovir cream may offer faster results, especially if treatment is initiated promptly. However, some studies indicate that the healing time is only marginally faster than some OTC options.

The best time to apply cold sore ointment is as soon as you feel the earliest symptoms, such as tingling, itching, or redness. The sooner the treatment begins, the more effective it will be at shortening the outbreak.

Neosporin is an antibiotic ointment and will not treat the herpes virus that causes cold sores. It can be used to prevent secondary bacterial infections, particularly after the blister has broken open and scabbed over, but it won't speed up the primary healing of the cold sore itself.

You should avoid picking or touching the sore, as this can prolong healing and increase the risk of scarring and spreading the virus. Also, avoid harsh substances, acidic foods, and sun exposure without protection.

Oral antiviral medications, like valacyclovir (Valtrex), can be more effective for managing severe or frequent outbreaks, as they treat the virus systemically. They work similarly to topical versions by shortening the duration of symptoms and preventing new sores.