How to tell if a cold sore is coming

Below, we’ve covered the best ways to attack cold sores when and as they form, as well as the medications that are most effective for helping you treat, heal and remove cold sores as quickly as possible once they start to develop.

Early Warning Signs a Cold Sore is Forming

The key to stopping a cold sore quickly is to treat it the moment you notice symptoms. While it’s rarely possible to completely avoid a cold sore, treating it before it develops into a larger sore is a good way to limit its development and deal with a smaller, less obvious sore.

In a best-case scenario, treating a cold sore early prevents it from developing into a full-on sore.

In a worst-case scenario, even if you act a little too late in treating it, you’ll still speed up the cold sore healing process.

Because of this, it’s important to be aware of the initial warning signs of a cold sore. The faster you can act once you notice these symptoms, the less time the cold sore will have to break out and affect your lips, gums and mouth.

Itching or tingling around the lips. Normally, you’ll start to notice your lips itching or tingling for a day or two before the cold sore starts to form — a phase known as a “prodrome.” If you’ve had cold sore outbreaks before, you might find it easier to recognize this feeling than someone who has never been affected.

While not a specific warning sign, cold sores tend to be triggered by things like stress, illness, sun exposure, hormone fluctuations or fatigue. It’s best to be extra attentive to the potential warning signs of a cold sore if any of these issues affect you.

Our other article goes more into detail about getting fever blisters from the sun.

your outbreak is no match against an Rx option.

How to Treat a Cold Sore Before it Develops

If you’ve noticed the warning signs above and think a cold sore is developing on or around your lips, it’s important to take action as promptly as possible. The faster you treat the cold sore, the shorter it will usually stick around once (or if) it pops up.

Topical Treatments for Early Cold Sores

There are several ways to treat cold sores while they’re still in the itching/tingling stage. If you rarely get cold sores, over-the-counter topical treatments like docosanol can provide a modest amount of relief and potentially shorten the amount of time needed for the cold sore to heal.

Topical medications are only effective on the area to which they’re applied, meaning you’ll need to use the medication over the area surrounding the cold sore as it begins to form.

Most topical medications will speed up the healing process, but they’re rarely the best option for preventing cold sores. If you get frequent outbreaks, the best option is usually to treat your cold sores using oral antiviral medication

Oral Antiviral Medication for Early Cold Sores

Antiviral medication is designed to prevent the spread of the virus by stopping it from replicating within your body. This means a cold sore doesn’t have the same environment in which to grow as it normally would, shortening its lifespan and making it smaller and less obvious.

Used early, antiviral medications like valacyclovir (Valtrex®) are scientifically proven to reduce the amount of time required for cold sores to heal. This means you can effectively “zap” a cold sore in its early stages and cut down the total amount of time required to heal.

Other oral antiviral medications used to treat cold sores include acyclovir and famciclovir, both of which have a similar mechanism of action to valacyclovir. All of these medications are available on prescription, meaning you’ll need to see your doctor before taking them. We have a detailed comparison between these three drugs: Valacyclovir vs. Acyclovir vs. Famciclovir.

Our guide to valacyclovir goes into more detail about how antiviral medications work to stop cold sores from developing and speed up the healing process, as well as things like common dosage instructions, potential side effects and the amount of time required for valacyclovir to work.

How to Treat a Cold Sore After it Develops

While it’s best to treat a cold sore during the itching/tingling stage before it can develop, doing so isn’t always possible.

Once a cold sore develops into an open sore, the treatment options are the same as before — topical medications such as docosanol and oral antiviral medications such as valacyclovir.

Cold sores can be quite painful after they develop, meaning you might also want to use an over the counter pain medication if your sores start to bother you. It’s best to avoid eating spicy foods or hot liquids (such as hot tea or coffee), as these can sting if they touch an open cold sore. It’s also suggested to avoid salty foods and citrus.

While healing a cold sore after it develops can be a slower process than treating it in the earlier stages, it can and will happen. Follow the instructions of your doctor and use medications such as valacyclovir as recommended, and within a few days, the sores will begin to heal.

your outbreak is no match against an Rx option.

Tips and Tactics for Speeding Up Cold Sore Healing

Beyond medication, there are also several tips and techniques you can use to speed up the cold sore healing process — and, just as importantly, to avoid accidentally making the outbreak worse.

First, avoid touching the cold sore. Cold sores contain infectious fluid that can affect other parts of your body. Touching an open cold sore is an easy way to transfer this fluid to your fingers and increase your risk of spreading it to your eyes, genitals or other parts of your body.

Touching a cold sore also increases your risk of spreading the virus to other people. It can also irritate the sore, worsening the appearance of the cold sore and increasing the amount of time required for it to heal.

If you accidentally touch a cold sore, even when it’s in the early stages of developing, wash your hands thoroughly as soon as possible.

Second, avoid using any non-pharmaceutical products to “treat” the cold sore. Things like facial moisturizers, lip balms and other products don’t speed up cold sore healing and are more likely to slow down the healing process than provide any improvement.

Instead, stick to proven treatments like topical cold sore ointments and oral antiviral medications.

Third, focus on a healthy lifestyle. Lack of sleep, excessive amounts of stress and a poor diet can all weaken your general health and slow down the healing process for a cold sore. Focus on sleeping well, eating well and avoiding too much strenuous activity until the sore heals.

Finally, make sure you avoid any activity that could spread the cold sore to other people. Skin contact like kissing is best avoided until the sore is completely healed. It’s also best to avoid sharing things like dining utensils and facial towels when you have a visible cold sore.

Most of the time, treating a cold sore early will reduce the size to which it develops and shorten the healing process.

From itching and tingling, to a burning sensation around your lips, pay attention to the warning signs of an impending cold sore and you’ll be better prepared to act quickly using medications like valacyclovir for a shorter, easier and less stressful outbreak.

How do you prevent cold sore when you feel it coming?

To reduce your chance of a major outbreak, it's important to start antiviral therapy medication as soon as you feel a cold sore coming on, even if blisters haven't formed yet..
acyclovir (Zovirax).
famciclovir (Famvir).
valacyclovir (Valtrex).
penciclovir (Denavir).

Can you stop a cold sore before it starts?

The key to stopping a cold sore quickly is to treat it the moment you notice symptoms. While it's rarely possible to completely avoid a cold sore, treating it before it develops into a larger sore is a good way to limit its development and deal with a smaller, less obvious sore.

What does the first stage of a cold sore look like?

Stage 1: Tingling Tingling is usually one of the first signs that a cold sore is about to develop on the surface of the skin. The area may also burn or itch. Treating a cold sore during the tingling phase may reduce its severity and duration, but it won't prevent the sore from forming.