Cold Sores (Orofacial Herpes):
Information for adults

Most herpes simplex infections are easy for physicians to diagnose. On occasion, however, a swab from the infected skin may be sent to the laboratory for viral culture, which takes a few days to grow. Blood tests may also be performed.

Untreated herpes simplex virus infections will go away on their own, but medications can reduce the symptoms and shorten the duration of outbreaks. There is no cure for herpes simplex virus infection.

Treatment for primary herpes simplex virus infection includes the following oral antiviral medications:

• Acyclovir pills
• Valacyclovir pills
• Famciclovir pills

These medications are usually taken for 5–14 days.

More severe primary herpes virus infections may require additional medications:

• Oral antibiotic pills if the areas are also infected with bacteria
• Topical anesthetic, such as viscous lidocaine, if the areas inside the mouth are very painful

In addition, very severe infections may require intravenous fluids (and even intravenous antiviral medications) or painkillers if the pain prevents you from drinking fluids.

Treatment for recurrent herpes simplex virus infection includes the same oral antiviral medications used to treat primary infection:

• Acyclovir pills
• Valacyclovir pills
• Famciclovir pills

People who experience early signs (prodromes) before recurrent infections may benefit from episodic treatment, by starting to take medication after the onset of tingling and burning but before the appearance of blisters and sores.

Other people have recurrent infections that are frequent enough or severe enough to justify suppressive therapy, in which medications are taken every day in order to decrease the frequency and severity of attacks.