Zovirax cream for cold sores - review of use, effectiveness and alternative aciclovir creams
Drug reviews

Zovirax Cream for cold sores | Aciclovir (acyclovir) cream

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Cold sores are a common viral infection caused by herpes simplex virus. Cold sores usually affect the area around the mouth (usually caused by the herpes simplex virus 1) or the genital area (usually caused by the herpes simplex virus 2). Cold sore can affect children and adults. Zovirax cream for cold sores can be purchased over the counter from pharmacies and supermarkets. Today I will review the use of Zovirax cream for cold sores. The following will be discussed:

  • Symptoms of cold sores
  • Availability of Zovirax cream (where to buy Zovirax cream from, where get the best deals for Zovirax cream)
  • What is Zovirax cream?
  • Restrictions on the use of Zovirax cream
  • How to use Zovirax cream for cold sores
  • Is Zovirax cream effective in the treatment of cold sores?
  • Alternative creams to Zovirax
  • Can you buy aciclovir (acyclovir) tablets for treatment or prevention cold sores?

Symptoms of cold sores

Initial symptoms of cold sores may be experienced before the appearance of blisters and may include:

  • Burning pain
  • Itching
  • Tingling
  • Discomfort in the affected area

The above symptoms are referred to as a prodrome stage of infection. In the later stages, the area becomes red, elevated (no fluid present) and after about 48 hours fluid-filled blister appears. In the last stage, the blisters burst and crust over. Cold sores usually affect lips or face.

Cold sores - symptoms and treatment with Zovirax cream for cold sores
Cold sores are usually self-limiting, meaning they go on their own, typically they may last for up to 10 days.

What is Zovirax cream?

Zovirax cream, marketed as Zovirax Cold Sore Cream, contains 5% of aciclovir. Zovirax cream for cold sores is licensed for the treatment of infections caused by Herpes simplex virus presented on lips or face in children and adults.

Aciclovir (acyclovir) is an antiviral drug, which stops the production (replication) of the virus at the site of infection.

A patient who finds cold sore painful may consider the use of simple painkillers, such as paracetamol.

Zovirax over the counter availability

Zovirax Cold Sore Cream is licensed as general sale list medications (GSL). It can be purchased from any retail outlets, including supermarkets and pharmacies.

Zovirax cream is available in two different pack types, each containing 2g of the cream:

  • Aluminium tube
  • Pump pack
Sale
Buy Zovirax cream for cold sores -  aciclovir cream in pump pack
2,114 Reviews
Zovirax Cold Sore Cream Aciclovir PUMP 2 g
  • Zovirax contains aciclovir, an anti-viral treatment; always read the label
  • Fights the cold sore virus
  • Works at the tingle and blister
Sale
Buy Zovirax cream for cold sores -  aciclovir cream in 2g tube
1,023 Reviews
Zovirax Cold Sore Treatment Cream, Tube 2 g
  • Zovirax contains aciclovir, an anti-viral treatment; always read the label
  • Fights the cold sore virus
  • Works at the tingle and blister

Restrictions on the use of Zovirax cream

Two groups of people should not use Zovirax cream:

  • Patients who are immunocompromised. This group of people should seek medical attention should they experience an infection with Herpes simplex virus.
  • Patients who are sensitive to aciclovir, valaciclovir (another antiviral drug) or any ingredients found in the composition of Zovirax cream.

How to use Zovirax cream for cold sores

Zovirax Cold Sore Cream is applied five times a day (every four hours). In preference, Zovirax cream should be used in the earliest stages of the infection (prodrome or erythema lesion stage), when people experience initial symptoms of cold sores. An early application is essential, as most of the virus that causes the infection reproduces (makes a copy of itself) happens within the first 24 hours of the condition.

The recommended duration of the treatment is four days unless no improvement is seen. In this case, the treatment can be extended for up to ten days.

Zovirax cream should not be used for the treatment of genital herpes or ocular herpes infections.

Can you use Zovirax cream in pregnancy or when breastfeeding?

Manufacturers of Zovirax cream for cold sores advice that pregnant women should only use the cream when benefits outweigh the risk of possible unknown risks. The amount of aciclovir, which gest to the body from the cream, is very low.

Breastfeeding women should expect insignificant amounts of aciclovir creams to be transferred from the cream into the milk.

Is Zovirax cream effective in the treatment of cold sores?

The evidence to support the effectiveness of aciclovir cream for the treatment of cold sores comes from a few small clinical studies, which happened in the 1980s. Two more extensive studies investigating the effectiveness of aciclovir cream (Zovirax cream) were concluded in 2002. The total number of participants in both studies was over 2000.

Patients were randomly given either Zovirax cream (containing aciclovir) or a placebo cream, which did not have any active ingredients. Patients were instructed to start the treatment with the cream at the earliest stage of infection when initial symptoms were experiences.

This review concluded that there was a significantly shorter duration of the infection in both studies in patients treated with Zovirax cream. The significant results translate into the following infection times (Spruance et al, 2002):

  • For patients treated with aciclovir cream, the duration of cold sore infection was 4.3 days versus 4.8 days with patients treated with placebo cream (study 1)
  • For patients treated with aciclovir cream, the duration of cold sore infection was 4.6 days versus 5.2 days with patients treated with placebo cream (study 2)
  • From the above, the average time of the infection episode from both studies was decreased by 0.55 day (just over half of the day) when aciclovir cream was used.

Aciclovir cream did not prevent the development of lesions formation (filled with fluid) and the latest stage of crust formation (ibid).

Generic Zovirax cream for cold sores

As previously mentioned, Zovirax cream contains 5% of aciclovir. Several ‘generic’ aciclovir creams for cold sores can be purchased from pharmacies and supermarkets. All generic cold sore creams have the same active ingredient – aciclovir. Most of ‘generic’ products come in the same pack size of 2g tube. Examples of generic aciclovir creams for cold sores:

  • Superdrug Cold Sore Cream
  • Lloyds Pharmacy Cold Sore Cream
  • Virasorb Cold Sore Cream
  • Lipsore 5% cream (available in Tesco Pharmacy)
  • Morrisons Cold Sore Cream
  • Careway Cold Sore 5% w/w Cream

Can you get a bigger size Zovirax Cold sore cream?

Larger, a 10g pack of Zovirax cream or generic aciclovir cream are classified as prescription-only medicines.

It is possible to purchase multiple packs of 2g tubes as seen on Amazon.co.uk

Galpharm Cold Sore Cream, generic aciclovir cream - three-pack
327 Reviews
Galpharm Cold Sore Cream 2g x 3 Packs
  • Cold sore cream is for the topical treatment of cold sores of lips and face.

Can you buy aciclovir (acyclovir) tablets for treatment or prevention cold sores?

Aciclovir tablets (including Zovirax tablets) are prescription-only medication. A GP may consider prescribing aciclovir tablets for recurrent infection (infections that comes back) caused by herpes simplex virus, which is severe, frequent and does not go away (NICE, 2016).

Oral antiviral treatment with the antiviral drug is generally not recommended mainly due to lack of evidence for benefit in controlling the infection. Some evidence exists to support long-term preventative therapy with antiviral drugs; however, the overall benefit is small (Chi at el, 2015).

Similarly to topical therapy (with the cream), oral therapy is recommended at the earliest signs of infection, which may be challenging to identify. Most replication (reproduction) of the virus which causes cold sores happens in the first 24 hours of the condition, hence the need for early treatment.

Cold sores: an alternative to Zovirax cream treatment

Customers who wish to try an alternative treatment to Zovirax cream have an excellent choice of creams and patches available from shops and online. Some popular products used for the treatment of cold sores are listed below.

Sale
Compeed Cold Sore patches
2,700 Reviews
Compeed Cold Sore Discreet Healing Patch, 15 Patches, Cold Sore Treatment, More Convenient than Cold Sore Creams, Dimensions: 1.5 cmx1.5 cm
  • FAST HEALING: ultra-thin hydrocolloid gel provides a moist environment to help reduce scab formation
  • REDUCES CONTAMINATION AND WORSENING: protective barrier against external environment
  • STAYS IN PLACE UP TO 12 HOURS: adhesive, tapered edges so Compeed flexes with movement

No products found.

References:

Chi CC, Wang SH, Delamere FM, Wojnarowska F, Peters MC, Kanjirath PP. Interventions for prevention of herpes simplex labialis (cold sores on the lips). Cochrane Database of Systematic Reviews 2015, Issue 8. Art. No.: CD010095. DOI: 10.1002/14651858.CD010095.pub2. Available at: https://doi.org/10.1002/14651858.CD010095.pub2 Accessed on 14/09/2020

NICE (2016). Herpes simplex – oral. Scenario: Herpes labialis (cold sores) and gingivostomatitis. Available at: https://cks.nice.org.uk/topics/herpes-simplex-oral/management/herpes-labialis-gingivostomatitis/ Accessed on 14/09/2020

Spruance SL, Nett R, Marbury T, Wolff R, Johnson J, Spaulding T. Acyclovir cream for the treatment of herpes simplex labialis: results of two randomized, double-blind, vehicle-controlled, multicenter clinical trials. Antimicrob Agents Chemother. 2002;46(7):2238-2243. doi:10.1128/aac.46.7.2238-2243.2002 Available at: https://dx.doi.org/10.1128%2FAAC.46.7.2238-2243.2002 Accessed on 14/09/2020

I am a community pharmacist working in UK. I blog about drugs, health and pharmacy.

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