Cold Sores

Question 1

What are some patient factors that a pharmacist should assess for?

Answer 1

Refer to MD if the following apply:
Under 12
First cold sore
Immunocompromised
More than 6 episodes per year (may need referral for prophylaxis)

Question 2

What are some red flags for cold sores?

Answer 2

Fever, swollen glands, other systemic symptoms
Lesion is present for longer than 14 days
Lesion on nose or ocular involvement
Lesion is excessively red, swollen or contain pus

Question 3

What are some symptoms of a typical cold sore?

Answer 3

Unilateral vascular lesion surrounded by erythema
Lesion appears on the border of the lip
Vesicles break open, leaking a clear, sticky fluid, and heal
Prodromal itching, tingling, or burning

Question 4

What are some treatments for cold sores when the lesion is present?

Answer 4

Docosanol
Local anesthetic

Question 5

What are some treatment options for cold sores when the lesion is not present (prodromal or for next episode)

Answer 5

Valacyclovir 2g BID for 2 doses