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Teeth, Mouth, and Gums
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Sores of the Mouth, Lip, and Tongue

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Combination Cold Sore Treatment

Combination therapy for cold sores has proven superior in a recent trial comparing the effects of a corticosteroid gel plus antiviral medication with the effects of an antiviral medication alone.

All the study participants had suffered from cold sores induced by ultraviolet radiation (UVR), or sunlight, in the past. Thus, researchers could "cause" cold sores in these individuals through UVR exposure. One group of patients in this trial used a combination of famciclovir, an antiviral drug taken orally and fluocinonide, a topical corticosteroid gel applied directly to the cold sore. The other group took famciclovir alone.

In the combination therapy group, almost half of participants’ cold sores were prevented from maturing fully, compared with only 8% of cold sores in the famciclovir-only group. The size of the cold sores in the combination therapy group was much smaller than in the famciclovir group, even when comparing only the cold sores that had grown to full maturity. The combination therapy group also experienced a faster healing time to "normal skin" than did the famciclovir group. "Normal" in this context means skin that lacks any abnormalities aside from a little redness where the cold sore was. When healing time was defined as a "loss of crust," healing times did not differ. In terms of pain caused by cold sores, only 59% of the combination therapy group reported pain, as compared with all individuals in the famciclovir group. Neither group reported serious side effects.

While a topical corticosteroid gel used in combination with an antiviral agent was found to work well as a therapy for cold sores in this trial, it is unclear whether they can be used safely alone. Long-term use of topical corticosteroids can cause skin to thin and they are generally not recommended for use on the face. It is not known whether repeated, short-term use of a these gels would produce the same effect as long-term use.
October 2000 Update

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