Docosanol is a generic treatment used to treat cold sores. It’s a topical antiviral that can help to clear up cold sores within four to six days. Cold sores are a viral condition caused by the herpes simplex virus. This virus is transmitted by skin-to-skin contact, kissing or sharing utensils with others.
Cold sores don’t always require treatment as they can clear up in around 10 days. However, treatments like Docosanol can speed up the healing process and relieve any pain.
How does Docosanol work?
Docosanol is an antiviral agent that stops the herpes simplex virus (HSV-1) from fusing with human cells. This blocks the virus from entering healthy cells, helping prevent the infection from replicating and spreading.[1]
Docosanol is most effective when used at the first sign of symptoms. Delaying treatment can cause the infection to spread, making it harder to treat.
What doses of Docosanol are there?
Docosanol comes as a 10% topical cream. It’s applied five times daily for up to 10 days or until the symptoms have cleared.
Treated trusted source:
Pope, L.E. et al. (1998).The anti-herpes simplex virus activity of n-docosanol includes inhibition of the viral entry process. Antiviral Research, 40(1-2), pp.85–94.
This page was written by The Treated Content Team.
This page was medically reviewed by Dr. Joseph Palumbo on February 20, 2025. Next review due on February 20, 2028.
How we source info.
When we present you with stats, data, opinion or a consensus, we’ll tell you where this came from. And we’ll only present data as clinically reliable if it’s come from a reputable source, such as a state or government-funded health body, a peer-reviewed medical journal, or a recognised analytics or data body. Read more in our editorial policy.
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How to take Docosanol
Start treatment with Docosanol at the first signs of symptoms, such as itching, tingling, or burning, to maximize effectiveness.
To use Docosanol:
Wash your hands.
Apply a thin layer of cream to the affected area on your face, avoiding contact with your eyes and mouth.
Reapply five times a day, preferably three hours apart.
Wash your hands thoroughly after treatment.
To avoid contamination, don’t touch the tip of the tube with your finger after touching your face; instead, use a cotton bud to apply the cream.
You should use Docosanol until your symptoms are gone, which typically takes 4 to 6 days, but it can be used for up to 10 days.
How long does Docosanol take to work?
Docosanol gets to work immediately, so you should notice an improvement in your symptoms within a few days. For some people, the symptoms completely clear at around four to six days, but for others it can take up to 10 days.
If you don’t notice any improvements after 10 days, contact your doctor, they may suggest taking oral antivirals.
What should I do if I make a mistake when taking Docosanol?
If you forget to apply a dose, just use it as soon as you remember.
If you accidentally applied too much, simply wipe off the excess. You shouldn’t experience any side effects.
This page was written by The Treated Content Team.
This page was medically reviewed by Dr. Joseph Palumbo on February 20, 2025. Next review due on February 20, 2028.
How we source info.
When we present you with stats, data, opinion or a consensus, we’ll tell you where this came from. And we’ll only present data as clinically reliable if it’s come from a reputable source, such as a state or government-funded health body, a peer-reviewed medical journal, or a recognised analytics or data body. Read more in our editorial policy.
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Docosanol isn’t suitable for everyone, and there are some things that you need to be aware of when taking it.
Here’s all the official info on it. If anything is unclear, let our clinician know, and they can talk with you about it.
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Docosanol: FAQ
Have something specific you want to know? Search our info below, or ask our experts a question if you can’t find what you’re looking for.
Is there a branded version of Docosanol?
Answer:
Yes, Abreva is the branded version of Docosanol. Both are topical creams that are applied directly to cold sores. The main difference between the two is their packaging and price – typically, the generic version is less expensive.
Will I get side effects using Docosanol?
Answer:
There is a chance of experiencing side effects while using Docosanol. Some common side effects include dry skin, skin rashes and facial swelling. The side effects should be mild and go away when you stop treatment.
What can I use Docosanol for?
Answer:
Docosanol is an antiviral treatment for herpes labialis, commonly known as cold sores. It’s most effective when applied in the early stages of an outbreak before the blisters appear. A study found that patients using docosanol healed completely in about four days, while those using a placebo took longer to recover. Additional benefits of docosanol include pain relief and complete healing of the lesions.[1]
Although Docosanol treats cold sores, it can't be used for genital herpes, which usually requires treatment with oral antiviral medication like acyclovir.
Is Docosanol a steroid?
Answer:
No, Docosanol is a topical antiviral that works by preventing the fusion of the herpes virus to human cells. This stops the virus from replicating and spreading in your body.
Steroids aren’t used to treat cold sores because they aren’t very effective and can even worsen the symptoms. In some cases, your doctor might recommend hydrocortisone to help relieve pain and swelling. Typically, you'll be prescribed a topical antiviral such as Docosanol or Acyclovir to treat cold sores.
How does Docosanol compare with Acyclovir?
Answer:
Docosanol and Acyclovir are antiviral medications used to treat cold sores. Docosanol is available as a topical cream, while Acyclovir is available in several forms: a topical cream, oral tablets, capsules, and suspension, and an injection. Most people will recover from cold sores with topical treatments, but if the infection is severe, you might need oral antivirals. Although both docosanol and acyclovir are effective against herpes, one study found that acyclovir is more effective. [2]
Treated trusted source:
Sacks, S.L., et al. (2001).Clinical efficacy of topical docosanol 10% cream for herpes simplex labialis: A multicenter, randomized, placebo-controlled trial. Journal of The American Academy of Dermatology, 45(2), pp.222–230.
McKeough MB, Spruance SL.Comparison of New Topical Treatments for Herpes Labialis: Efficacy of Penciclovir Cream, Acyclovir Cream, and n-Docosanol Cream Against Experimental Cutaneous Herpes Simplex Virus Type 1 Infection. Arch Dermatol. 2001;137(9):1153–1158.
Last updated on Feb 20, 2025.
How we reviewed this page:
Our experts continually monitor new findings in health and medicine, and we update our articles when new info becomes available.
Feb 20, 2025
Published by: The Treated Content Team.Medically reviewed by: Dr. Joseph Palumbo, Senior Medical Adviser
How we source info.
When we present you with stats, data, opinion or a consensus, we’ll tell you where this came from. And we’ll only present data as clinically reliable if it’s come from a reputable source, such as a state or government-funded health body, a peer-reviewed medical journal, or a recognised analytics or data body. Read more in our editorial policy.
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Dr. Joseph Palumbo
Senior Medical Adviser
Joseph joined Treated in 2023, and is one of the lead doctors providing prescribing services for the platform.
When we present you with stats, data, opinion or a consensus, we’ll tell you where this came from. And we’ll only present data as clinically reliable if it’s come from a reputable source, such as a state or government-funded health body, a peer-reviewed medical journal, or a recognised analytics or data body. Read more in our editorial policy.
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