Bidwell Health

I Feel a Cold Sore Starting — What Should I Do?

For recurrent cold sores, antiviral medication is usually most useful when started early, often during tingling, burning, itching, or tenderness before the sore is fully developed. Bidwell can review treatment only for adults with a prior diagnosis.

Medically reviewed by Bidwell Cranage, APRN, FNP-C · Last updated 2026-05-27

Choose herpes visitDaily suppressive therapy
Prior diagnosis required. Bidwell treats adults ages 18-64 who have already been diagnosed with oral or genital herpes by a healthcare provider. Bidwell does not diagnose new herpes infections online, does not require photo upload, and does not guarantee treatment.

Why timing matters

Cold sores often have a prodrome before the visible blister appears. Because antivirals work on viral replication, early treatment is usually more helpful than waiting until the lesion is fully crusted.

What counts as early?

Early can mean the first day of symptoms or the familiar warning signs a patient has had before. If this is a new kind of sore, a first episode, or something near the eye, do not self-treat online.

What can Bidwell do?

Bidwell can review a recurrent cold sore history and consider oral antivirals or topical acyclovir cream when clinically appropriate. The visit does not require a video call or photo upload.

When should I get examined instead?

Get examined for first-ever sores, lesions near the eye, severe swelling, fever with severe illness, trouble swallowing, or if you are immunocompromised.

References

  1. CDC STI Treatment Guidelines: Genital Herpes
  2. DailyMed: Valtrex (valacyclovir hydrochloride)
  3. DailyMed: Acyclovir tablets
  4. DailyMed: Famciclovir tablets
  5. DailyMed: Acyclovir cream

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