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[Sticky] Cold Sores


Michael Gray MD JD
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Yes — cold sores (oral herpes / HSV-1 flare-ups) are commonly treated through telemedicine.

Most cases can be safely evaluated based on symptoms, history, and a visual exam (video or photos), and treatment can be prescribed when appropriate.

✅ What telemedicine can usually do

During a virtual visit, the clinician can:

  • Confirm the rash is likely a cold sore

  • Review onset, triggers, and recurrence pattern

  • Check your medical history & medications

  • Provide prevention and outbreak counseling

  • Prescribe antiviral medication when needed

Commonly prescribed options (case-by-case):

  • Valacyclovir (Valtrex)

  • Acyclovir

  • Famciclovir

These work best when started at the first sign of tingling, burning, or swelling.

Many providers will also prescribe a standing prescription for future outbreaks so you can start treatment early.

🧴 Supportive / over-the-counter options

Telemedicine providers may also recommend:

  • Docosanol (Abreva)

  • Petroleum jelly to protect the lesion

  • Avoiding picking, friction, or kissing

  • Hand-washing to prevent spread

⚠️ When an in-person exam may be needed

Seek urgent or in-person care if you have:

  • Cold sores spreading to the eye

  • Severe facial swelling or high fever

  • Large or persistent sores (>2–3 weeks)

  • Frequent outbreaks (≥6 per year)

  • Immune-compromising conditions

  • Unsure if it might be shingles or impetigo

Babies, pregnant patients, and people on chemotherapy or steroids may need closer evaluation.


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