There is no cure for herpes virus infections. There are antiviral drugs available that have some effect on lessening the symptoms and decreasing the length of herpes outbreaks. There is evidence that some may also prevent future outbreaks. These antiviral drugs work by interfering with the replication of the viruses, and are most effective when taken as early in the infection process as possible. For the best results, drug treatment should begin during the prodrome stage before blisters are visible. Depending on the length of the outbreak, drug treatment could continue for up to 10 days.

Acyclovir (Zovirax) is the drug of choice for herpes infection and can be given intravenously or taken by mouth. It can be applied directly to sores as an ointment, but is not very useful in this form. A liquid form for children is also available. Acyclovir is effective in treating both the primary infection and recurrent outbreaks. When taken by mouth to prevent an outbreak, acyclovir reduces the frequency of herpes outbreaks.

During an outbreak of cold sores, salty foods, citrus foods (oranges etc.), and other foods that irritate the sores should be avoided. Wash the sores once or twice a day with warm, soapy water and pat gently to dry. Over-the-counter lip products that contain the chemical phenol (such as Blistex Medicated Lip Ointment) and numbing ointments (Anbesol) help to relieve cold sores. A bandage may be placed over the sores to protect them and prevent spreading the virus to other sites on the lips or face. Acetaminophen (Tylenol) or ibuprofen (Motrin, Advil) may be taken if necessary to reduce pain and fever.