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Benzocaine: What Is It and How Can It Help Your Cold Sore?

A red light therapy device shines on a close-up of a smiling woman's lip in an article about benzocaine for cold sores.

 

Even though cold sores aren't usually dangerous, they can be painful and uncomfortable. And their angry red appearance draws attention, leading to stress and embarrassment for many people.

When you develop a cold sore, you want to do everything you can to minimize your pain and discomfort. You may want to hide at home until the worst is over, but you know that isn't really a viable option. You'd be content if you could just enjoy a cup of coffee without pain.

Many over-the-counter products contain the numbing medication benzocaine for cold sores. But what exactly is benzocaine? Does it help speed the healing of a cold sore or just make you more comfortable while the cold sore lasts?

What benzocaine products are available? And is benzocaine safe to use with other products or treatments?

Let's start by looking at exactly what a cold sore is.

What Is a Cold Sore?

A cold sore, or fever blister, is a small but painful blister that develops on or around the lips. They sometimes appear in small clusters of two or more sores. Cold sores usually result from infection with the herpes simplex virus type 1 (HSV-1), a very common viral infection.

HSV-1 spreads through saliva and from the skin around the mouth. The most common ways to infect another person are through intimate contact such as kissing or oral sex. It's also wise to avoid sharing straws and drinks with others during a cold sore outbreak.

Even though cold sores are caused by a herpes virus, a cold sore on your lip does not mean that you have genital herpes. The two conditions are caused by similar viruses, but genital herpes is considered a sexually transmitted infection and usually results from infection with the herpes simplex virus type 2 (HSV-2).

There is no cure for either type of herpes virus. Once you've been infected, the virus hides in your nerve endings until a trigger "wakes it up" again to cause an outbreak of sores. After the outbreak, the virus returns to dormancy until the next trigger.

Symptoms of HSV-1

Red blisters on or around the lips are the main signs of an HSV-1 infection. They may be preceded by a tingling, burning or itching sensation, and accompanied by pain or burning once they emerge.

Sometimes, particularly during an initial outbreak, a person can experience other symptoms like fever, headache, muscle aches and swollen lymph nodes.

Possible Misdiagnoses

Although cold sores have a distinctive look to them, it is possible to mistake cold sores for other conditions, such as angular cheilitis, pimples, cracked lips or canker sores. If you're unsure exactly what you're dealing with, it's helpful to consult with a healthcare provider to make sure your treatments target your actual condition.

benzocaine cold sore

What Is Benzocaine?

Benzocaine is a local anesthetic that blocks nerve signals in the skin. It's sold in creams, gels and ointments or sprays for you to apply to painful (minor) skin conditions, such as cold sores. When you use benzocaine, cold sores aren't so painful anymore.

The percentage of benzocaine can vary from product to product, and even between different products within the same brand. To ensure you're getting the product you want, read the drug facts on the label.

Orajel, Anbesol and Lanacane are among the most common brands of oral numbing products that contain benzocaine. You can purchase them all online or at your local drugstore.

Orajel Touch-Free Cold Sore Patented Treatment

Orajel makes a product specifically for cold sores which contains 5% benzocaine for numbing and 0.13% benzalkonium chloride as an antiseptic. The bottle includes an applicator so you don't have to touch the product with your fingers and dispose it after use. The gel adheres to your cold sore and dries clear within minutes.

You can use Orajel on your cold sores up to three times per day. It is not for use on children younger than two years of age.

Anbesol Cold Sore Therapy Ointment, Maximum Strength

Anbesol's cold sore product contains 1% allantoin and 64.9% white petrolatum as skin protectants, as well as 3% camphor and 20% benzocaine as cold sore treatments. It also contains vitamin E and aloe to soothe and moisten cold sores.

You can apply Anbesol ointment three to four times per day. This product is also not appropriate for children under the age of two.

Lanacane Maximum Strength Anti-Itch Cream

Many people also find that Lanacane Maximum Strength Anti-Itch Cream provides relief for their cold sores. Despite the "anti-itch" name, the active ingredients in this Lanacane product are .2% benzethonium chloride as an antiseptic and 20% benzocaine as a numbing agent, which work just as well to relieve pain as itching.

You can use Lanacane one to three times per day except on children under the age of two.

How Does Benzocaine Interact With Cold Sores?

Benzocaine, when applied to the site of the cold sore, numbs the nerve endings in your skin.

Before using, cleanse your lip area around the cold sore with warm water. Remove the residue of any drink, lipstick or lotion. Apply the benzocaine product with a clean finger, cotton swab or applicator, distributing it evenly to allow the medication to completely saturate the cold sore.

Possible Side Effects of Benzocaine

The most common side effect of benzocaine is a temporary stinging at the site of application until the numbing kicks in. However, long term use of benzocaine can also cause a serious but rare side effect called methemoglobinemia.

Benzocaine can cause methemoglobinemia by itself, but the risk increases when used in combination with certain other drugs. The greatest risk is for children under the age of two, which is why benzocaine products should not be used for this age group.

Methemoglobinemia is a life-threatening condition of the blood that deprives vital body tissues and organs of oxygen. It must be treated immediately. Symptoms of methemoglobinemia include:

  • bluish tint to the skin
  • headache
  • fatigue
  • shortness of breath
  • lethargy

To see which drugs increase your risk of developing methemoglobinemia while using benzocaine, consult this list of known drug interactions. It includes prilocaine (a numbing agent, often for dental procedures) and sodium nitrite (a treatment for cyanide poisoning) as well as phenobarbital, nitroglycerin, metoclopramide (Reglan) and many more.

Other Methods To Speed Up Cold Sore Healing

If you prefer to avoid benzocaine, a variety of other treatments exist to help with the pain caused by cold sores and let you get on with your life.

Home Remedies

Many over-the-counter medications can help to numb cold sore pain and reduce healing time.

Abreva, for example, contains docosanol, a drug that has been shown to help speed the healing of cold sores.

Curoxen uses homeopathic ingredients like calendula and olive extract to help treat cold sores. It also includes clove oil, which research has shown to work as effectively as benzocaine for numbing the skin.

Cold ice packs or compresses of cornstarch paste can also provide some relief.

Foods

Though it can be painful to even think about eating when you have a cold sore, foods that boost your immune system are great to help in the treatment of your cold sores.

Omega-3 fatty acids in foods like flaxseed and salmon can help control inflammation, while lean proteins from chicken and eggs can give your body the energy it needs to heal. Increasing your lysine intake can also help to suppress the herpes virus that's causing your cold sores.

It's also important to avoid added sugars and heavily processed foods in favor of healthier choices like fresh fruits and vegetables.

Red Light Therapy

Research shows that red light therapy speeds the healing time of cold sores, reduces the pain they cause and increases the time between outbreaks. This treatment uses high-powered, medically optimized wavelengths of red light to shine directly onto the affected areas. The skin cells absorb and metabolize the light to aid in healing.

The Luminance RED is designed specifically to use this type of light therapy for the management of cold sores. It can even be used in combination with other cold sore treatments like benzocaine.

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