Synopsis

Source of validity: Scientific
Rating (out of 5): 4

Docosanol is an over-the-counter topical antiviral agent primarily used to treat cold sores, which are caused by herpes simplex virus type 1 (HSV-1). The scientific rationale for its use is well-established. Docosanol works by inhibiting the fusion between the viral envelope and the host cell membrane, thereby preventing the virus from entering cells and replicating. This mechanism is distinct from other antiviral medications like acyclovir, which target viral replication after entry into the cell.

Multiple randomized, double-blind, placebo-controlled clinical trials have demonstrated that docosanol 10% cream, when applied at the first sign of a cold sore (such as tingling or redness), can reduce the duration of symptoms by about 18 hours compared to placebo. Additionally, it may help to decrease the severity of symptoms. The U.S. Food and Drug Administration (FDA) approved docosanol for the treatment of recurrent oral-facial herpes simplex based on this accumulated clinical trial evidence.

While the benefit is moderate, and docosanol does not cure or eradicate the herpes virus, there is a strong scientific basis and regulatory approval for its use as a supportive therapy in managing cold sores. Therefore, its use is justified by scientific evidence rather than tradition or anecdote.

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