When people compare cold sore treatments, they often focus on cost and how long they have to wait. But there are two more useful things to know about NHS cold sore treatment and aciclovir cream: small packs of aciclovir cream can be bought from pharmacies without a prescription, and antiviral creams are generally most useful when started as soon as the early signs of a cold sore appear.
The other important point is that you cannot buy aciclovir tablets over the counter in the UK. They are prescription medicines. Your GP may also decide not to prescribe cold sore cream because NHS England guidance recommends that OTC treatments for infrequent cold sores of the lip should not routinely be prescribed in primary care. There are exceptions where a person's clinical circumstances mean a prescription is appropriate.
Put together, these points explain why the right treatment is not simply about cost. It depends on what you have, how severe it is, how early you start treatment and whether you need a prescription medicine. This page explains NHS prescribing guidance for aciclovir cream and antiviral tablets, the difference between pharmacy and prescription treatments, why early treatment matters, and when a cold sore may need medical advice.
Key Things to Know
- Antiviral creams for cold sores can be bought from pharmacies without a prescription
- Aciclovir tablets are prescription-only medicines in the UK
- Valaciclovir and famciclovir are also prescription-only antiviral medicines
- NHS England guidance says OTC treatments for infrequent cold sores of the lip should not routinely be prescribed in primary care
- Aciclovir 5% cream and penciclovir 1% cream are available as pharmacy treatments for cold sores
- Starting an antiviral cream at the first signs of a cold sore is generally more useful than waiting until the outbreak is well established
Is There a Prescription Treatment for Cold Sores?
Yes. Oral antiviral medicines such as aciclovir can be prescribed when a clinician thinks they are appropriate. They are not usually needed for an ordinary cold sore, which often clears on its own within 7 to 10 days. Antiviral creams can be bought from a pharmacy and may ease symptoms and shorten healing time when used correctly and started early.
A GP may consider antiviral tablets when cold sores are very large, painful or keep coming back. People with a weakened immune system may also need medical advice rather than treating a cold sore themselves with an OTC cream.
Can You Buy Aciclovir Tablets Over the Counter in the UK?
No. Aciclovir tablets are prescription-only medicines in the UK. You will need an appropriate clinical assessment before they can be prescribed.
What you can buy without a prescription is certain aciclovir cream for cold sores. The exact product, pack size and legal supply category can vary, so check the packaging or ask a pharmacist if you are unsure.
| Treatment | Status in the UK | How you get it |
|---|---|---|
| Aciclovir 5% cream, small pack | Pharmacy medicine | Buy from a pharmacy without a prescription |
| Penciclovir 1% cream | Pharmacy medicine | Buy from a pharmacy without a prescription |
| Hydrocolloid patches | Medical device | Buy without a prescription |
| Aciclovir tablets | Prescription-only | GP or another appropriate prescriber after assessment |
| Valaciclovir tablets | Prescription-only | GP or another appropriate prescriber after assessment |
| Famciclovir tablets | Prescription-only | Prescription required if clinically appropriate |
Do not assume that a larger tube of cream is simply the same product with more medicine. The legal supply category depends on the specific product and pack, so check the product information or ask a pharmacist.
Is Cold Sore Treatment Free on the NHS?
This can be confusing because there are two separate questions: whether you qualify for free NHS prescriptions and whether the NHS would prescribe the treatment in the first place.
The Charge Itself
In England, the NHS prescription charge is £9.90 per prescription item from 1 May 2026. Prescriptions are free in Scotland, Wales and Northern Ireland. In England, some people are also entitled to free NHS prescriptions because of their age, income, benefits or an exemption certificate.
Prescription charges can change, so check the current NHS information if the amount matters to you.
The Part Nobody Mentions
Being exempt from prescription charges does not automatically mean that an NHS prescription will be issued.
NHS England guidance recommends that OTC treatments for infrequent cold sores of the lip should not routinely be prescribed in primary care. The guidance is based on the fact that these cold sores are usually self limiting and that suitable OTC treatments are available for self care. It also allows for exceptions, including cases where symptoms are not minor, the condition has not responded to an OTC treatment, or the person has a complex condition such as immunosuppression.
So, if a GP advises you to buy cold sore cream from a pharmacy, that does not necessarily mean your symptoms have been dismissed. It can simply reflect NHS prescribing guidance.
If your cold sores are unusually severe, very painful, keep coming back, or you have another health condition that changes your treatment needs, a prescriber may decide that a prescription medicine is appropriate.
The practical answer is simple: being entitled to free prescriptions does not guarantee that an NHS prescription for cold sore cream will be appropriate. The decision depends on your clinical situation as well as the NHS prescribing guidance.
The Two Antiviral Creams You Can Buy
There is more than one antiviral cream used for cold sores. Aciclovir and penciclovir contain different active ingredients, so the products are not simply different brands of the same medicine.
| Aciclovir 5% cream | Penciclovir 1% cream | |
|---|---|---|
| Active ingredient | Aciclovir | Penciclovir |
| Typical application | Around five times a day, roughly every four hours while awake | Follow the product leaflet, as application frequency differs from aciclovir |
| Course | Follow the product leaflet | Follow the product leaflet |
| Age | Follow the pack | Follow the pack |
| Where | Lips and face around the lips | Lips and around the mouth |
| Not for | Inside the nose or mouth, near the eyes, genitals | Inside the mouth or near the eyes |
For aciclovir cold sore cream, UK product information recommends applying a thin layer five times a day at approximately four hour intervals and starting as soon as possible, preferably during the early stage of the cold sore. The exact course length depends on the product, so follow the leaflet supplied with your cream.
Cold sores are caused by herpes simplex virus and usually appear as small blisters on or around the lips and mouth. Antiviral creams are intended for the areas specified in their product information. For example, aciclovir cold sore cream should not be used inside the nose or mouth, in or near the eyes, or on other areas not covered by the product licence.
Both medicines are antiviral treatments, but they have different active ingredients and dosing instructions. Rather than choosing based only on how often you need to apply the cream, check the individual product leaflet or ask a pharmacist which option is suitable for you.
One safety point worth knowing is that penciclovir and famciclovir are related medicines. If you have previously had an allergic reaction to one of these medicines, tell your pharmacist or prescriber before using another antiviral.
Aciclovir, Valaciclovir and Famciclovir Tablets for Herpes Simplex Virus
Aciclovir, valaciclovir and famciclovir are prescription antiviral medicines. They work against herpes viruses, but they are not interchangeable, and the choice depends on what infection is being treated and on your individual circumstances.
Aciclovir is a commonly used antiviral medicine and is available as tablets, among other forms.
Valaciclovir is converted into aciclovir in the body and can be taken less often than some aciclovir regimens.
Famciclovir is converted into penciclovir in the body and is another prescription antiviral medicine.
The appropriate medicine, strength, frequency and duration depend on the condition being treated and your individual circumstances. Always follow the instructions from your prescriber and the directions on your pharmacy label. This is particularly important if you have kidney problems, as the dose may need to be adjusted.
Is There a Steroid Cream for Cold Sores?
A plain steroid cream is not a treatment for a cold sore, and you should not use one on a cold sore unless a healthcare professional has specifically advised you to do so.
Steroids reduce inflammation and affect the local immune response. That does not make them a suitable treatment for a herpes simplex infection. If a doctor has prescribed a steroid cream for a problem affecting your lips, there may be another reason for it because several lip conditions can look similar to a cold sore.
If you are not sure whether a sore on your lip is actually a cold sore, a pharmacist or GP can help you work out what it could be before you start using a different treatment.
Why Timing Matters More Than the Route
The timing of antiviral treatment matters because these medicines work against the virus while it is multiplying. NHS England guidance says antiviral creams for cold sores should be applied as soon as the first signs appear, and that starting them after this early period is unlikely to have much effect.
That is why people who regularly get cold sores may find it useful to have an appropriate treatment available when the first tingling or itching starts. NHS guidance also recommends starting antiviral creams as soon as you recognise the early tingling if you regularly get cold sores.
This does not mean that starting treatment later is dangerous or that the cream will definitely have no effect. It simply means the potential benefit is greater when treatment is started early.
The same principle does not mean that a pharmacy treatment is automatically better than a prescription treatment. The right option depends on the severity of the outbreak, your health and whether you need a prescription medicine.
When to See a GP
Most ordinary cold sores can be managed without a GP appointment. It is worth getting medical advice if:
- The cold sore has not started to heal within about 10 days
- Your outbreaks are very frequent, very painful or becoming more severe
- This is your first outbreak and you are unsure whether it is a cold sore
- The sore is unusually large, painful or spreading
- You have several sores or symptoms such as painful gums, mouth sores or fever
- The eye is affected, particularly if you have eye pain, redness or changes in vision
- You have eczema and develop spreading or painful blisters
- You have a weakened immune system
- You are pregnant and are unsure which treatment is suitable
- You are concerned about a cold sore around a newborn baby, particularly if the baby appears unwell
- The lesion does not heal or you are worried that it may not be a cold sore
NHS guidance recommends seeing a GP if a cold sore has not started to heal within 10 days, is very large or painful, or if you have a weakened immune system. A GP may prescribe antiviral tablets if cold sores are very large, painful or keep coming back.
A pharmacist is also a useful first stop for straightforward cold sore questions. They can advise on OTC treatments and tell you when you should see a GP instead.
NHS, Pharmacy or Private: An Honest Comparison
| Pharmacy counter | NHS GP | Private online prescriber | |
|---|---|---|---|
| What you can get | Antiviral creams, patches, pain relief | Prescription medicines where clinically appropriate, plus assessment | Prescription medicines where appropriate after assessment |
| Speed | Usually available during the pharmacy visit | Depends on appointment availability | Depends on the service, assessment and delivery |
| Cost | Retail price of the product | Prescription charge in England if a prescription is issued, free elsewhere in the UK | Consultation and medicine cost |
| Best for | A typical cold sore treated early | Severe, frequent or unusual outbreaks, or anything needing medical assessment | People who need a prescription assessment and are suitable for remote care |
| Not suitable for | Anything needing examination or diagnosis | The prescriber may advise self care where OTC guidance applies | Problems that need a physical examination or urgent assessment |
The private route is not automatically faster or more suitable. A legitimate online prescriber should assess whether treatment is appropriate and may decide that an online consultation is not enough.
If this is your first outbreak, the sore looks unusual, symptoms are severe, or you have symptoms that need an examination, an in person assessment may be more appropriate.
Treatment Options
Treatment suitability depends on an individual clinical assessment, and your prescriber will determine what is appropriate for you.
| Treatment | From |
|---|---|
| Aciclovir 5% Cream | £8.99 |
| Aciclovir Tablets | £12.99 |
Prices are confirmed at checkout and the live product page takes precedence over any figure quoted here. Medicines are dispensed by a UK pharmacy operating under GPhC regulation, with full labelling and a patient information leaflet. Delivery timescales depend on the option chosen at checkout and on when a prescriber approves the order.
Medical Disclaimer
This article is provided for general information only and does not constitute medical advice. It is not a substitute for a consultation with a qualified healthcare professional, and it does not tell you what dose to take.
Prescription-only medicines should only be used under the supervision of an appropriately qualified prescriber. Always follow the instructions on the pack, your pharmacy label and the patient information leaflet.
NHS prescribing guidance and prescription charges can change, so check the current information rather than relying on an older article. Seek medical advice if this is your first suspected cold sore, the sore is unusually large or painful, it is not starting to heal within about 10 days, the eye is affected, you have a weakened immune system, or you are unsure whether the lesion is actually a cold sore.
