What are Cold Sores?

Cold Sores are viral infections that appear as small, painful fluid filled blisters (vesicles) in and around the lips, nose mouth and chin, (Orofacial region. Hence Cold Sores are also called Orofacial Herpes or Herpes Labialis (meaning Herpes on Lips).

Stages of Cold Sores Outbreak

Day 1: Prodromal (Erythema) – A tingling, itching or burning sensation is experienced beneath the skin.

Day 2 to 3: Blistering (Vesiculation) – The emergence of painful, fluid filled vesicles occurs 24-48hrs after prodromal stage, and is the first sign of a cold-sore.

Day 4: Ulceration and Weeping – The most contagious and painful stage as rupturing of the vesicles occurs. This results in 1-3mm shallow, grey-white ulcers on erythemous bases of the skin.

Day 5 to 8: Crusting Stage (Induration) – The blisters dry up, forming a yellow or brownish crust which eventually falls off. This scab will easily crack or break and care of the scab is important.

Day 9 to 14: Healing Stage (Recovery) – A series of scabs form on the lesion. They eventually flake as the cold-sore heals, usually without scarring.

Management of HSV Infections

  • Antiviral Medication – Often the most effective way in managing the occurrence of outbreaks.
  • Topical Medicine – The most widely used treatments include acyclovir and derivatives. These treatments need to be applied multiple times a day at the very onset of cold sores (the very early prodromal stages) to suppress the virus. Studies show that there are now acyclovir resistant strains of HSV.
  • Oral Medications – Treatments include acyclovir and derivatives as well as supplements such as lysine HCL.
  • Preventative measures – These are essential to stop the spread of infection and include:
    • Prevention – Healthy immune system and hygiene.
    • Wash hands thoroughly before and after applying medication.
    • Avoid physical contact with infected person – Practice safe sex.
    • Avoid sharing personal items as well as food and drink with infected person.
  • Novel Treatment – Dynamiclear has been clinically tested to provide quick and fast relief from symptoms of Cold Sores.

Clinically Proven

Efficacy and Tolerability Assessment of a  Topical Formulation Containing Copper Sulfate and Hypericum perforatum on Patients With Herpes Skin Lesions: A Comparative, Randomized Controlled Trial


Background: Topical Acyclovir has moderate efficacy on recurrent HSV symptoms, requiring repeat applications for several days. Topical Dynamiclear, which requires only a single dose application, may provide a more effective and convenient treatment option for symptomatic management of HSV.

Objectives: The study assessed the comparative efficacy and tolerability of a single use, topical formulation containing copper sulfate pentahydrate and Hypericum perforatum that is marketed as Dynamiclear™ to a topical 5% Acyclovir cream standard preparation and use.

Methods: A prospective, randomized, multi-centered, comparative, open-label clinical study was conducted. A total of 149 partici-pants between 18 and 55 years of age with active HSV-1 and HSV-2 lesions were recruited for the 14-day clinical trial. Participants were randomized into two groups: A (n=61), those receiving the Dynamiclear formulation, and B (n=59), those receiving 5% Acyclovir. Efficacy parameters were assessed via physical examination at baseline (day 1), day 2, 3, 8, and 14. Laboratory safety tests were conducted at baseline and on day 14.

Results: Use of the Dynamiclear formulation was found to have no significant adverse effects and was well tolerated by participants. All hematological and biochemical markers were within normal range for the Dynamiclear group. Statistically, odds for being affected by burning and stinging sensation were 1.9 times greater in the Acyclovir group in comparison to the Dynamiclear group. Similarly, the odds of being affected by symptoms of acute pain, erythema and vesiculation were 1.8, 2.4, and 4.4 times higher in the Acyclovir group in comparison to the Dynamiclear group.

Conclusions: The Dynamiclear formulation was well tolerated, and efficacy was demonstrated in a number of measured parameters, which are helpful in the symptomatic management of HSV-1 and HSV-2 lesions in adult patients. Remarkably, the effects seen from this product came from a single application.

J Drugs Dermatol. 2012;11(2):209-215.

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