L-Mesitran Soft Outperforms Conventional Treatments for Healing Cold Sores

Cold sores are blisters around the nose and lips. Cold sores can be considered uncomfortable, causing itch and pain and negatively impacting aesthetics and the quality of life of the patients. Cold sores are caused by an infection with the virus herpes simplex (HSV).

Approximately two-thirds of the global population between 0 and 49 years of age are infected with HSV, accounting for an estimated 3.7 billion people. In most cases the infection is present in a latent form, meaning they are “sleeping” without causing any symptoms. The virus can be (re-)activated by several triggers, such as stress, illness, premenstrual tension, exposure to sunlight (ultraviolet light), or surgical procedures. Luckily, the prevalence of a cold sore is lower and only 2.5 per 1000 patients are affected. 

Cold sores develop via several stages characterized by different symptoms. In the first stage, patients may feel tingling, itching, or a burning sensation, but without the blister being formed yet. Next, lesions will develop, starting with the vesicular stage (1-2 days after initial symptoms), the opening of the blister(s) (around day 4), and subsequently drying out (day 5-8). The final stage is the healing, and scabs will become smaller in time until complete healing. The complete healing process normally takes 7-14 days. 

In a recent clinical study, it was shown that L-Mesitran improves the healing time of cold sores in relation to conventional treatments. In addition, pain and itching decreased.

Effective treatments options are limited and often restrain on antiviral drugs and topical creams, such as acyclovir (Zovirax), famciclovir (Famvir), valacyclovir (Valtrex), docosanol (Abreva), and penciclovir (Denavir). These treatments limit viral DNA replication and may reduce the duration of a cold sore by 0.5 to 2.5 days. Thus, these treatments have a limited effect. Moreover, they may also sometimes (1-10%) cause side effects, including irritability, tiredness, nausea, vomiting, cramps, diarrhea, body aches or pain, rash, itching, and sore throats.

Therefore, novel therapies that have antiviral activity with fewer side effects and decreased wound healing time are warranted. Medical grade honey (MGH) exerts a broad range of antimicrobial activities and also promotes wound healing, and may therefore be a potent alternative treatment for treating cold sores. 

In this clinical study, the efficacy of topical application of the MGH-based formulation L-Mesitran Soft for treating recurrent cold sores was investigated and compared to the experience of the patients with conventional treatments. In total, 29 patients were included in the study. The majority (65.6%) of these patients experience four or more episodes per year, thus forming a valid self-control group. The patients applied L-Mesitran Soft on their cold sore three times per day and compared it to their conventional treatments.

After complete healing, patients filled in a questionnaire evaluating healing, pain, and itching. The average absolute healing time was 10.0 days with conventional treatment and 5.8 days with MGH. In 86.2% of the patients, the healing time was shorter with L-Mesitran (6.9% similar and 6.9% slower). Patients thought the healing time was shorter in 79.3% of the cases (20.7% similar). Moreover, pain and itching were lower in 72.4% and 71.4% of the patients, respectively. All patients prefer MGH treatment over conventional treatment and will use it again on future cold sores. 

In conclusion, MGH is a promising alternative treatment for cold sores, likely by combining both increased antiviral and wound healing activities while alleviating pain and itching.