Preparation H for cold sores – Wrong hole?

Ok ok, try not to laugh.

But it turns out some people use Preparation H hemorrhoid cream for treating cold sores.

No joke.

Now being the immature man(ish)-child that I am, my first reaction was to point out the obvious: “wrong hole buddy”.

Because, you know, butt cream.

However, I have to admit that cold sores and hemorrhoids are similar in many ways.

They’re both swollen masses of painful itchiness that everybody hates. A lot.

But given that I pride myself on digging deeper into popular cold sore treatments to figure out if they’re the real deal or a load of BS, I looked a little closer to find out if using preparation H on cold sores is a good idea.

Here’s what I found out.

What are the active ingredients in preparation H?

So the first thing I did was find out what the active ingredients in Preparation H are.

Aaannnnd things got a little complicated. Because you can buy preparation H in many different and wondrous forms. Here’s a quick and dirty breakdown (according to

There’s Preparation H Ointment

The ointment contains petrolatum (71.9%), mineral oil (14%), shark liver oil (3%) and phenylephrine HCl (0.25%).

There’s Preparation H Maximum Strength Cream

The Maximum Strength Cream contains petrolatum (15%), glycerin (14.4%), pramoxine HCl (1%) and phenylephrine HCl (0.25%).

There’s Preparation H Suppositories

The Suppositories contain cocoa butter (i.e. the stuff they make chocolate with, 85.5%), shark liver oil (3%), and phenylephrine HCl (0.25%).

There’s Preparation H Cooling Gel

The cooling gel contains phenylephrine HCl (0.25%) and witch hazel (50%).

There’s Preparation H Anti-Itch cream

The anti-itch cream contains hydrocortisone (1%).

But that’s not all.

There’s Wipes, Totables (i.e. individually wrapped wipes, for the hemorrhoid sufferer on the go) , Wipes for Women, etc… The creativity of marketing departments never fails to astound me.

Now unfortunately, most websites I read don’t mention exactly what form of preparation H to use against herpes or cold sore outbreaks.

But thanks to my slightly developed powers of deduction, I noticed that the main active ingredient across all forms is phenylephrine HCl.

What the hell is phenylephrine HCl? Glad you asked.

Again according to, phenylephrine HCl (or phenylephrine hydrochloride, for the geeks among us) is a decongestant which is used to constrict blood vessels and thus, decrease swelling.

Which makes a lot of sense, given that hemorrhoids are nothing more than swollen blood vessels.

But does preparation H work against cold sores?

Now, given that cold sores (like hemorrhoids) are due in part to itchy and painful swelling, it also makes sense that it would work well against cold sores.

If you decrease the blood flow at the site of the cold sore, you decrease the swelling. And if you decrease the swelling, you decrease the discomfort.

But as far as killing off the herpes virus goes, Preparation H won’t be much help at all.

Or will it?

As I mentioned above, there are quite a few additional ingredients contained in these ever popular butt creams. Let’s break those down, shall we.

Do the other ingredients in preparation H help fight the herpes virus?

Phenylephrine HCl isn’t all it contains.

As it turns out, Preparation H also contains shark liver oil, pramoxine HCl, cocoa butter and/or witch hazel (depending on the… preparation, of course (pun fully intended)).

So can any of these help fight off either the swelling caused by a herpes outbreak or help kill the herpes virus itself?

Let’s look at each one by one.

If you buy either the ointment or the suppositories, you’ll be getting a hefty dose of shark liver oil.

Interesting little compound this.

It’s been used by Scandinavian fishermen for a long, looong time to treat skin problems (now this is just a guess, but I always imagined Vikings as having soft and flawless skin…).

And as we know, cold sores are a kind of skin problem, right? Not much, I know.

But it gets a little better.

See, shark liver oil contains alkylglycerol, a compound that has been shown to stimulate the activity and proliferation of white blood cells, notably neutrophils which are the first white blood cells to show up to a herpes virus infection.

Meaning it may help stimulate the immune system to come an nuke the herpes virus into the next dimension.

It may not be the most potent ingredient to fight off cold sores, but it looks like shark liver oil can’t hurt.

Next up, we’ve got pramoxine HCl, as found in the Maximum Strength Cream.

Turns out, this one’s a local anesthetic and serves to calm unbearable itchiness. Cold sores are itchy, right?

So my guess is pramoxine HCl (or pramoxine hydrochloride, for the geeks among us) is a great way to calm down that throbbing cold sore of yours if, you know, you’re willing to spring the extra dinero on the Maximum Strength Cream.

Next in line is cocoa butter, as found in the Preparation H Suppository.

Cocoa butter is used a lot in skin products, but mostly as a moisturizer. Oh, and chocolate.

It has been shown to help with rashes and the likes, but I couldn’t find anything directly linking it to cold sores or the immune system. So this stuff falls squarely into the “can’t hurt” category as well.

Up next is witch hazel, which is contained in the Preparation H cooling gel.

Witch hazel is basically an astringent, meaning it constricts or “shrinks” bodily tissues (think alum, like in old Looney Tunes episodes). Now I assume this includes blood vessels too, so it can be good for reducing the inflammation during the early stages of a cold sore.

Last but not least, we’ve got hydrocortisone that can be found in the Preparation H anti-itch cream.

Hydrocortisone is a corticosteroid that reduces redness, itchiness and swelling, 3 things that are typical of a cold sore (especially during the early stages). Plus, hydrocortisone is used in combination with acyclovir in a cold sore cream called Xerese, so it must do something good.

So, is Preparation H a good way to fight cold sores?

So what does this all mean? All this fun info points to the fact that Preparation H is a pretty legitimate option for fighting off cold sores.


Because it checks off three important boxes: it reduces swelling, numbs the pain (maximum strength cream only) and stimulates the immune system (depending on which preparation you splurge on).

And it really doesn’t matter all that much which one you choose. The important thing is you get yourself dat phenylephrine HCl and drown your damn cold sore in it.

It’ll keep inflammation low and help limit the size of the blisters. And smaller blisters are less itchy and less painful. Plus they tend to heal a heck of a lot faster. Win win.

When an how should you use Preparation H on cold sores?

At the first damn sign, duh!

As soon as you feel that tingle, it means inflammation is starting. So the earlier you catch it, the more inflammation it can help prevent.

Another obvious thing to keep in mind is, don’t eat it. First because I doubt butt cream is formulated to be very tasty, second because there’s not much info about the safety of ingesting Preparation H. I wouldn’t chance it.

That being said, I’d definitely use it in combination with something that can help kill the herpes virus like acyclovir, Abreva or heck, even tea tree oil. Because reducing the pain and swelling with preparation H is all fine and dandy and can really help limit inflammation, but it doesn’t help kill off that damn herpes virus.

As far as how effective it may be, you’ll have to try that out for yourself. But it’s designed to fight off inflammation, something practically all cold sore treatments fail to do, instead focusing on the herpes virus exclusively.

So, using preparation H on a cold sore isn’t the worst idea ever, despite sounding silly at first.

Heck, I might even try it myself.

I just have to wait for my next outbreak, which might take a while.

Because Instead of fighting symptoms as they show up, I focus on stopping cold sores from coming back at all.

I leverage a little known scientific discovery that reveals how to keep the virus in a state of latency and make it impossible for it to wake up and trigger cold sores.

If you want to learn how to prevent outbreaks from coming back at all, make sure to sign up to our newsletter by clicking here.

That way you won’t even need Preparation H or any other cold sore cream, regardless if it works or not.

If you want to learn how to use your diet to prevent outbreaks from coming back at all, make sure to sign up to our daily newsletter.

That way you won’t even need Preparation H or any other cold sore cream, regardless if it works or not.


Chris “the Cold Sore Killer” Mueller

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Chris "the Cold Sore Killer" Mueller