Can stress cause cold sores to form?

A cold sore breakout can be triggered by a number of factors, including stress1. Some of the most common stressors people deal with on a regular basis include job interviews, major life events (such as weddings), work deadlines, exams, financial troubles, fatigue, and lack of sleep. Unfortunately, though, it is unknown exactly how or why increased stress may cause a cold sore to form.

Other cold sore triggers include:

  • A viral infection1
  • Wind exposure1
  • Sunlight exposure1
  • Hormonal changes1
  • Changes in immune system1


If you tend to get cold sores whenever the level of stress in your life increases, you may want to practice relaxation techniques2. Relaxation can help you maintain your health and well-being by freeing your mind and body from the effects of stress2.

Common relaxation techniques include:

  • Breathing exercises2
  • Meditation2
  • Tai Chi2
  • Yoga2
  • Exercise2


  1. Mayo Clinic (May 15, 2015). Cold Sore [Causes]. Retrieved June 15, 2016 from
  2. Mayo Clinic (April 8, 2014). Stress Management [Relaxation Techniques]. Retrieved June 21, 2016 from
Indication & Important Safety Information
Sitavig® (acyclovir) 50 mg buccal tablet is indicated for
the treatment of recurrent herpes labialis (cold sores) in immunocompetent


  • Sitavig® (acyclovir) 50 mg buccal tablet should not be used in patients with known hypersensitivity to acyclovir, milk protein concentrate, or any other component of the product.
  • Sitavig has not been studied in immunocompromised patients. No interaction studies have been performed. Sitavig’s safety and efficacy have not been established in pediatric patients.
  • There are no available data on Sitavig use in pregnant women. However, published observational studies over decades of use of acyclovir have not identified a drug-associated risk of major birth defects, miscarriage, or adverse maternal or fetal outcomes. It is not known if Sitavig is excreted in breast milk; however, systemic exposure following buccal administration of acyclovir is minimal. Before administration, discuss if the patient is lactating or planning to breastfeed.
  • The possibility of viral resistance to acyclovir should be considered in patients who fail to respond or experience recurrent viral shedding during therapy.
  • In a controlled clinical trial, the most common side effects (greater than or equal to 1%) for Sitavig were: headache (3%), dizziness (1%), lethargy (1%), gingival (gum) pain (1%), aphthous stomatitis (canker
    sores) (1%), application site pain (1%), application site irritation (1%), erythema (redness) (1%), and rash (1%). In the same trial, these side effects ranged from 0% to 3% for placebo.

You are encouraged to report negative side effects of prescription
drugs to the FDA. Call
1-800-FDA-1088 or visit

Please see Full Prescribing Information.

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