Q: I bought A&D diaper rash ointment after reading in your column that it night help smooth rough skin. There may have been very minimal improvement on my elbows; however, I gambled and came up with another usage.

I had a cold sore in the corner of my lips. Figured trying A&D couldn’t hurt, since it was made for irritated, tender baby skin. It certainly was much cheaper to use than the expensive name brand product made for cold sores. Maybe the A&D helped or maybe the cold sore had run its course. I don’t know. Anyway, it was soothing. Thought I’d pass this hint along for what it’s worth in case others may want to try it.

A: Cold sores are fluid-filled blisters that commonly occur on the lips, gums, and roof of the mouth. They are caused by the herpes simplex virus and are contagious. Generally speaking and about two days prior, pain and tingling will be noticeable in the area of the pending outbreak. Once the lesion(s) present, they generally clear within 7 to 10 days. A cold sore should not be confused with a canker sore that may be similar in appearance but is not contagious, yet it produces painful lesions in the soft tissues of the mouth and tongue.

As you mentioned, A&D is promoted as an ointment for diaper rash. However, it is commonly used to treat cuts or burns, following chemical peel and apparently for countless other related conditions. In fact, tattoo parlors recommend it to their customers who have recently been inked.

The product contains several ingredients, the first of which is lanolin, a wax-like byproduct from the wool of sheep. Lanolin is often an added ingredient in lip balms, hand creams, hair products and skin moisturizers. This emollient acts as a barrier against evaporation, allowing the skin to be moisturized. The amount of lanolin in the product is just over 15%. The next ingredient that makes up the bulk of A&D at 53% is petrolatum. This ingredient is similar to the lanolin and is derived from petroleum hydrocarbons. Petrolatum is an added ingredient to countless ointments and other health care products, is inexpensive and has a long shelf life. It is well-tolerated, except on those that suffer from acne where it may aggravate the condition. The next ingredient is cod liver oil that has high concentrations of vitamins A and D, giving the product its name. These two vitamins contain anti-inflammatory properties and antioxidants, derived from a specific type of fresh fish. Lastly, and while only in minimal amounts, the product contains paraffin, microcrystalline wax, light mineral oil and minimal fragrance. The paraffin, wax and oil function in a similar fashion as the petrolatum and give the products its texture.

There are countless over-the-counter cold sore remedies on the market but for comparative purposes, I will mention just two that are well-known. Abreva contain 10% docosanol and inactive ingredients to include benzyl alcohol, light mineral oil, propylene glycol, sucrose distearate, and sucrose stearate. Herpicin L contains lysine, vitamins B6, C and E, lemon balm, dimethicone, Octinoxate, Octisalate, Meradimate, and Oxybenzone. Both products appear to be effective but keep in mind that it depends how quickly you use a product once you get that tingling feeling indicating a cold sore is coming on. Abreva is more expensive but appears to live up to its name for some users. Herpectin L lasts longer and is much more reasonable to purchase. Perhaps the answer is to keep both products on hand – Abreva to attack a full blown cold sore to bring it under control and the Herpectin L to be used as a preventive as soon as symptoms present.

Alternatives might include the amino acid lysine that can be found in turkey, chicken, fish and beans or purchased as a supplement, lemon balm that appears to speed up the healing process, and stress reduction. Stress is known to cause outbreaks of cold sores. Displacing yourself from such situations might go a long way toward prevention. Further, there are prescription remedies packaged as either pills or creams. Generally speaking, the pills work better than do the creams.