Oral Herpes Treatment & Prevention

Medications and Measures to Reduce the Severity of HSV Infection

Feb 7, 2008

Recurrent Herpes labialis (oral herpes) infections, also known as cold sores or fever blisters, are common worldwide among adolescents and adults.

Prevention of Oral Herpes Recurrent Infection

Unfortunately, a vaccine to prevent herpes virus infection is not yet available although research continues for an effective vaccine.

Preventing factors that precipitate recurrent oral herpes outbreaks can reduce the frequency of cold sore and other types of herpes outbreaks:

Stress:

Reduce exposure to stressful environments and find healthy ways to reduce the effects of stress (e.g. exercise, meditation, rest, relaxation, etc.).

Excessive exposure to sunlight:

Use of sun-block may be effective in preventing sunlight-induced recurrent infection.

Maintain a healthy immune system:

Maintain the health of the immune system (e.g. exercise, healthy diet, rest, relaxation, etc.).

Fatigue:

Ensure adequate rest and sleep.

Trauma:

Dermatological face peels, surgical procedures, and dental procedures can result in recurrent infection.

Applying zinc sulphate cream (e.g. Lipactin gel) after the first signs of a cold and continuing to apply zinc sulphate until the cold sore disappears has been suggested as a way to prevent and reduce the duration of cold sore outbreaks.

Treatment of Recurrent Oral Herpes Infections

A lot of recurrent cold sore sufferers self-administer topical antiviral agents at the onset of symptoms. It is important that you consult your physician on the appropriate and correct use of antiviral treatments.

Antiviral treatments are most effective when applied at the first sign of infection (i.e. when tingling, discomfort or itching is first felt).

Topical agents:

5% Acyclovir cream applied six times a day: reduces the duration of lesions if applied early (e.g. Zovirax).
1% Penciclovir (e.g. Denovir cream)
10% Docosanol (e.g. Abreva cream)

Oral agents:

Oral suppressive therapy may be required in people who have frequent recurrent outbreaks of HSV-1 infection.

Valacyclovir (e.g. Valtrex) is currently the only oral antiviral approved for treatment of oral herpes in people with healthy immune systems.
Acyclovir (e.g. Zovirax)
Famcyclovir (e.g. Famvir)

Intravenous agents:

Intravenous antiviral agents may be considered for severe infections or treatment of infection in people with compromised immune systems (e.g. HIV infection).

Acyclovir (e.g. Zovirax)
Valacyclovir (e.g. Valtrex)

Pain relief from oral herpes lesions:

Topical creams or ointments containing benzocaine, lidocaine, tetracaine or dibucaine can help relieve burning, itching and pain (e.g. Lipactin gel, Zilactin)
Aspirin, ibuprofen or acetaminophen
Skin protectants can help prevent cracking of cold sore lesions (e.g. allantoin, petrolatum, dimethicone)

Valacyclovir is currently the only oral antiviral agent approved for the treatment of oral herpes outbreaks in people with healthy immune systems.

Supplements

A number of supplements have been suggested for treatment of herpes simplex virus infections (e.g. lysine, citrus bioflavonoids, Lactobacillus acidophilus, Lactobacillus bulgaricus, vitamin supplements (C, E and B12), although there are no clinical trials to support the effectiveness of these products.

Other measures to reduce spread of the herpes simplex virus and infection of cold sores and other lesions include frequent hand-washing.