Herpes Labialis
Herpes labialis, also known as cold sores, is caused by a reactivation of a latent viral infection.
Symptoms
- Burning, itching, or pain 12–36 hours before eruption
- Vesicles rupture, ulcerate, and crust within 48 hours
Treatment
- Administer topical or systemic antiviral agents, either prophylactically, abortively, or for a full course of treatment.
- Topical 1% pencyclovir cream may help speed healing and reduce pain even if started after the prodrome.
- Oral medications should be initiated during the prodrome to be effective.
- Consider prophylactic antiviral prescription for recurrent outbreaks.
Early HSV Vesicles Indicated by White Arrow
Large Crusted Lesions of HSV
References
Spruance SL, Jones TM, Blatter MM, Vargas-Cortes M, Barber J, Hill J, et al. High-dose, short-duration, early valacyclovir therapy for episodic treatment of cold sores: results of two randomized, placebo-controlled, multicenter studies. Antimicrobial Agents Chemother 2003;47:1072-80.
Gonsalves WC, Chi AC, Neville BW, Common Oral Lesions: Part I. Superficial Mucosal Lesions, AFP 2007;75:501-507.
Nasser M, Fedorowicz Z, Khoshnevisan MH, et al. Acyclovir for treating primary herpetic gingivostomatitis. Cochrane Database of Systemic Reviews. 2008;(4);C0006700
Nolan A. Intervention for prevention and treatment of herpes simplex virus in cancer patients. Evidence Base Dent. 2009; 10(4): 116-7. Â