Management
- it is usually too late to alter the course of the illness in immunocompetent patients who present with Herpes labialis.
- management consists of:
- treatment
- look for any underlying infection which may have precipitated the cold sore
- consider acyclovir cream - although for maximal clinical benefit the treatment should begin as early as possible
- systemic antivirals use for herpes labialis generally should be reserved for those who are immunocompromised (1)
- prevention
- advice as to how the virus is transmitted - kissing is probably the most important method and patients should be encouraged to avoid kissing non-affected relative
- avoid sharing cups, or lip balms (2)
- area of the body where there is a herpes infection should be kept away from other people (2)
- advise on ways to reduce further recurrence - for example, suncreams in patients who get bad attacks in sunlight
- treatment
Public Health England guidance states (3):
- most resolve after 5 days without treatment
- topical antivirals applied prodromally can reduce duration by 12 to 18 hours
- if frequent, severe, and predictable triggers:
- consider oral prophylaxis: aciclovir 400mg, twice daily, for 5 to 7 days
Reference:
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