Treatment for Oral Herpes
Acyclovir is often taken orally for a severe primary attack of HSV-1 and may even be beneficial for children. When taken for prevention, it reduces frequency and severity of recurring infections. Valacyclovir (Valtrex), taken twice a day for one or two days at the first sign of a cold sore, is proving to be safe, effective, and easy to administer. Studies in 2003 study are mixed on the extent of its benefits, however, and whether they outweigh its high cost. Oral famciclovir has also been somewhat helpful.
Topical Treatments
Topical agents are now available that might help shorten the duration of pain and symptoms, although none is truly effective in eliminating outbreaks.
- Penciclovir (Denavir) heals HSV-1 sores on average about half a day faster than without treatment, stops viral shedding, and reduces the duration of the pain. Ideally, the patient should apply the cream within the first hour of symptoms, although benefits have also been noted with later application. It is continued for four consecutive days and should be reapplied every two hours while awake.
- Docosanol cream (Abreva) is an over-the-counter agent for oral-facial herpes. It helps resist infection by inhibiting the ability of the virus to become fully active after it has attached itself to the host cell. It is applied five times a day, beginning at the first sign of tingling or pain. Studies have been mixed on it benefits.
- Acyclovir cream (Zovirax) has been approved. It may speed healing of oral herpes lesions and lessen the duration of pain, particularly if it is applied early on (at the first sign of pain or tingling).
- Lidex is a gel that contains a fluocinonide, as corticosteroid. Corticosteroids, commonly called steroids, are anti-inflammatory agents and not ordinarily used for herpes. Some evidence suggests it may be effective in combination with oral famciclovir.
- Over-the-counter topical anesthetics may provide modest relief. They include Anbesol gel, Blistex lip ointment, Campho-phenique, Herpecin-L, Viractin, and Zilactin. In one study, Viractin reduced the duration of the attack compared to placebo (a dummy pill) by two days. It also relieved itching but had little effect on other symptoms. In general, however, few studies have been conducted on any of these products.
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