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Management

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

Authoring team

  • 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

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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