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Stages Of Herpes Labialis
Share Your Story The diagnosis of herpes cold sores is easily made based on the visual appearance of the lesions, and the best approach is to see a doctor at the first sign of a blister. If there is concern that the rash may not be herpes, a swab of blister fluid may be collected for viral culture or polymerase chain reaction PCR test. This is most useful in the first 48 hours before the blister has crusted over. If lesions resolve, then cultures are of no help, because there's nothing left to culture. Culture results take a minimum of three to five days. PCR testing detects herpes DNA, but it is not as readily available as culture and is a very expensive test to do for simple cold sores. Blood tests for herpes antibodies are not usually needed, since finding antibodies to herpes just means that the body has been exposed to this virus at some point in the past. It does not determine if the current lesion is due to herpes. They can be done, though, if the diagnosis is unclear or there is a specific reason to know for certain. How long do cold sores last? In primary herpes, the healing process usually takes two to three weeks, but skin pain can last for one to six weeks. What is the treatment for cold sores, are there any home remedies, and what medications treat oral herpes? Share Your Story Currently, there is no cure or vaccine for herpes simplex virus. Avoiding risk factors, such as sunburn and stress, can help prevent additional outbreaks. Cold sores will usually heal within two weeks without treatment. However, there are established cold sore treatments available to help decrease healing time, reduce pain, and in specific cases, suppress the recurrence of the virus. Home remedies include applying a cool wet compress to the lesion to decrease pain and keep the lesion from drying and cracking. Applying compresses too often will cause more drying, however, so a moisturizing balm should be applied after the lesion is first softened with a wet compress. Lemon balm Melissa officinalis and L-lysine are popularly used as home remedies. While there is there is very limited data suggesting that these substances have antiviral properties, and not enough data to support recommendations, these remedies seem generally well tolerated for those who wish to try them at their own risk. Most topical OTC products provide symptomatic relief but they do not speed up healing time. Commonly used products include Lipactin gel and Zilactin. It is important to keep in mind that these topical anesthetics have a short duration of action, usually only lasting minutes. Skin protectants, such as allantoin, petrolatum, and dimethicone-containing products help keep the lesion moist and prevent cracking of the lesion. Sunscreen -containing lip balms may also help prevent additional outbreaks if the sun is a precipitating factor. For additional pain relief, using anti-inflammatory drugs such as aspirin , ibuprofen Advil , or acetaminophen Tylenol may be beneficial. These products should be used according to package instructions. It may or may not halt an outbreak if started very early. Abreva is applied five times per day until the lesion is healed. Common side effects include rash and itching at the site of application. Topical treatment is limited in its effectiveness because it has poor penetration to the site of replication of the virus and therefore is restricted in its healing ability. Acyclovir cream should be applied five times per day for four days, and penciclovir cream should be applied every two hours while awake for four days. The current FDA-approved oral antiviral drugs used in the treatment of herpes simplex virus in adults are acyclovir, valacyclovir Valtrex , and famciclovir Famvir. These oral medications have been shown to decrease the duration of the outbreak, especially when started during the prodrome before the rash appears. Acyclovir, valacyclovir, and famciclovir are considered relatively safe and effective when used in pregnancy , although topical treatment would be preferred when appropriate. Acyclovir and valacyclovir have been used while breastfeeding. However, pregnant women and nursing mothers should contact their physician or pharmacist prior to using any medication. These medications are generally well tolerated with few side effects, though they may cause headache , nausea , or diarrhea. Doses may vary depending on the individual situation as determined by the prescriber. Treatment for the first outbreak of oral herpes in an otherwise healthy person may include the following medications: Acyclovir, mg milligrams orally three times a day for 10 days or until the lesions have crusted Valacyclovir, 2, mg orally every 12 hours for one day Famciclovir, mg orally three times a day for seven to 10 days Treatment doses for recurrent oral herpes are as follows: Acyclovir, mg orally three times a day for five days: It may also be given as mg orally twice a day for five days or mg three times a day for two days. Valacyclovir, 2, mg orally every 12 hours for one day Famciclovir, 1, mg orally once Suppressive treatment for those with frequent outbreaks may be given for 12 months, but it may be extended if needed: Acyclovir, mg orally twice a day Valacyclovir, mg orally once a day Famciclovir, mg orally twice a day Other treatment options such as lemon balm, L-lysine supplements , citrus bioflavonoids, Lactobacillus acidophilus and bulgaricus, vitamin C , vitamin E oil, and vitamin B12 have also been considered in the potential treatment of herpes simplex virus, but there is no good clinical evidence to support these treatments. Lemon balm may have some anti-herpes properties, but it is impossible to tell if it is effective in affected people from the few laboratory experiments that have been published. L-lysine similarly has limited laboratory data suggesting antiviral properties and has been touted for reducing recurrence of herpes. Unfortunately, results in patients with cold sores have been highly variable; and there are no high quality studies suggesting benefit. Treatment for children is similar to that in adults other than being dosed by weight , except that famciclovir does not have an approved pediatric dose. Treatment, Pictures, Causes, and Symptoms What are the possible complications of oral herpes cold sores? Autoinoculation occurs most commonly at the time of primary infection, when viral shedding is high and the immune system is still gearing up to contain it. The antibodies that are made after primary infection are usually -- but not always -- successful in preventing autoinoculation during recurrent attacks. A more serious complication is infection of the eye, or ocular herpes herpetic keratitis. It may be a mild surface ulceration with little discomfort, or it may cause deeper, painful ulcers that threaten vision. Ocular herpes is also caused by autoinoculation. If not treated, ocular herpes may lead to serious damage or even blindness. Rarely, herpes simplex may infect the brain, causing encephalitis. This infection requires hospitalization and intravenous antiviral medications. HSV-1 is among the commonest causes of fatal viral encephalitis worldwide. In immunocompromised people, such as those with HIV infection or those receiving chemotherapy, severe outbreaks of herpes may occur. Colds sores may spread to large parts of the lower face or invade organs. Antiviral drugs are used to prevent or lessen such attacks. In a few people, outbreaks of herpes will be associated with erythema nodosum. Erythema nodosum is an inflammatory skin reaction characterized by red and painful skin lumps that usually appear on the front side of the legs. This condition can be caused by many inflammatory and infectious diseases, including herpes virus infections. Erythema nodosum can be self-limited and resolve on its own in three to six weeks. Treatment of the herpes episode usually hastens the resolution of erythema nodosum. I also agree to receive emails from MedicineNet and I understand that I may opt out of MedicineNet subscriptions at any time. What is the prognosis for oral herpes cold sores? Cold sores, if they recur, are most likely to do so during the first year after infection. They usually resolve on their own within one to two weeks. After the initial outbreak, cold sores may never appear again, or appear only when something triggers them. Usually people with cold sores lead normal lives and are not terribly affected by them unless they happen to recur very often several times a year or more. Is it possible to prevent cold sores? The best way to prevent a herpes simplex infection is to avoid physical contact with someone else's cold sores. Items that touch the lips but cannot be washed or sanitized, such as lipstick or lip balm, should not be shared. Wash hands immediately after applying topical treatments to a cold sore. L-lysine and other supplements have not been shown to consistently reduce outbreaks. To prevent future outbreaks, avoid long periods of time in the sun and use sunblock on lips and face, reduce stress by getting adequate rest and relaxation, avoid trauma to the mouth or involved area, and take any antiviral medication exactly as prescribed.
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