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Herpes labialis - Treatment

Alternative Names

Cold sore; Fever blister; Herpes simplex - oral; Oral herpes simplex

Treatment:

Untreated, the symptoms will generally go away in 1 to 2 weeks. Antiviral medications taken by mouth may help the symptoms go away sooner and decrease pain. Acyclovir, famciclovir, and valacyclovir are the three oral treatments currently available.

Herpes sores often come back again and again. The antiviral medicines work best if you take them when the virus is just starting to come back -- before you see any sores. If the virus returns frequently, your doctor may recommend that you take the medicines all the time.

Topical (rubbed onto the skin) antiviral cream (penciclovir andaacyclovir) may be used, but must be applied every 2 hours while you're awake. They are expensive and often only shorten the outbreak by a few hours to a day.

Wash blisters gently with soap and water to reduce the spread of the virus to other areas of skin. An antiseptic soap may be recommended. Applying ice or warmth to the area may reduce pain.

Tips to prevent future outbreaks include applying a sunblock or lip balm containing zinc oxide to the lips when you're outdoors. A moisturizing balm to prevent the lips from becoming too dry may also help.

Expectations (prognosis):

Herpes labialis usually goes away by itself in 1 to 2 weeks. It may come back. Infection may be severe and dangerous if it occurs in or near the eye, or if it happens in immunosuppressed people.

Complications:

  • Recurrence of herpes labialis
  • Spread of herpes to other skin areas
  • Secondary bacterial skin infections
  • Generalized infection -- may be life-threatening in immunosuppressed people, including those with atopic dermatitis, cancer, or HIV infections
  • Blindness

Herpes infection of the eye is a leading cause of blindness in the United States, causing scarring of the cornea.

Calling your health care provider:

Call for an appointment with your health care provider if you have :

  • Symptoms of herpes labialis that are severe or that don't go away after 2 weeks
  • Cold sores near your eyes
  • Herpes symptoms and have a weakened immune system (immunosupression) due to disease or certain medications
  • Reviewed last on: 12/7/2010
  • Linda J. Vorvick, MD, Medical Director, MEDEX Northwest Division of Physician Assistant Studies, University of Washington, School of Medicine; Jatin M. Vyas, MD, PhD, Assistant Professor in Medicine, Harvard Medical School; Assistant in Medicine, Division of Infectious Disease, Department of Medicine, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

References

Haile-Mariam T, Polis MA. Viral illnesses. In: Marx JA, Hockberger RS, Walls RM, et al, eds. Rosen’s Emergency Medicine: Concepts and Clinical Practice. 7th ed. Philadelphia, Pa: Mosby Elsevier; 2009:chap 128.

Habif TP. Warts, herpes simplex, and other viral infections. In: Habif TP, ed. Clinical Dermatology. 5th ed. Philadelphia, Pa: Mosby Elsevier; 2009: chap 12.

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