Herpes labialis, the clinical name for the skin and mouth lesions patients often refer to as "cold sores" or "fever blisters," affects up to 500,000 Americans each year, according to the National Institute of Dental and Craniofacial Research. In fact, the disease is so common, says University of Washington Professor Lawrence Corey, M.D., in the 2008 edition of "Harrison's Principles of Internal Medicine," that 90 percent of Americans test positive for the virus that causes it by the time they reach age 50. Doctors divide treatments for herpes labialis into three categories.
Antiviral Medications
Antiviral medications target the replication of the herpes simplex virus that causes herpes labialis. In the 2008 edition of "Basic and Clinical Pharmacology," University of California-San Francisco Professor Sharon Safrin, M.D., explains that the Food and Drug Administration has approved five antiviral medications for the treatment of herpes labialis. Four of them -- acyclovir, valacyclovir, famciclovir and penciclovir -- substitute for the nucleic acid guanosine in viral DNA. However, unlike guanosine, the drugs have no attachment site for another nucleic acid, so DNA synthesis stalls, leaving the virus unable to reproduce. A fifth drug, docosanol, prevents the virus from entering and infecting the cells in the first place. A doctor must prescribe acyclovir, valacyclovir, famciclovir and penciclovir. Patients may purchase docosanol over the counter. While all of the drugs reduce the duration and severity of herpes labialis symptoms, none eradicate the virus, so some patients experience recurrent outbreaks.
Pain Relievers
Herpes labialis causes pain and itching that can range in severity from mild to severe. Corey recommends over-the-counter, topical local anesthetics such as benzocaine, tetracaine and lidocaine. Alternatively, products that contain menthol or camphor provide different sensory signals that override pain or irritation from skin lesions. For lesions inside the mouth or nose or skin lesions that don't respond to local medications, MayoClinic.com recommends over-the-counter, oral pain medications such as acetaminophen, ibuprofen or aspirin. However, MayoClinic.com notes, children with herpes labialis should not be treated with aspirin, as aspirin may cause a rare neurological disease called Reye's syndrome.
Supportive Care
Supportive care contributes to healing by preventing herpes labialis lesions from becoming secondarily infected with mouth or skin bacteria and protecting them from mechanical and chemical irritants. Cleaning skin at least daily with mild cleanser and warm water protects lesions on the lips and face from bacteria, skin oils and chemical irritants like dirt. Performing regular oral hygiene and rinsing with antibacterial mouthwash protects lesions inside the mouth from food debris and bacteria. As lesions start to heal, the Academy of General Dentistry notes that the delicate, new skin is susceptible to dehydration. The Academy recommends applying an emollient such as lotion or lip balm at least three times per day. Products that contain aloe may accelerate healing, according to the Academy.
References
- National Institute of Dental and Craniofacial Research: Oral Health in America: A Report of the Surgeon General
- "Harrison's Principles of Internal Medicine, 23rd Edition"; Anthony S. Fauci, M.D. et al.; 2008
- "Basic and Clinical Pharmacology, 11th Edition"; Bertram G. Katzung, M.D., Ph.D. et al.; 2008
- Academy of General Dentistry: Oral Health Resources: What Are Cold Sores?
- MayoClinic.com: Cold Sores
