Herpes simplex treatment
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1], Associate Editor-In-Chief: Cafer Zorkun, M.D., Ph.D. [2]
Overview
Currently, there is no treatment that can eradicate any of the herpes viruses from the body. Non-prescription analgesics can reduce pain and fever during initial outbreaks. Topical anesthetic treatment (such as prilocaine, lidocaine or tetracaine) can relieve itching and pain.[1][2]
Antiviral Therapy
Topical treatments
Docosanol
- Docosanol prevents herpes simplex virus from fusing to cell membranes, thus barring the entry of the virus into the skin.
- It was approved for use after clinical trials by the FDA in July 2000.[3]
- It was the first over-the-counter antiviral drug approved for sale in the United States and Canada
Tromantadine
- Tromantadine is available as a gel that inhibits entry and spreading of the virus by altering the surface composition of skin cells and inhibiting release of viral genetic material.
Zilactin
- It is a topical analgesic barrier treatment, which forms a "shield" at the area of application to prevents a sore from increasing in size and decrease viral spreading during the healing process.
Other drugs
Cimetidine
Cimetidine commonly used in heartburn, has been shown to lessen the severity of herpes zoster outbreaks in several different instances, and offered some relief from herpes simplex.[4][5][6] This is an off-label use of the drug. It and probenecid have been shown to reduce the renal clearance of aciclovir.[7] These compounds also reduce the rate, but not the extent, at which valaciclovir is converted into aciclovir.
Aspirin
- Low doses aspirin (125 mg daily) have shown to be beneficial in patients with recurrent HSV infections. However, there are lack of sufficient supporting evidences.
- It reduces the level of the inflammatory mediators prostaglandins [8]
- A recent study in animals showed inhibition of thermal (heat) stress-induced viral shedding of HSV-1 in the eye by aspirin, and a possible benefit in reducing the frequency of recurrences.[9]
References
- ↑ "Local anesthetic creams". BMJ. 297 (6661): 1468. 1988. PMID 3147021.
- ↑ Kaminester LH, Pariser RJ, Pariser DM; et al. (1999). "A double-blind, placebo-controlled study of topical tetracaine in the treatment of herpes labialis". J. Am. Acad. Dermatol. 41 (6): 996–1001. PMID 10570387.
- ↑ "Drug Name: ABREVA (docosanol) - approval". centerwatch.com. July 2000. Retrieved 2007-10-17.
- ↑
Vaseline
- Vaseline or any other type of fat prevents water, or saliva, from reaching the cold sore. Since, water helps in perpetuation of the cold sore, preventing water exposure will fasten the healing process.
Kapinska-Mrowiecka M, Toruwski G (1996.). "Efficacy of cimetidine in treatment of herpes zoster in the first 5 days from the moment of disease manifestation". Pol Tyg Lek. 51 (23–26): 338–339. PMID 9273526. Check date values in:
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(help) - ↑ Hayne ST, Mercer JB (1983). "Herpes zoster:treatment with cemetidine". Can Med Assoc J. 129 (12): 1284–1285. PMID 6652595.
- ↑ Komlos L, Notmann J, Arieli J, et.al. (1994). "In vitro cell-mediated immune reactions in herpes zoster patients treated with cimetidine". Asian Pac J Allelrgy Immunol. 12 (1): 51–58. PMID 7872992.
- ↑ De Bony F, Tod M, Bidault R, On NT, Posner J, Rolan P. (2002). "Multiple interactions of cimetidine and probenecid with valaciclovir and its metabolite acyclovir". Antimicrob. Agents Chemother. 46 (2): 458–463. PMID 11796358.
- ↑ Karadi I, Karpati S, Romics L. (1998). "Aspirin in the management of recurrent herpes simplex virus infection". Ann. Intern. Med. 128 (8): 696–697. PMID 9537952.
- ↑ Gebhardt BM, Varnell ED, Kaufman HE. (2004). "Acetylsalicylic acid reduces viral shedding induced by thermal stress". Curr. Eye Res. 29 (2–3): 119–125. PMID 15512958.