Treatment of recurrent herpes simplex labialis with topical butylated hydroxytoluene

Butylated hydroxytoluene (BHT) is a hydrophobic compound with in vitro activity against many enveloped viruses, including herpes simplex virus. The effect of topical therapy with 15% BHT in mineral oil on the course of recurrent herpes simplex labialis was examined in 30 patients in a double-blind, placebo-controlled pilot study in which treatment was initiated by the physician. Sixteen patients received BHT and 14 received the placebo mineral oil vehicle. The time from lesion onset to dry crust formation was slightly shorter among BHT recipients than among placebo recipients (2.0 and 2.4 days; P = 0.01). Duration of the vesicle-ulcer stages was likewise shorter (1.2 and 2.0 days; P = 0.09), and lesion virus excretion appeared to be less in the subjects who received BHT than in the controls, but these differences were not significant. There was no clinical or laboratory evidence of toxicity.