Treatment of herpes labialis

Untreated herpes labialis may take up to 10 days or more to heal and antiviral therapy must be initiated early if it is to be effective. Acyclovir ointment has been reported to have an antiviral effect but no clinical benefit and a newer formulation, acyclovir cream, has been developed in an attempt to enhance skin penetration. In placebo-controlled trials, acyclovir cream shortened the duration of lesions significantly and when therapy was started before vesicles developed, the number of lesions aborting was increased significantly. This therapy was well tolerated by most patients. Topical acyclovir offers hope for the successful management of herpes labialis where systemic therapy is considered inappropriate.