Treatment of Oral Herpes
Herpes is a common and usually mild recurrent skin condition; most infections are unrecognized and undiagnosed. Herpes is caused by a virus: the herpes simplex virus (HSV). HSV is in a family of viruses called herpes viruses. This family includes Epstein-Barr virus (the cause of mono) and the varicella zoster virus (the cause of chicken pox and shingles). Although there are several viruses in the herpes virus family, each is a separate virus and different from one another. Having one virus does not mean you will have another.
There are two types of herpes simplex: herpes simplex virus type 1 (HSV-1) and herpes simplex virus type 2 (HSV-2). HSV can cause oral herpes (sometimes called cold sores or fever blisters) on the mouth or facial area as well as genital herpes. The majority of oral herpes cases are caused by HSV-1 and the majority of genital herpes cases are caused by HSV-2; however, type-1 or type-2 can occur in either the genital or oral area.
Topical application of ice, alcohol or lip balms may relieve the symptoms of cold sores.
A cold sore outbreak may be pre-empted or aborted by application of Peniclovir (Denavir), an antiviral prescription cream, or Docosanol (Abreva), an over-the-counter cream, early during the onset of symptoms. Both are easy to apply. (Note: Patients must be sure to wash their hands after applying these or any topical herpes medication.)
Oral antiviral medications are typically reserved for those who have frequent or severe outbreaks of cold sores and those who are immunocompromised. For maximal efficacy, these medications also should be started during the prodrome, or within 24 hours of an outbreak.
Topical anesthetics such as lidocaine or agents such as Kaopectate that coat the gums and roof of the mouth may be used to treat the symptoms of intraoral herpes. Pain-relieving medications such as acetaminophen (Tylenol), aspirin or ibuprofen (Advil, Motrin, etc.) are also helpful. Frequent, severe recurrences may benefit from prescription oral antivirals.
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