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Herpes simplex - oral - Management
Should I advise use of a topical antiviral to treat cold sores?
- Advise that the benefits of topical antivirals (aciclovir 5% or penciclovir 1% cream) are small and that the cold sores will usually resolve within 7–10 days even without treatment.
- If topical antiviral therapy is desired, remind the individual that:
- Topical antivirals only affect the course of the current episode. They do not cure the individual or prevent future episodes of cold sores.
- Treatment needs to be initiated at the onset of symptoms before vesicles appear.
- Compliance is important, as topical antivirals need to be applied frequently for a minimum of 4–5 days.
- Topical antivirals are widely available (without prescription). This can help to minimize the delay to starting treatment in future recurrences.
- Seek specialist advice when managing neonates and people who are immunocompromised (including people with HIV) with cold sores.
In depth
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