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Depiction of the molecular interactions in the ganglia showing the inverse relationship between LATs and lytic proteins.
Vaccine and Infectious Diseases Division, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA.
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Dermal fillers are substances that are injected into the skin to overcome the harm done by aging, exposure to sun and from scarring.
HighlightsHerpes Simplex VirusesHerpes simplex virus 1 (HSV-1) is the main cause of oral herpes infections that occur on the mouth and lips. The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. Activation comprises active transcription of viral RNA and high lytic protein expression accompanied by low LAT production. To address this issue, a two-vaccine schedule for measles (15 months and four to six years of age) is recommended.
If symptoms occur during the first episode of a genital herpes outbreak, they can be quite severe. The first sign of oral herpes outbreak is usually a tingling sensation in the area of the skin which then turns red. These blisters are filled with clear fluid which eventually burst and they appear soon after the initial symptoms. However, there are availiable anitiviral medications to minimize the severity, frequency, and frequency of outbreaks.
Some dermal fillers are used superficially to smoothen out shallow lines and wrinkles while others are injected deep into the skin to fill out deeper lines and creases.
A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions.
Blisters pop themselves and will look like sores, but will crust up to disappear with time.
There is no doubt that at some point herpes sores resemble pimples but usually it is very difficult to make that mistake. If this is your first outbreak, you may experience pain while urinating or difficulty in emptying your bladder, swollen lymph nodes in the groin, and mild to severe itching where the outbreak is about to occur. Antiviral medications are proven to stimulate the immune system and slow down the replication rate of the virus.
Dermal fillers are used in areas where the natural fat of the body has atrophied leaving wrinkles and sunken areas. All the participants were asked to provide blood samples and swabs of their eyes and mouth for 30 consecutive days. HSV-1 can also cause genital herpes. Herpes simplex virus 2 (HSV-2) is the most common cause of genital herpes, but it can also cause oral herpes.
Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. The fluid filled blisters eventually break and fluid that comes out of the blisters is full of millions of herpes virus cells making this the most contagious phase. Aciclovir (Zovirax), Famciclovir ( Famvir), and Penciclovir are examples of presciption antiviral medications avaliable in the market. Trends in HSV Types and Genital HerpesGenital herpes can be caused by either HSV-2 or HSV-1. Illness is manifested by a prodrome of three days with systemic toxicity, prostration, high fever, coryza, headache, photophobia, dry hacking cough, and impressive conjunctivitis. Koplik’s spots, the pathognomonic enanthem of measles, appear on the buccal mucosa opposite the molars during the prodromal period and fade within three days after the onset of the rash.
In recent years, HSV-1 has become a significant cause in developed countries, including the United States.
The risk of infection is highest during outbreak periods when there are visible sores and lesions. It’s real danger lies in severe fetal infection that can develop if infection occurs during early pregnancy. SymptomsWhen genital herpes symptoms do appear, they are usually worse during the first outbreak than during recurring attacks. In the first few weeks of pregnancy, the chance of transmission is 30 to 50%; at five to eight weeks, it is 25%, and from nine to 12 weeks, the risk is 8%.
The prodrome consists of malaise, cough, sore throat, low grade fever, headache, and a pink maculopapular rash that begins on the face with caudal progression. Herpes, Pregnancy, and Newborn InfantsHerpes can pose serious risks for a pregnant woman and her baby.
The risk is greatest for mothers with a first-time infection, because the virus can be transmitted to the infant during childbirth. Other clinical findings include suboccipital and postauricular adenopathy and arthralgia (in 25% of affected patients). Guidelines from the American Academy of Pediatrics recommend using specific diagnostic tests for women in labor to determine the risk of transmission.
Babies born to mothers infected with genital herpes are often treated with the antiviral drug acyclovir, which can help suppress the virus. Unlike measles, where systemic toxicity and fever are the rule, fever is less common in rubella.Erythema Infectiosum (Fifths Disease)Erythema infectiosum is a mildly contagious disease caused by human parvovirus B19. It typically affects school aged children (5 to 15 years of age).53-61 The incubation period is usually one to two weeks with a prodrome consisting of low grade fever, malaise, and headache.
A fiery red macular rash soon appears on the cheeks (“slapped cheek”), lasts one to four days, and is followed by a more generalized rash which evolves into a distinctive, lacy, reticular pattern most prominent on the extensor surfaces of the extremities. Herpes viruses include human herpes virus 8 (the cause of Kaposi sarcoma) and varicella-zoster virus (also known as herpes zoster, the virus responsible for shingles and chickenpox). Children with erythema infectiosum typically feel well but constitutional symptoms, such as headache, fever, sore throat, and coryza, occur in 5 to 15% of patients. Lastly, this infection is associated with transient aplastic crisis63,68 in patients with hemolytic anemias, hemoglobinopathies (particularly sickle cell disease),69 or idiopathic thrombocytopenic purpura,57,62,70 as well as intrauterine infection and fetal death71 (risk ranges from 3 to 10%) in pregnant women infected during the first 20 weeks of gestation.
The word "herpes" comes from the Greek word "herpein," meaning "to creep." This refers to the unique characteristic pattern of all herpes viruses to creep along local nerve pathways to the nerve clusters at the end, where they remain in an inactive (dormant) state for variable periods of time. Yoto et al72 reported epidemiological evidence suggesting that parvovirus B19 may be the cause of acute hepatitis. It should be noted that, when children have the rash of fifth’s disease, they are no longer infectious.Roseola27,48,49Roseola is caused by human herpes virus 6 (the other five human herpes viruses, herpes simplex 1 and 2, varicella-zoster, cytomegalovirus, and Epstein-Barr virus are also known causes of skin eruptions). The usual cause of oral herpes (herpes labialis), which are commonly called cold sores or fever blisters. HSV-1 can also cause genital herpes, which is a sexually transmitted disease (STD). Herpes simplex virus 2 (HSV-2). Virtually all cases occur between six months and three years of age, with most cases occurring before age one. The incubation period is one to two weeks and the illness classically presents with a fever of up to five days followed by precipitous defervescence and the appearance of a pink maculopapular rash on the neck and trunk. Despite the elevated temperature, affected children are brighteyed and do not appear to be acutely ill. Until recently, the general rule was to assume that HSV-1 caused oral herpes and HSV-2 caused genital herpes. It is now clear, however, that either type of herpes virus can be found in the genital or oral areas (or other sites). In fact, HSV-1 is now responsible for more than half of all new cases of genital herpes in developed countries. The Disease ProcessHerpes is transmitted through close skin-to-skin contact. To infect people, the herpes simplex viruses (both HSV-1 and HSV-2) must get into the body through tiny injuries in the skin or through a mucous membrane, such as inside the mouth or on the genital or anal areas. Periorbital edema, when present in a febrile otherwise non-toxic child, is a useful clue during the pre-exanthematous stage. The risk for infection is highest with direct contact of blisters or sores during an outbreak. A common complication (seen in approximately 6% of cases) is febrile seizures.Varicella48,49,73,74Varicella is a common and highly contagious systemic illness caused by the varicella-zoster virus. But the infection can also develop from contact with an infected partner who does not have visible sores or other symptoms. Once the virus has contact with the mucous membranes or skin wounds, it enters the nuclei of skin tissue cells and begins to replicate.
The virus is then transported from the nerve endings of the skin to clusters of nerve cells (ganglia) where it remains inactive (latent) for some period of time. Half of the cases occur before age five and 90% by 15 years, with peak incidence in late winter and spring.
After an incubation period of two to three weeks, the illness begins with a low grade fever and malaise.
However, at some point, the virus wakes up and travels along nerve pathways to the surface the skin where it begins to multiply again. The characteristic skin eruption begins as red macules that progress to discrete vesicles surrounded by erythema.
During this time, the virus can infect other people if it is passed along in body fluids or secretions. The eruption typically begins on the face and trunk and spreads in successive crops centrifugally to the extremities over a week long period. Viral shedding may be accompanied by noticeable symptoms (outbreak) but it can also occur without causing symptoms (asymptomatic shedding). In either case, a person is infectious during periods of viral shedding. Symptoms may appear as multiple small red bumps or patches that develop blisters. The presence of lesions in varying stages of evolution and minimal distal extremity involvement helps to differentiate chickenpox from smallpox. Severe presentations of varicella may occur in children receiving steroids and immunocompromised patients.
The Tzanck smear can demonstrate multinucleated giant cells and, in questionable cases, can be used to confirm the diagnosis.
Certain triggers can wake up the virus from its dormant state and cause it to become active again.
In most cases, management of varicella is directed at symptomatic relief of constitutional symptoms and ameliorating pruritis. Secondary bacterial infections, if present, should be treated with antibiotics directed against Staphylococcus aureus.


In general, recurrent episodes of herpes cause less severe symptoms than the primary outbreak. Acyclovir may be effective in treating varicella and has been shown to prevent visceral dissemination in immunocompromised children. Results were less supportive with respect to the number of days to the relief of itching, and there was no clinically important difference between acyclovir and placebo with respect to complications associated with chickenpox. HSV-1 is the most prevalent form of herpes simplex virus, and infection is most likely to occur during preschool years.
In summary, the clinical importance of acyclovir treatment in otherwise healthy children remains uncertain. Children with a history of chickenpox in the first year of life have a much higher incidence of zoster (shingles) in childhood (relative risk 2.8). The calculated incidence rate of zoster by 12 years of age in children who acquired varicella by one year of age in the Rochester study was 4.1 cases per 1000. In addition, because HSV-1 can be passed in saliva, people should also avoid sharing toothbrushes or eating utensils. Transmission of Genital Herpes Genital herpes is transmitted through sexual activity. Herpes SimplexThe most common presentation of primary herpes simplex in children (one to five years of age) is herpetic gingivostomatitis (HSV-1), but infection may also involve the eye (herpetic keratoconjunctivitis), the external genitalia (HSV-2), and fingers (herpetic whitlow). People can get HSV-2 through genital contact or HSV-1 through mouth-to-genital contact with an infected partner.
It should be noted, however, that oral HSV-2 and genital HSV-1 infections have become increasingly more common. Wrestlers are prone to spread herpes infection to one another, a condition called herpes gladiatorum.Treatment76-77 is usually symptomatic, though acyclovir may be prescribed to shorten the course of more severe or recurrent disease.
Recurrent HSV presents as grouped vesicles near the site of primary infection, and are often preceded by a burning or tingling sensation in the affected area.
Triggering mechanisms responsible for reactivation include febrile illness, menses, stress, sunburn, or local trauma. People with active symptoms of genital herpes are at very high risk for transmitting the infection. Recurrent infection differs from primary infection in the smaller size of vesicles, their close grouping, and the usual absence of constitutional symptoms. Unfortunately, most cases of genital herpes infections occur when the virus is shedding but producing no symptoms.
Neonatal herpes usually develops when infants are delivered vaginally to mothers who have genital herpes. Most people either have no symptoms or do not recognize them when they appear. In the past, genital herpes was mostly caused by HSV-2, but HSV-1 genital infection is increasing. About half of these infected infants will have skin manifestations, and half of these, if untreated, will either die or suffer serious neurologic or ocular sequelae.
Again, the Tzanck smear can demonstrate multinucleated giant cells and, in questionable cases, can be used to confirm diagnosis. There is also evidence that children today are less likely to get cold sores and become exposed to HSV-1 during childhood. Children who received acyclovir had oral lesions for a shorter period of time verses placebo (four vs. Centers for Disease Control and Prevention (CDC), about 1 in 6 Americans ages 14 to 49 years have genital herpes. While HSV-2 remains the main cause of genital herpes, HSV-1 has significantly increased as a cause, most likely because of oral-genital sex.
This group of viruses was previously divided into coxsackie, echo, and polioviruses, but has now been unified within the picornavirus family.
African-American women are at particularly high risk. People with compromised immune systems, such as those who have HIV, are at very high risk for genital herpes. The age of the child at the time of infection appears to be significant in disease expression; exanthems are more common in younger children, whereas aseptic meningitis is more prominent in older children.
The cutaneous manifestation is typically morbiliform, though vesicular and urticarial rashes have been reported. Drugs that suppress the immune system, and organ transplantation, can also weaken the immune system and increase the risk for contracting genital herpes. Common complications include pericarditis, myocarditis, pleurodynia, parotitis, hepatitis, pancreatitis, and encephalitis. It is almost impossible to defend against the transmission of oral herpes, because it can be transmitted by very casual contact, including kissing. Hand-foot-mouth disease, also caused by enteroviruses (most commonly coxsackie A16), is manifested by malaise and fever with oral vesicles (severe odynophagia with associated anorexia), followed by vesicles on the hands and feet.
Still, you can help reduce the risk of transmitting oral herpes by not sharing objects that touch the mouth, such as eating and drinking utensils, toothbrushes, and towels. The diaper area may be affected in infants.Epstein-Barr InfectionsIn young children, an exanthem is seen in as many as one-third of infected patients. It is best to refrain from any type of sex (vaginal, anal, or oral) during periods of active outbreak. After an incubation period of one to two months, acute infection begins insidiously with a high fever, congestion, odynophagia, adenopathy, and hepatosplenomegaly. However, herpes can also be transmitted when symptoms are not present (asymptomatic shedding).
The mono-spot test is unreliable in children younger than four years of age and if symptoms have been present for less than five days.
Although condoms may not provide 100% protection, they are proven to significantly reduce the risk of sexual disease transmission, including herpes.
Acute and convalescent EB viral titers and the finding of atypical lymphocytosis (seen in 70%) are supportive. It is purported that up to a quarter of children with EBV may have concurrent beta-hemolytic streptococcal infection. Natural condoms made from animal skin do NOT protect against HSV infection because herpes viruses can pass through them. Use a water-based lubricant. Lubricants can help prevent friction during sex, which can irritate the skin and increase the risk for outbreaks. Only water-based lubricants (K-Y Jelly, Astroglide, AquaLube, and glycerin) should be used.
However, it is best not to use condoms pre-lubricated with spermicides. Do not use spermicides for protection against herpes.
Nonoxynol-9 can cause irritation around the genital areas, which makes it easier for herpes and other STDs to be transmitted. Use a dental dam or condom for oral sex. If you have any symptoms of oral herpes, it is best not to perform oral sex on a partner until any visible sores or blisters have healed. Limit the number of sexual partners. The more sexual partners you have, the greater your chances of becoming infected or infecting others.
It is very unlikely to transmit or contract genital herpes from a toilet seat or bath towel. Studies suggest that male circumcision may help reduce the risk of HSV-2, as well as human papillomavirus (HPV) and HIV infections. However, herpes can cause significant and widespread complications in people who don't have a fully functioning immune system. The CDC recommends that all people diagnosed with herpes simplex virus 2 (HSV-2) get tested for HIV. Most people with HIV are co-infected with HSV-2 and are particularly vulnerable to its complications. HSV-2 infection increases HIV levels in the genital tract, which makes it easier for the HIV virus to be spread to sexual partners. Herpes and PregnancyPregnant women who have genital herpes due to either HSV-2 or HSV-1 have an increased risk for miscarriage, premature labor, inhibited fetal growth, or transmission of the herpes infection to the infant in the uterus or at the time of delivery. Herpes in newborn babies (herpes neonatalis) can be a very serious condition. Fortunately, neonatal herpes is rare.
Although about 25 to 30% of pregnant women have genital herpes, less than 0.1% of babies are born with neonatal herpes.
The baby is at greatest risk during a vaginal delivery, especially if the mother has an asymptomatic infection that was first introduced late in the pregnancy.
The risk for transmission also increases if infants with infected mothers are born prematurely, there is invasive monitoring, or instruments are used during vaginal delivery.
Transmission can occur if the amniotic membrane of an infected woman ruptures prematurely, or as the infant passes through an infected birth canal. This risk is increased if the woman is having or has recently had an active herpes outbreak in the genital area. Very rarely, the virus is transmitted across the placenta, a form of the infection known as congenital herpes.
Aggressive treatment with antiviral medication is required. Most infected pregnant women do not have a history of symptoms, so herpes infection is often not suspected or detected at the time of delivery. Fortunately, if a woman does have genital lesions, rapid diagnostic blood tests can quickly determine her chances of transmitting the virus to her baby during delivery.
Some women with new or recurrent herpes may also be prescribed antiviral medication during pregnancy. A woman with herpes can usually safely breastfeed her baby, as long as she does not have a lesion on her breast or nipple.
Neonatal herpes can spread to the brain and central nervous system, causing encephalitis and meningitis.
Herpes can also spread to internal organs, such as the liver and lungs. Infants infected with herpes are treated with acyclovir, an antiviral drug.
They usually receive several weeks of intravenous acyclovir treatment, often followed by several months of oral acyclovir. It is important to treat babies quickly, before the infection spreads to the brain and other organs. Fortunately, rapid diagnostic tests and treatment with acyclovir have significantly improved survival rates and reduced complication rates.
Nearly all who recover have some impairment, ranging from very mild neurological changes to paralysis. Like encephalitis, meningitis symptoms include headache, fever, stiff neck, vomiting, and sensitivity to light.
Ocular herpes is usually a simple infection that clears up in a few days, but in its more serious forms, and in severe cases, it can cause blindness. It only affects the upper layer (epithelium) of the cornea and heals with scarring. Stromal Keratitis. Iridocyclitis is another serious complication of ocular herpes, in which the iris and the area around it become inflamed. Herpes Skin ComplicationsEczema Herpeticum A rare form of herpes infection called eczema herpeticum, also known as Kaposi varicelliform eruption, can affect people with skin disorders and those with a weakened immune system. Untreated, this condition can be extremely serious and possibly fatal. Gingivostomatiti Oral herpes can cause multiple painful ulcers on the gums and mucus membranes of the mouth, a condition called gingivostomatitis.


In children, this is often caused by thumb sucking or finger sucking while they have a cold sore.
It can also occur in adult health care workers, such as dentists, because of increased exposure to the herpes virus. The use of latex or polyurethane gloves prevents herpes whitlow in health care workers. SymptomsHerpes symptoms vary depending on whether the outbreak is initial or recurrent.
The primary outbreak is usually worse than recurrent outbreaks, with more severe and prolonged symptoms.
In fact, studies indicate that 10 to 25% of people infected with HSV-2 are unaware that they have genital herpes. The first signs are a tingling sensation in the affected areas (genitalia, buttocks, and thighs) and groups of small red bumps that develop into blisters.
The sores may sometimes itch, but itching decreases as they heal. About 40% of men and 70% of women develop other symptoms during initial outbreaks of genital herpes, such as flu-like discomfort, headache, muscle aches, and fever.
Some women may have difficulty urinating and may, occasionally, require a urinary catheter. Women may also experience vaginal discharge. Recurrent Genital Herpes Outbreak In general, recurrences are much milder than the initial outbreak. The virus sheds for a much shorter period of time (about 3 days) compared to an initial outbreak of 3 weeks. Women may have only minor itching, and the symptoms may be even milder in men. On average, people have about four recurrences during the first year, although this varies widely.
There are some differences in frequency of recurrence depending on whether HSV-2 or HSV-1 caused genital herpes. HSV-2 genital infection is more likely to cause recurrences than HSV-1. Symptoms of Oral HerpesOral herpes (herpes labialis) is most often caused by HSV-1, but it can also be caused by HSV-2.
It usually affects the lips and, in some primary attacks, the mucus membranes in the mouth. A herpes infection may occur on the cheeks or in the nose, but facial herpes is very uncommon. Primary Oral Herpes Infection If the primary (initial) oral infection causes symptoms, they can be very painful, particularly in children. The sores last 10 to 14 days and can be very uncomfortable. Blisters that may be preceded or accompanied by sore throat, fever, swollen glands, and painful swallowing. Recurrent Oral Herpes Infection A recurrent oral herpes infection is much milder than the primary outbreak.
It usually manifests as a single sore, commonly called a cold sore or fever blister (because it may arise during a bout of cold or flu).
The sore usually shows up on the outer edge of the lips and rarely affects the gums or throat. Recurrences of genital herpes are more likely with HSV-2 infection than with HSV-1 infection.
The outbreak of infection is often preceded by a prodrome, an early group of symptoms that may include itchy skin, pain, or an abnormal tingling sensation at the site of infection. Recurrent outbreaks feature most of the same symptoms at the same sites as the primary attack, but they tend to be milder and briefer.
Occasionally, the symptoms may not resemble those of the primary episode, but appear as fissures and scrapes in the skin or as general inflammation around the affected area. They include sunlight, wind, fever, physical injury, surgery, menstruation, suppression of the immune system, and emotional stress. Oral herpes can be triggered within about 3 days of intense dental work, particularly root canal or tooth extraction. Timing of Recurrences Recurrent outbreaks may occur at intervals of days, weeks, or years.
For most people, outbreaks recur with more frequency during the first year after an initial attack. The good news is that in most healthy people, recurring infections tend to become progressively less frequent, and less severe, over time. However, other conditions can resemble herpes, and doctors cannot base a herpes diagnosis on visual inspection alone.
These tests include: Virologic tests (viral culture of the lesion) Serologic tests (blood tests that detect antibodies) The CDC recommends that both virologic and serologic tests be used for diagnosing genital herpes.
People diagnosed with genital herpes should also be tested for other sexually transmitted diseases.
At this time, experts do not recommend screening for HSV-1 or HSV-2 in the general population. Genital herpes can be caused by either HSV-1 or HSV-2.
It is important to determine which virus is involved, as the type of herpes infection influences prognosis and treatment recommendations. Recurrences of genital herpes, and viral shedding without overt symptoms, are much less frequent with HSV-1 infection than with HSV-2. False-negative (testing negative when herpes infection is actually present) or false-positive (testing positive when herpes infection is not actually present) results can occur.
Your health care provider may recommend that you have a test repeated. Virologic TestsViral culture tests are made by taking a fluid sample, or culture, from the lesions as early as possible, ideally within the first 48 hours of the outbreak.
PCR tests are much faster and more accurate than viral cultures, and the CDC recommends PCR for detecting herpes in spinal fluid when diagnosing herpes encephalitis. PCR can make many copies of the virus' DNA, so that even small amounts of DNA in the sample can be detected.
However, many labs now use PCR for herpes testing because it is highly accurate. An older type of virologic testing, the Tzanck smear test, uses scrapings from herpes lesions.
The scrapings are stained and examined under a microscope for the presence of giant cells with many nuclei or distinctive particles that carry the virus (called inclusion bodies).
The Tzanck test is not reliable for providing a conclusive diagnosis of herpes infection and is not recommended by the CDC. Serologic TestsSerologic (blood) tests can identify antibodies that are specific for either HSV-1 or HSV-2.
When the herpes virus infects you, your body's immune system produces specific antibodies to fight off the infection. If a blood test detects antibodies to herpes, it is evidence that you have been infected with the virus, even if the virus is in a non-active (dormant) state. The presence of antibodies to herpes also indicates that you are a carrier of the virus and might transmit it to others. Serologic tests can be especially useful for people who do not have active symptoms, but who have other risk factors for herpes (such as other STDs, multiple sex partners, or a monogamous partner who has genital herpes). Although glycoprotein (gG) type-specific tests have been available for many years, many of the older nontype-specific tests that cannot distinguish HSV-1 from HSV-2 are still on the market.
Canker sores frequently crop up singly or in groups on the inside of the mouth, or on or underneath the tongue.
The drugs are used initially to treat a first attack of herpes, and then afterward to either treat recurrent outbreaks (episodic therapy) or reduce frequency of recurrences (suppressive therapy). Drugs can, however, reduce the severity of symptoms, improve healing times, and prevent recurrences.
If people experience very severe disease or complications, they need to be hospitalized and receive an antiviral drug intravenously.
Your health care provider will prescribe one of the three antiviral medications, which you will take for 7 to 10 days. You should begin the medication as soon as you notice any signs or symptoms of herpes, preferably during the prodrome stage that precedes the outbreak of lesions. If taken during prodrome, episodic therapy may help prevent an outbreak from occurring or reduce its severity. Valacyclovir is taken once a day. Suppressive treatment can reduce the frequency of outbreak recurrences by 70 to 80%. It is generally recommended for people who have frequent recurrences (6 or more outbreaks per year). Because herpes recurrences often diminish over time, you should discuss annually with your health care provider whether you should stay with drug therapy or discontinue it. While taking any suppressive therapy for genital herpes, it is still important to regularly use latex condoms and to avoid any sexual activity during recurrences.
A new form of acyclovir (Sitavig) is administered orally as an adhesive tablet; it is applied to the gum region of the mouth, where it dissolves during the course of the day.
In addition, acyclovir is available in topical form, as is the related drug penciclovir (Denavir). Topical TreatmentsThese ointments or creams can help shorten healing time and duration of symptoms. However, none are truly effective at eliminating outbreaks. Penciclovir (Denavir) heals HSV-1 sores on average about half a day faster than without treatment, stops viral shedding, and reduces the duration of pain. Ideally, you should apply the cream within the first hour of symptoms, although the medication can still help if applied later. Apply the cream 5 times a day, beginning at the first sign of tingling or pain. Over-the-counter topical ointments may provide modest relief. They include Anbesol gel, Blistex lip ointment, Campho-phenique, Herpecin-L, Viractin, and Zilactin. Some contain a topical anesthetic such as benzocaine, tetracaine, or phenol. Lip balm that contains sunblock, or sunscreen applied around the lips may help prevent sun-triggered outbreaks.
Herbs and SupplementsGenerally, manufacturers of herbal remedies and dietary supplements do not need FDA approval to sell their products. Just like a drug, herbs and supplements can affect the body's chemistry, and therefore have the potential to produce side effects that may be harmful.
There have been several reported cases of serious and even lethal side effects from herbal products. Always check with your provider before using any herbal remedies or dietary supplements. Many herbal and dietary supplement products claim to help fight herpes infection by boosting the immune system. There has been little research on these products, and little evidence to show that they really work. Epidemiology, clinical presentation, and antibody response to primary infection with herpes simplex virus type 1 and type 2 in young women. Seroprevalence of herpes simplex virus type 2 among persons aged 14 - 49 years -- United States, 2005-2008. Guidance on management of asymptomatic neonates born to women with active genital herpes lesions. Genital shedding of herpes simplex virus among symptomatic and asymptomatic persons with HSV-2 infection. Martin, MD, MPH, ABIM Board Certified in Internal Medicine and Hospice and Palliative Medicine, Atlanta, GA.



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