According to WHO, herpes simplex virus type 1 (HSV-1) has infected about 3.7 billion people under the age of 50 worldwide, representing 67% of the population.
The majority of the population is infected with HSV-1 in childhood, after which it develops a lifelong persistence in the human body.
Frequent relapses of oral herpes are associated with the development of psychological discomfort and many social problems. Herpes infection is especially dangerous for patients with a weakened immune system, as well as for newborns.
In this article on estet-portal.com read about the modern principles of treatment of oral herpes, which meet international recommendations and postulates of evidence-based medicine.
Why is it necessary to treat recurrent herpes infection
According to modern scientific concepts, systemic antiviral therapy for herpes infection helps to reduce the duration and severity of signs of infection exacerbation, thereby improving the quality of life of patients.
There is evidence that the use of antiviral therapy for herpes infection reduces the risk of transmission to others by 48%.
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It is known that HSV-1 can cause not only classic herpes labialis, but also genital herpes.
The patient is most contagious during the period of exacerbation of the infection – at this time it is necessary to exclude the sharing of objects that may come into contact with saliva, as well as limit kissing and orogenital sexual intercourse.
Symptoms of oral herpes infection in immunocompetent patients
The incubation period is 2 to 12 days. The course of the primary infection is, in most cases, asymptomatic.
Fever and pharyngitis can sometimes occur with primary infection – such manifestations of herpes often go unnoticed. After a few days, characteristic rashes may appear on the mucous membrane of the oral region and pharynx, which are accompanied by pain and regional lymphadenopathy.
Oral herpes recurrences are characterized by stereotypic localization of characteristic rashes, which may be preceded by a sensation of local itching, tingling and burning.
Vesicles and ulcerations are usually located along the red border of the lips. Over time, the lesions crust over and heal within 10 days.
Treatment of recurrent oral herpes in immunocompetent patients
Treatment of recurrent oral herpes should be carried out in all patients and is essential to prevent the development of neurological symptoms of the infection.
Treatment for a recurrent herpes infection should be initiated within the first 72 hours of the onset of symptoms.
Today, international protocols recommend the use of the following drugs as an etiotropic therapy for oral herpes in immunocompetent patients:
1. Aciclovir 200 mg 5 times a day;
2. Valacyclovir 2 g qd ;
3. Famciclovir 1.5 g qd;
Duration of treatment: 5 days. If oral herpes is accompanied by local pain syndrome, the patient should be advised to apply topical lidocaine in the form of a 5% ointment 2-3 times a day. It is necessary to warn the patient about the possible risk of developing an allergic reaction to lidocaine.
The feasibility of topical therapy for oral herpes: evidence-based medicine
According to modern international recommendations, systemic antiviral therapy is in the first place in the treatment of the oral form of herpes infection.
According to the results of clinical studies, antiviral creams have very low efficacy compared to systemic antiviral therapy for herpes infection.
Cream containing aciclovir reduces the duration of an oral herpes infection by only 0.5 days.
The preference for the use of topical oral herpes therapy by patients is due, rather, to the greater availability of antiviral creams (available without a prescription in many countries, including the UK), as well as a certain stereotyped thinking of the population. But this has nothing to do with evidence-based medicine.
Thank you for staying with estet-portal.com. Read other interesting articles in the "Dermatology" section. You may also be interested in Troubles and dangers due to the herpes simplex virus
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