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BMJ Clin Evid. 2009 Sep 23;2009. pii: 1704.

Herpes labialis.

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Memorial University of Newfoundland, Newfoundland, Canada.



Herpes simplex virus type 1 infection usually causes a mild, self-limiting painful blistering around the mouth, with 20% to 40% of adults affected at some time. Primary infection usually occurs in childhood, after which the virus is thought to remain latent in the trigeminal ganglion. Recurrence may be triggered by factors such as exposure to bright light, stress, and fatigue.


We conducted a systematic review and aimed to answer the following clinical questions: What are the effects of antiviral treatments for the first attack of herpes labialis? What are the effects of interventions aimed at preventing recurrent attacks of herpes labialis? What are the effects of treatments for recurrent attacks of herpes labialis? We searched: Medline, Embase, The Cochrane Library, and other important databases up to February 2009 (Clinical Evidence reviews are updated periodically; please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA).


We found 27 systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions.


In this systematic review we present information relating to the effectiveness and safety of the following interventions: oral antiviral agents, sunscreen, topical anaesthetic agents, topical antiviral agents, and zinc oxide cream.

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