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Oral Herpes (Cold Sore)

A type of herpes simplex. An outbreak typically causes small blisters or sores on or around the mouth. The sores typically heal within 2-3 weeks, but the herpes virus remains, periodically reactivating (in symptomatic people) to create sores in the same area of the mouth or face.

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What works? Research summarized

Evidence reviews

Antiviral agents for treatment of herpes simplex virus infection in neonates

The virus herpes simplex (herpes) causes a rare but devastating disease in the newborn that can range from skin and eye infection to shock, organ failure, brain infection, and death. Newborn herpes infection is an uncommon complication of active genital herpes in the mother around the time of delivery or after direct contact with a herpes blister ("fever blister", "cold sore") of an infected caregiver. We reviewed five studies conducted to assess the effects of antiviral agents (medications that reduce the spread of virus in the body) on mortality and long‐term complications of herpes disease in the newborn. Antiviral agents were shown to reduce mortality from the condition, but the reduction was not statistically significant due to the small number of infants in the study. There was insufficient trial data to guide caregivers regarding the duration of antiviral therapy or dose.

Interventions for the prevention and treatment of herpes simplex virus in patients being treated for cancer

Treatment of cancer is increasingly effective, but associated with oral complications such as mucositis, fungal infections, bacterial infections and viral infections such as the herpes simplex virus (HSV). Oral complications can impact severely on quality of life and may lead to life‐threatening systemic infection. Infection with HSV can cause pain and blistering on or around the lips and within the mouth. Orofacial lesions are most commonly caused by HSV type 1. Aciclovir and other antiviral drugs such as valaciclovir, famiciclovir and penciclovir, have been widely used to treat HSV‐related conditions. Recurrent HSV type 1 infection in patients who are immunocompromised due to treatment for cancer may be more aggressive, painful and slower to heal. These more extensive lesions often require much longer treatment and leave the patient more susceptible to developing drug‐resistant strains of HSV. This review of 17 trials found evidence that aciclovir is efficacious in the prevention and treatment of HSV infections, in terms of preventing clinical/culture positive HSV infections, reduction in healing time, duration of viral shedding and relief of pain. There is no evidence that valaciclovir is more efficacious than aciclovir, or that a high dose of valaciclovir is better than a low dose of valaciclovir. There is evidence that for prevention, placebo is more efficacious than prostaglandin E. However, in all included trials, risk of bias is unclear. No trials reported on duration of hospital stay, amount of analgesia or patient quality of life.

Antiviral medicines, interferon, and corneal surface removal in the treatment of herpes simplex virus infection of the eye

We compared different treatments of people's eyes infected with herpes simplex virus (HSV).

See all (98)

Summaries for consumers

Antiviral agents for treatment of herpes simplex virus infection in neonates

The virus herpes simplex (herpes) causes a rare but devastating disease in the newborn that can range from skin and eye infection to shock, organ failure, brain infection, and death. Newborn herpes infection is an uncommon complication of active genital herpes in the mother around the time of delivery or after direct contact with a herpes blister ("fever blister", "cold sore") of an infected caregiver. We reviewed five studies conducted to assess the effects of antiviral agents (medications that reduce the spread of virus in the body) on mortality and long‐term complications of herpes disease in the newborn. Antiviral agents were shown to reduce mortality from the condition, but the reduction was not statistically significant due to the small number of infants in the study. There was insufficient trial data to guide caregivers regarding the duration of antiviral therapy or dose.

Interventions for the prevention and treatment of herpes simplex virus in patients being treated for cancer

Treatment of cancer is increasingly effective, but associated with oral complications such as mucositis, fungal infections, bacterial infections and viral infections such as the herpes simplex virus (HSV). Oral complications can impact severely on quality of life and may lead to life‐threatening systemic infection. Infection with HSV can cause pain and blistering on or around the lips and within the mouth. Orofacial lesions are most commonly caused by HSV type 1. Aciclovir and other antiviral drugs such as valaciclovir, famiciclovir and penciclovir, have been widely used to treat HSV‐related conditions. Recurrent HSV type 1 infection in patients who are immunocompromised due to treatment for cancer may be more aggressive, painful and slower to heal. These more extensive lesions often require much longer treatment and leave the patient more susceptible to developing drug‐resistant strains of HSV. This review of 17 trials found evidence that aciclovir is efficacious in the prevention and treatment of HSV infections, in terms of preventing clinical/culture positive HSV infections, reduction in healing time, duration of viral shedding and relief of pain. There is no evidence that valaciclovir is more efficacious than aciclovir, or that a high dose of valaciclovir is better than a low dose of valaciclovir. There is evidence that for prevention, placebo is more efficacious than prostaglandin E. However, in all included trials, risk of bias is unclear. No trials reported on duration of hospital stay, amount of analgesia or patient quality of life.

Antiviral medicines, interferon, and corneal surface removal in the treatment of herpes simplex virus infection of the eye

We compared different treatments of people's eyes infected with herpes simplex virus (HSV).

See all (23)

More about Oral Herpes

Photo of a young adult

Also called: Herpes labialis, Herpes simplex labialis, Fever blister, Orolabial herpes, Human herpesvirus 1, Herpes simplex virus 1, HHV 1, HSV 1

Other terms to know:
Antivirals, Herpes Simplex Viruses, Viruses

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