Management of mild recurrences of oral mucocutaneous herpes in an immunocompetent patient
For immunocompetent patients with mild recurrences of oral mucocutaneous herpes, episodic antiviral therapy may reduce the duration of symptoms. Start treatment at the first sign of recurrence or during the prodromal stage. Use:
1aciclovir (adult and child) 5% cream topically, only on lesions on the skin around the mouth, 5 times daily (every 4 hours while awake) for 5 days1 aciclovir aciclovir aciclovir
OR
1famciclovir 1500 mg orally, as a single dose1. famciclovir famciclovir famciclovir
If lesions are inside the nose or mouth, oral famciclovir is recommended rather than aciclovir cream.
Using aciclovir cream for longer than 5 days has no additional benefit.
To reduce the risk of virus transmission, advise patients with an active HSV infection to avoid direct contact of the lesion with other people. Children who do not have control of oral secretions should be excluded from childcare and school. Barrier cream (eg petroleum jelly) applied to the lips can help prevent adhesionsThe Royal Children's Hospital (RCH), 2020.