Topical acyclovir is beneficial in recurrent herpes labialis

BMJ 1996;312:975 (13 April)

Letters

Topical acyclovir is beneficial in recurrent herpes labialis

EDITOR,--In his editorial on oral acyclovir in the managementof recurrent herpes labialis Graham Worrall understates theevidence for the efficacy of topical acyclovir cream.¹ One ofthe principal benefits of topical 5% acyclovir cream in recurrentherpes labialis is that it terminates the condition at the prodromalstage² in addition to resulting in more rapid healing and lesspain in those lesions that do develop.³ Further evidence tosupport the ability of the cream to prevent the developmentof recurrent herpes labialis past the prodromal stage comeswith the use of electronic infrared thermography as a reliable,non-invasive means of confirming the prodromal stage of thecondition.⁴ Preliminary results obtained with this method corroboratethe earlier clinical observations: normalisation of the thermographicprofile occurs when such early lesions are terminated at theprodromal stage by the cream.⁵ It therefore seems appropriateto evaluate the true benefit of topical acyclovir in the treatmentof recurrent herpes labialis before addressing the value oforal acyclovir.

Professor of oral medicine School of Clinical Dentistry, Queen'sUniversity of Belfast, Royal Victoria Hospital, Belfast BT126BP

P-J Lamey