Acyclovir in recurrent herpes labialis

Justified as oral prophylaxis only in severely affected people

Recurrent herpes labialis is one of the most common skin complaints general practitioners see; in his meticulous record of all patients seen in his NHS practice Hodgkin estimated the incidence to be about 10 cases per 1000 patients seen per year.1

After the initial attack of herpes labialis, herpes simplex virus type 1 is thought to remain latent in the trigeminal ganglion and to be reactivated by various types of stress.2 Although things such as fever, upper respiratory tract infections, ultraviolet light, and psychological stress are thought to trigger recurrence, the condition is variable and unpredictable in most patients, as is the extent and duration of each attack.3 Recurrent attacks are usually shorter and less painful than the original attack.

The discovery of acyclovir seemed to offer great promise in the treatment of herpes labialis. Acyclovir acts as a substrate for the thymidine kinase …