Currently, there are no cures or vaccines for the herpes simplex virus. However, avoiding precipitating factors, such as sunburn and stress, can help prevent additional outbreaks. There are established treatments available to help decrease healing time, reduce pain associated with the lesion, and in specific cases, suppress the recurrence of the virus.

• Nondrug therapy: Frequent hand washing will help reduce the spread of the virus to other parts of the body or to other people. Also, applying cool, moist compresses to the lesion may decrease pain and keep the lesion from drying and cracking.

• Over-the-counter (OTC) topical medications: Most topical OTC products provide symptomatic relief only; they do not decrease healing time. Using topical anesthetics that contain benzocaine (5%-20%), lidocaine (0.5%-4%), tetracaine (2%), or dibucaine (0.25%-1%) will help relieve burning, itching, and pain. The most commonly recommended products are Lipactin gel and Zilactin. It is important to keep in mind that these topical anesthetics have a short duration of action, usually only lasting 20-30 minutes. Skin protectants, such as allantoin, petrolatum, and dimethicone-containing products help keep the lesion moist and prevent cracking of the lesion. Sunscreen-containing lip balms may also help prevent additional outbreaks if the sun is a precipitating factor. For additional pain relief, using aspirin, ibuprofen (Advil), or acetaminophen (Tylenol) may be beneficial. These products should be used according to package directions.

Docosanol 10% cream (Abreva) is the only OTC topical product that is known to decrease healing time when applied at the first sign of recurrence (for example, the prodrome or tingling sensation). Docosanol is applied five times per day until the lesion is healed. Common side effects include rash and itching at the site of application.

• Prescription-strength topical medications: Treatment with topical acyclovir (Zovirax 5% cream) or penciclovir (Denavir 1% cream) will reduce healing time by approximately half a day and decrease pain associated with the lesion. Topical treatment is limited in its effectiveness because it has poor penetration to the site of replication of the virus, and therefore is restricted in its healing ability. Acyclovir cream should be applied five times per day for four days, and penciclovir cream should be applied every two hours while awake for four days. In August 2009, the FDA approved a cream containing acyclovir and a topical steroid, which reduces healing time by approximately one day.

• Oral prescription-strength medications: The current FDA-approved oral antiviral medications used in the treatment of herpes simplex virus in adults are acyclovir, valacyclovir (Valtrex), and famciclovir (Famvir). Famciclovir has not been tested in children with cold sores. These oral medications have been shown to decrease the duration of the outbreak, especially when started during the prodrome (symptom onset before the actual condition becomes fully evident). The medications are generally well tolerated with few side effects. Most common side effects include headache, nausea, and diarrhea. Treatment is only for one day with valacyclovir and famciclovir. Valacyclovir is given as 2 grams orally every 12 hours for one day, and famciclovir is given as 1,500 milligrams orally for one dose. Acyclovir is given as 400 mg orally five times per day for five days. Acyclovir, valacyclovir, and famciclovir are considered relatively safe and effective when used in pregnancy, although topical treatment would be preferred when appropriate. Acyclovir and valacyclovir have been used while breastfeeding. However, pregnant women and nursing mothers should contact their physician or pharmacist prior to using any medication.

People who have more than two outbreaks in four months, which significantly affect their daily lives, should consider chronic suppressive therapy. The FDA has approved the use of oral valacyclovir daily to prevent recurrence of the herpes simplex virus in people with normal immune systems and famciclovir in people with suppressed immune systems.

• Other treatment options: Lysine supplements, citrus bioflavonoids, lactobacillus acidophilus and bulgaricus, and vitamins C, E, and B12 have also been identified in the potential treatment of herpes simplex virus. However, there is no good clinical evidence to support these treatments, and they are not recommended.

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there is some new research from an Australian company called viradux.  Their website has some good info on this.  I am using theor anti herpetic crème an having good results.  Cheers!

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