New treatments for herpes are needed

Published 4:30 am Friday, December 1, 2017

DEAR DR. ROACH: I am wondering about oral herpes. Have there been any advances made for treating or preventing oral herpes?

I know about and use Abreva, but is there anything that works better? — L.P.

ANSWER: Herpes simplex virus type one is the cause of oral herpes, usually called “cold sores” or “fever blisters.” These often start as a clear fluid-filled blister on the lips or in the mouth. Many people carry the virus, and some people experience periodic outbreaks of these painful lesions.

Docosanol (Abreva) is an over-the-counter cream that prevents viral entry and replication of the virus.

Several, but not all, studies show that it is effective at speeding healing. However, it is not as effective as the prescription cream penciclovir at reducing the size and number of herpes lesions. Unfortunately, the cost of penciclovir cream is prohibitive for many, with a single 5-gram tube retailing for around $800 in the U.S. Another over-the-counter medication, benzalkonium (Viroxyn), was shown to be about as good as or better than Abreva at making cold sores go away faster, and it also contains an anesthetic to ease the pain.

We really need better treatments for this common, painful condition. There is hope for a vaccine in the future.