Herpes, caused by the herpes simplex virus (HSV), is a common viral infection that can manifest as oral cold sores or genital lesions. While there is no cure for the virus itself, topical creams can significantly help manage outbreaks by reducing symptoms and speeding up the healing process. This article explores the various types of creams available to treat herpes outbreaks.
Antiviral Topical Treatments
Antiviral creams directly target the herpes simplex virus to inhibit its replication. These treatments are most effective when applied at the earliest signs of an outbreak, such as tingling, itching, or redness, before blisters fully develop. Early application can help shorten the duration and severity of an outbreak.
Prescription antiviral creams include acyclovir (Zovirax) and penciclovir (Denavir). Acyclovir cream, typically applied five times a day for four days, works by stopping the herpes virus from reproducing, potentially reducing outbreak length by about half a day. Penciclovir cream, usually applied every two hours while awake for four days, also inhibits viral DNA synthesis. Both are nucleoside analogs that interfere with viral replication.
Docosanol (Abreva) is the only over-the-counter (OTC) antiviral cream approved for cold sores. It works by preventing the virus from entering and replicating within healthy cells. Docosanol should be applied five times a day until the cold sore resolves, typically within 10 days, and is most effective when used within 12 hours of the first symptoms.
Symptomatic Relief and Protective Creams
Beyond antivirals, certain creams provide symptomatic relief by managing the discomfort associated with herpes outbreaks, rather than directly fighting the virus. These creams can help alleviate pain, reduce inflammation, and protect the affected skin. They do not treat the underlying viral infection.
Pain-relieving creams often contain local anesthetics like lidocaine or benzocaine. Lidocaine, for example, works by numbing the affected area, blocking nerve signals that transmit pain sensations to the brain. This provides temporary relief from pain and discomfort. These creams can be applied directly to the sores to reduce pain.
Protective creams and ointments, such as petroleum jelly or zinc oxide, create a barrier over the lesions. Petroleum jelly helps keep the area moisturized, prevent cracking, and reduce irritation, particularly when applied to genital sores to lessen discomfort during urination. Zinc oxide can help reduce the severity of blistering, soreness, itching, and tingling.
Hydrocortisone cream, a low-dose topical corticosteroid, can reduce inflammation, redness, and burning caused by an outbreak. While it can ease symptoms, hydrocortisone does not treat the virus and should be used cautiously as it may sometimes delay healing of viral lesions. Some combination creams, such as acyclovir/hydrocortisone, are available by prescription and have been shown to shorten healing time by addressing both the viral replication and the inflammatory response.
Best Practices for Application and When to Seek Professional Advice
Proper application of topical creams is important for effectiveness and preventing infection spread. Always wash hands thoroughly with soap and water before and after applying any cream. Apply a thin layer, ensuring it covers all lesions. Avoid touching other body parts or sharing applicators to prevent spreading the virus. For optimal results, apply antiviral creams at the very first sign of an outbreak, such as tingling or itching.
While topical treatments can provide significant relief, professional medical advice is necessary in certain situations. Consult a doctor for your first herpes outbreak or if diagnosis is uncertain. Seek medical attention for frequent or severe outbreaks, or if they do not respond to topical treatments.
Contact a healthcare provider if lesions appear near the eyes, as herpes can affect vision. Signs of a bacterial infection, such as pus, increased redness, swelling, fever, or worsening pain, warrant immediate medical consultation.
Topical creams are primarily for symptom management and do not cure herpes; systemic antiviral medications may be prescribed for more severe or frequent cases.