Antiviral drugs for the treatment of herpes: we advise the buyer

Modern pharmaceutical consulting is not only a test of professional knowledge, but also a real test of the character of the leader. Many buyers are confident that they have a good understanding of medications, and from this position they communicate with a pharmacist or pharmacist. At the same time, they can take antibiotics “to prevent ARVI” or retell the most sophisticated advice from popular TV presenters. In such a situation, the chief administrator should, on the one hand, dispense the required over-the-counter drugs, on the other hand, warn the person about the danger of his misconceptions regarding drugs, and on the third, not take on the role of a doctor and not make a diagnosis based on symptoms. Confusion and misunderstanding can arise even over something as simple as a seasonal problem like orolabial herpes. Our “cheat sheets” are intended to help the pharmacist communicate with the client on this topic. With the season of winter infectious exacerbations on the rise, let’s remember once again what most often worries customers with requests for remedies for “colds on the lips.”

Give me some kind of alcohol tincture for colds on the lips - maybe calendula or boric alcohol

Applying alcohol solutions to lesions is a very controversial method. On the one hand, they, of course, dry and have an antiseptic effect. However, not a single tincture, as well as boric or salicylic alcohols, are active against the causative agents of “colds on the lips” - herpes simplex viruses. Moreover: these drugs contain ethyl alcohol in a fairly high concentration - up to 70%. When applied to damaged skin, irritation and even burns may occur, which will only worsen the situation. The pharmacy's assortment today includes products that act directly on herpes viral particles, preventing their reproduction and accelerating recovery. It is these drugs that are considered the “first line” for the treatment of herpes on the lips.

Causes of herpes

Herpes simplex virus type 1 (HSV-1) can be transmitted through household contact. Airborne transmission is also possible.

The airborne route is the main route of infection with the varicella zoster virus.

Genital herpes and cytomegalovirus are transmitted sexually.

You can also become infected with herpes through blood or saliva. The virus can be transmitted through saliva through kissing. Small children who put things in their mouths every now and then are also very vulnerable. If at least one child in a children's group is infected, a rapid spread of the infection can be expected.

All medicines against herpes on the lips are the same, give me something cheaper

Indeed, many drugs intended for the treatment of orolabial herpes contain the same active substance. Most often this antiviral drug is acyclovir, less often - penciclovir. However, there are means that have characteristic differences. For example, one of the creams, along with acyclovir, contains hydrocortisone. This remedy, unlike single drugs, simultaneously prevents the formation of new rash components and shortens the healing time of existing rashes, reducing the severity of the inflammatory reaction and itching [2].

Pain during contouring - myth or reality?

Thanks to unscrupulous players in the beauty market, potential clients have the impression that lip correction using fillers is a pleasant and painless procedure. But in reality this is absolutely not the case. Even the use of special anesthetic gels does not relieve pain. Subcutaneous manipulation with a needle is, to put it mildly, unpleasant, especially on such a sensitive area as the lips. Even those who have a fairly high pain threshold experience discomfort.

Manufacturers of lidocaine fillers claim that their solutions can reduce sensitivity by 35–40%. Cosmetologists also talk about positive experiences and slight swelling. But stories about serious complications that arise specifically from lidocaine-containing drugs are regularly covered in the media. Although we are mostly talking about overdoses or violations of sanitary standards.

An initial consultation with your doctor before the procedure is a wise thing to do. It is necessary to discuss with a specialist the selection of the drug, execution technique and contraindications. The doctor will take into account the individual characteristics of your body. This will help reduce the risk of side effects and eliminate allergic reactions.

I heard that there are some very effective pills against herpes on the lips. This is true?

Indeed, there are antiviral drugs for the treatment of herpes intended for oral administration. Today, three oral drugs in this group are used - acyclovir, valacyclovir and famciclovir. Penetrating inside a cell infected with the herpes virus, they block DNA synthesis and stop the reproduction of the pathogen. All oral antiviral drugs are available only with a doctor's prescription.

Local forms remain over-the-counter: ointments, gels or creams. For recurrent colds on the lips, it is advisable to use these drugs, since they are practically not absorbed into the bloodstream and do not have a systemic effect.

Drugs against herpes on the lips in tablets can be prescribed in cases where relapses occur very often. This happens, for example, when the immune system is malfunctioning. If you keep having recurrent cold sores, you'd better see a doctor. He will find out why your immune system is not doing its job and may prescribe an oral antiviral medication for herpes.

Classification of viruses

According to the existing international classification, primary and recurrent genital herpes . The latter, in turn, is divided into typical and atypical clinical forms and asymptomatic viral shedding.

The term “genital herpes” arose at the beginning of the 20th century. to designate the lesion on the skin and mucous membranes of the external genitalia. With the development of virological research methods, information about “atypical” forms of the disease began to appear. The diagnosis “atypical form of genital herpes” is made by gynecologists to designate a chronic inflammatory process of the internal genitalia (colpitis, vulvovaginitis, endocervicitis, etc.) in the presence of a laboratory confirmed herpetic nature of the disease, in contrast to the “typical” picture of the disease, in which on the mucous membrane These organs have lesions with vesicular-erosive elements. At the same time, herpetic lesions of the urethra, anal area and rectal ampulla fall out of this group, although these organs are anatomically and functionally closely related to the genital area.

Research conducted at the Herpetic Center has shown that diagnosing the HSV virus is now complicated due to the fact that in 65% of cases the disease is atypical.

I caught a cold, and lo and behold, my lips were covered. Give me some tea for colds

You are confusing two completely different infections - respiratory and herpes. A cold, or ARVI, develops when the body is infected with respiratory viruses. But a “cold on the lips,” or a relapse of orolabial herpes, appears when the herpes simplex viruses, which live in the body constantly, are activated. Therefore, when itching or rash appears on the lips, traditional cold remedies are not effective: they only act on the symptoms of acute respiratory viral infections or respiratory viruses. In the case of “cold lips,” it is advisable to use antiviral drugs that are active against herpes simplex pathogens.

How long does the virus live?

Fully formed and ready for subsequent reproduction, “daughter” infectious virions appear inside the infected cell after 10 hours, and their number becomes maximum after 15 hours. During its entire life, the primary (“mother”) viral particle reproduces from 10 to 100 “daughter” ones. viral particles, and 1 ml of the contents of a herpetic vesicle contains from 1000 to 10 million viral particles. Virions are extremely thermostable - they are inactivated (destroyed) at 50-52 degrees for 30 minutes, at 37.5 degrees for 20 hours, stable at 70 degrees, and remain in tissues for a long time. On metal surfaces (coins, door handles, water taps) it survives for 2 hours, on plastic and wood - up to 3 hours, in damp medical cotton wool and gauze during the entire drying time at room temperature (up to 6 hours). A unique biological property of viruses is the lifelong preservation of viruses in a modified form in the nerve cells of the regional (relative to the site of virus introduction) ganglia of sensory nerves. The most active herpes simplex viruses (labial and genital) in this regard, the least active are the Epstein-Barr virus.

All known varieties of viruses are capable of recurrence . For example, recurrence of infections caused by the herpes simplex virus is often observed against the background of stress, nonspecific endocrine disorders, changes in the geographic area of residence, increased solar radiation, etc. Asymptomatic relapses of cytomegalovirus infection are most often observed in pregnant women and patients receiving immunosuppressive and hormonal therapy . In general, herpetic infections take a recurrent course in no more than 8-20% of patients with obvious malfunctions of the immune system.

Herpes viruses can lead to infection of the fetus during pregnancy. Pregnancy is very often a physiological immunosuppressive factor (there is a natural decrease in immunity). In the cervical canal of pregnant women, the risk of intrauterine infection of the fetus, as well as infection of the child during childbirth, significantly increases. The virus is the most common sexually transmitted infection in pregnant women. Therefore, before an expected pregnancy, we recommend that expectant mothers be examined for the presence of herpes simplex virus and cytomegalovirus infection on the mucous membranes of the genital organs, determine the presence and level of antibodies to these viruses, and, if necessary, receive a course of preventive treatment.

Organs and systems of the body that can be affected by the herpes simplex virus and the diseases it causes:

Optic tract (keratitis, iridocyclitis, chorioretinitis, optic neuritis, phlebothrombosis)
ENT organs (pharyngitis, “herpetic sore throat”, laryngitis, external ear, sudden deafness, vestibular disorders)
Oral organs (stomatitis, gingivitis)
Skin and mucous membranes (face, lips, genital herpes, etc.)
Lungs (bronchopneumonia)
Cardiovascular system (myocarditis, myocardiopathy, participation of HSV in the processes underlying atherosclerosis)
Gastrointestinal tract (hepatitis, ileo-colitis, proctitis)
Female genital organs (colpitis, intrauterine HSV infection: endometritis, amnionitis, chorionitis, metroendometritis, reproductive dysfunction)
Male genital organs (prostatitis, urethritis, sperm damage)
CNS (encephalitis, sympathoglioneuritis, nerve plexus damage)
Psycho-emotional sphere (depression, aggravating influence of HSV on the course of hydrocyanic dementia and nuclear schizophrenia)
Lymphatic system (HSV lymphadenopathy)

Recommend some remedy for cold sore lips for a pregnant woman

Unfortunately, first-line drugs for the treatment of exacerbations of orolabial herpes are indicated for use during pregnancy only if the benefit to the mother outweighs the risk to the fetus and child [2]. Expectant mothers can be encouraged to use a lip balm or cream with a UV filter - it protects the skin of the lips from the negative effects of ultraviolet radiation, which is considered one of the triggers for relapses of herpes. Additionally, I would recommend lip moisturizers to prevent dry skin.

Prevention methods

What is herpes - it is a viral disease. It is transmitted by using other people's things, kissing, and unprotected contact. Preventive measures are aimed at preventing infection with the virus:

Wash dishes thoroughly after other people.
Do not take other people's towels, combs, toothbrushes and other personal hygiene items.
Women should not use other people's lipsticks, glosses, or balms.
Avoid touching your face and groin area with unwashed hands.
Damage to the skin must be treated with disinfectants.
Take vitamins regularly to strengthen your immune system.
Avoid unprotected sexual contact with strangers.

When in contact with people who have visible symptoms of herpes, the risk of becoming infected is higher. But even if a person is a hidden carrier of the infection, he can become infected. Therefore, you need to follow the rules of personal hygiene.

Recommend something effective to get rid of this herpes once and for all

Unfortunately this is not possible. Once entering the body - most often this happens in childhood - herpes simplex viruses never leave it. They penetrate the nerve ganglia of the trigeminal nerve and migrate from them only during relapses, and then return again to the zone of permanent “dislocation”. Activation of the infection occurs against the background of a number of risk factors, or triggers. They can be: fever, stress, fatigue, hormonal changes, respiratory infections, etc. By the way, with age, the frequency of relapses of orolabial herpes decreases.

There is no remedy that would allow you to get rid of herpes infection at once. However, there are drugs that alleviate the condition during the activation of the disease and speed up recovery. These are primarily acyclovir-based products that block the proliferation of herpes viruses. Acyclovir ointments and creams are the drugs of choice for recurrent colds on the lips, having an optimal balance of effectiveness and safety.

Forms of herpetic infection

There are several forms of herpes infection. The bullous form of herpes is characterized by the appearance of blisters that can reach the size of a plum. The abortive form occurs without the formation of a blistering rash, and at the site of the lesion there is swelling and small cone-shaped elevations above the surface of the skin or mucous membranes. The most severe forms of herpes are ulcerative, ulcerative-necrotic and gangrenous. They are characterized by the appearance of vesicles with hemorrhagic contents, the appearance of long-term non-healing deep ulcers that leave scars. The development of the gangrenous form occurs in people weakened by any diseases, as well as in elderly patients with gastric ulcers, diabetes mellitus and other concomitant pathologies.

I always bought ointment with acyclovir for herpes on the lips. Maybe there is something more modern now?

Acyclovir is truly a drug with “experience”: it was synthesized back in 1977 [4]. In those years, it was an innovative drug that offered a unique opportunity to control herpes infection. Today it remains one of the most popular remedies against herpes, although, of course, it has competitors. However, it cannot be said that they have any significant advantages compared to acyclovir.

Thus, the only alternative to local forms of acyclovir, penciclovir, which is also available in the form of an ointment, has a structure and mechanism of action similar to the parent of the group. Research results indicate that 1% penciclovir is as effective for cold sores as 3% acyclovir [5]. However, if acyclovir is applied 5 times a day, then penciclovir should be used a little more often - every 2 hours. Whether it makes sense to change the drug is up to you to decide.

Treatment methods

There is no single way to quickly cure the virus: herpes occurs differently in different people. The treatment method depends on the strain, location of the affected area and other factors. At Polyclinic +1, doctors select a suitable herpes treatment regimen for each patient. Comprehensive treatment of infection with drugs prescribed by a doctor gives quick results.

Creams and ointments

The most popular drug is Acyclovir. It is available in the form of a cream or ointment with an active ingredient content of 5%: Acyclovir-Sandoz, Zovirax, Acyclovir-hexal. For treatment, it is better to use creams rather than ointments. Creams are better absorbed into the affected areas. The drugs must be applied to the affected area five times a day for seven days.

Despite its prevalence, acyclovir is considered an obsolete drug. It copes poorly with relapses of the disease, eliminates symptoms, but does not suppress the virus inside the body. In 30% of patients, treatment with acyclovir does not produce results.

A more modern drug is penciclovir. Fenistil Pentsivir is manufactured on its basis. This cream contains propylene glycol + cetomacrogol. They accelerate the penetration of the active substance into the skin. Only 0.2% of strains are resistant to Fenistil Penciclovir. The reproduction of the herpes virus stops on the second day after applying the cream, making the healing process faster. But the drug has a drawback: it is not suitable for children under twelve years of age.

Pills

When a treatment regimen for herpes in adults is drawn up, drugs can be prescribed in tablet form. The use of potent tablets is permitted for the treatment of adolescents over twelve years of age. When treating young children, parents should use the Viferon ointments and suppositories listed above.

The action of acyclovir in tablets is similar to the action of the ointment of the same name. The tableted drug is inexpensive and available in almost every pharmacy. It is approved for use in the treatment of children under twelve years of age.

Valaciclovir is used to synthesize acyclovir. It is contained in the drug Valtrex. When the tablet enters the body, valacyclovir is converted to acyclovir. This technique increases the concentration of the drug in the body. The effect of taking valacyclovir can be compared with intravenous administration of acyclovir. It is suitable for people with normal immunity.

Famciclovir is the most effective medicine for herpes. After administration, famciclovir is almost completely absorbed and quickly turns into active penciclovir, which allows you to get rid of symptoms and suppress the activity of the herpes virus. Famciclovir is contained in the drugs Famvir and Favirox. A single dose of three tablets is allowed to quickly stop inflammation. Famciclovir is suitable for adults with weak immune systems.

Folk recipes

Traditional recipes help eliminate the symptoms of the disease, but do not fight the herpes virus as the cause. Here are examples of common recipes:

Apply lemon balm essential oil to the affected area every two hours.
Lubricate the area of inflammation with Kalanchoe juice three times a day.
The affected area can be lubricated with crushed garlic cloves three times a day. If garlic causes a burning sensation, you should choose a different recipe.
A mixture of bee honey and apple cider vinegar, taken in a ratio of 1 to 1, can be applied to the inflamed area. Treat the skin three times a day.

We do not recommend treatment solely according to traditional recipes. To eliminate symptoms and suppress the activity of the herpes virus, use medications prescribed by an experienced doctor.

Symptoms of herpes simplex infection

There are few signs of herpes, but they are all very characteristic. Therefore, difficulties in differential diagnosis almost never arise.

The main symptoms of infection with herpes simplex, which is the most common form of herpetic lesions, are as follows:

painful tissue swelling appears in the affected area;
after 1-2 days it transforms into a denser infiltrate;
the infiltrate turns into a bubble with liquid;
the blister bursts and a painful ulcer forms in its place;
the ulceration dries out and is covered with a new layer of epithelium - the wound heals.

The way lips look after herpes is the same as after any other skin disease: the swelling disappears, but the ulcer cannot heal for some time. It is covered with a yellowish film that constantly “peels off” from the wound surface, thereby exposing the wound and delaying the process of epithelial regeneration at the site of the lesion.

Possible complications

The herpes virus should not be perceived as an unpleasant but harmless “sore.” This is a rather insidious disease that poses a particular danger to pregnant women, infants and people with weakened immune systems (patients with cancer, people with HIV and AIDS).

The virus is not limited to superficial tissues - it easily penetrates into internal ones. The main targets of herpes are the mucous membranes, skin, eyes (conjunctivitis can also be a consequence of herpes), as well as the central nervous system and brain. Lymph nodes and internal organs can be affected by the virus. Due to the fault of the pathogenic microorganism, the functioning of the liver, lungs, intestines and kidneys can be disrupted.

The consequences of herpes can be stomatitis, infertility, miscarriage, congenital deformities in children, encephalitis, inflammation in the joints, prostatitis, benign and malignant tumors. Scientists, based on research, associate the development of multiple sclerosis and Alzheimer's disease with herpes.

If a person’s immune system is weakened, other infections, both viral and bacterial, can “join” herpes, and this, in turn, puts an increased burden on the heart.

Fibrosis and compaction - complications after lip contouring

In the first days after the injection of fillers, lumps may appear at the injection site, this is due to the fact that the substance has not yet had time to distribute evenly. Sometimes it happens that a hematoma (bruise) appears due to damage to a vessel. Within a week, it usually resolves, but if the cause of the lump is fibrosis, then the situation is much more complicated and requires your close attention.

Why does fibrosis occur?

The distribution of fillers in the lip occurs gradually, and the effect can last up to 12 months. Immediately after administration of the drug and during the first week, balls are felt under the skin, which dissolve on their own. Clots are nothing more than drops of filler, which is quite natural. Fibrosis is an unpleasant complication when connective tissue grows with the appearance of scar changes.

One of the obvious reasons for the formation of fibrosis is the rejection of a foreign substance by the body . In this case, a well-chosen injection solution can solve this issue. But only a professional cosmetologist can determine the dosage and prescribe the necessary drug that will not aggravate the situation. The doctor will also tell you what care is suitable after lip contouring in your case.

Unobvious reasons for the formation of fibrosis include:

inexperience of the cosmetologist;
violation of sanitary norms and rules;
mechanical damage to the walls of blood vessels;
counterfeit or low-quality filler;
violation of the technology and technique of drug administration;
incorrectly selected dose of the administered substance.

Rehabilitation after lip contouring

Fibrous changes after filler injection can occur anywhere on the face, but a particularly favorite area for localization of compactions is the upper lip. This is due to the fact that the skin here is extremely sensitive, delicate and thin. Swelling may not even arise from the filler, but simply from trauma to the skin with a needle.

Seals on the lips cannot be corrected with makeup. Fibrosis is noticeable to the naked eye, and you won’t be able to hide lumps with lipstick and gloss; rather, on the contrary, you only focus attention on this area. It is possible to get rid of fibrosis in one of two ways: surgical or conservative. In the first case, surgical intervention will be required, and in the second, an external agent with collagenase enzymes. The operation is an extreme measure, which is usually used to extract biogel; most often, gentle methods can be used.