Herpes on the lips - a chronic recurrent form of herpes, which is a consequence of infection with the herpes virus in early childhood. After a child has a primary herpetic infection - the herpes virus remains in the body for life, and is periodically activated, causing the formation of a herpetic eruption on the lips and skin around the mouth.
The very first case of herpes always occurs in the form of herpetic gingivostomatitis. In 90% of cases, the primary case of the disease is mild, and is usually taken by parents for teething symptoms. All repeated outbreaks of herpes most often appear on the lips, sometimes on the skin of the face and the oral mucosa.
Herpes on the lips: photo
In these photos, you can see examples of mild herpes. In some cases, herpetic eruptions can completely capture the entire surface of the lips, as well as the skin around the entire mouth. Children often have combined lesions when rashes appear simultaneously on the lips, in the mouth or around the eyes.
What does herpes look like on lips: photo
The fact that herpes occurs most often on the lips is not accidental. After the primary disease, the herpes simplex virus persists for life in the sensory and autonomic nerve ganglia (clusters of nerve cells). This is the reason why herpetic eruptions occur primarily where there is a large number of sensory nerve fibers. There are many of them on the lips, oral mucosa, and eye cornea.
Herpes on the lips: causes
Herpes simplex virus is one of the most common viruses acquired by humans. An interesting fact about herpes on the lips - the treatment of herpetic lesions is mentioned in manuscripts dating back thousands of years, but now we still suffer from this virus. There is a whole family of herpesviruses, but the herpes of the red lips Qais is caused only by the herpes simplex virus (types HSV-1 and HSV-2).
1. Causes of Primary Herpes -
When a child is born, antibodies to the herpes virus, obtained from the mother during pregnancy, are detected in his blood. While the titer of these antibodies is high enough, the disease does not occur, despite the fact that the child may already be infected with the herpes virus. Gradually, the number of maternal antibodies is reduced, and usually in the period of 6-24 months - the first outbreak of herpes occurs in a child.
How does the infection occur?
infection of the child in early childhood occurs through people who have contact with the child, as well as through the personal belongings of sick people. The most infectious are people whose herpes is at the stage of bursting or unbroken vesicles. However, infection of a child can occur even from a person without any clinical manifestations of herpes, for example -
- through kisses
- the use of single dishes and appliances for food,
- through the use of someone else's towels or personal items
- and even through touching the subjects touched by a person with active clinical manifestations of herpes.
2. The cause of repeated outbreaks of herpes -
During the initial contact with the cells, the herpes virus penetrates deep into the tissue, including nerve fibers. Spreading along the nerve fibers, the virus penetrates the nerve ganglia, in which it will be in an inactive dormant state all your life. Under the influence of adverse environmental factors, the virus will periodically activate and cause clinical manifestations.
Recurrent herpes on the lips: causes
- contact with a person with clinical manifestations of herpes,
- weakened immunity against the background of colds,
- weakened immunity in patients receiving steroids, chemotherapy, hepatitis ...
- excessive sun exposure, dehydration,
- stress and severe physical fatigue,
- abrasions, cuts, scratches on the skin and red border of the lips,
- dental and cosmetic procedures,
- during menstruation in women.
Herpes on the lip: symptoms
The important point is that after the activation of the virus, herpes sores do not appear immediately. At the very beginning, you may feel that itching, burning, redness or a feeling of bursting of tissues appeared on a certain part of the lip. Such symptoms always precede the stage of active herpetic eruptions, and this period is called the prodromal period of the disease.
For different people, this period can last from several hours to 1-2 days. Many patients ask: if herpes appeared on the lip than to heal quickly - and the answer is that effective rapid treatment is possible only when you start it already in this prodromal period (before the appearance of herpetic vesicles). And below we will recommend you a herpes ointment on the lips, the use of which during this period can sometimes even prevent the appearance of rashes.
Stages of active clinical manifestations -
At the very beginning of the development of the active phase of the disease, the patient notices that on that part of the red border of the lips (where itching and burning were), a slight swelling appeared. This is due to the fact that during this period the herpes virus begins to actively divide, which ends with the formation of herpetic vesicles. The fluid inside the vesicles is very contagious, and it is simply teeming with the herpes virus. That is why in no case can you squeeze out the bubbles, because this will lead to an increase in the area of the affected lip
At first, the bubbles are filled with a clear liquid, but gradually it becomes cloudy. After the appearance of swelling, herpetic vesicles appear almost immediately, and it usually takes about 2 days until their spontaneous opening. If you did not start the treatment of herpes right away, then it is very important to start it before opening the herpetic vesicles (ie, up to 48 hours after the onset of herpetic eruptions). Otherwise, the treatment will not lead to faster healing.
Usually on day 3, all the tiny bubbles burst and, when combined, create one big “wet ulcer” (Fig. 7). By the way, during this period of opening the vesicles, sometimes a slight increase in body temperature + an increase in submandibular lymph nodes may occur. Approximately for 4-6 day the surface of an ulceration becomes covered by crusts (fig. 8-10). This stage is still contagious, because from cracks in the crusts is still a fluid rich in virus.
After the inflammation subsides under the crusts, the red border of the lip gradually begins to recover, it occurs from 7 to 12 days. In no case can the crusts be torn off, because this can lead to both a new outbreak of herpes and a lengthening of the healing process (a wet ulcer reappears at the site of the removed crusts, which again becomes covered with a crust, under which healing will begin again).
The total duration of the outbreak of herpes on the lip (until the moment of complete epithelialization) is on average 12-13 days. However, when using classical remedies based on slightly outdated acyclovir, the duration of the disease is reduced to 8.5 days, which is confirmed by clinical studies. But the best remedy for herpes on the lips, which we describe below (provided that you started using it quickly) - can reduce this period to 6 days, and sometimes even prevent rashes.
How to treat herpes on the lips -
If there is herpes on the lip - the treatment is carried out by means of antiviral action. The course of treatment usually lasts 4 to 6 days, allowing you to shorten the duration of symptoms of the disease - pain and discomfort, as well as speed up the healing of the lips. The most pronounced result of treatment can be achieved if you begin treatment at the prodromal stage of the disease (see above), or within the first 12 hours after the onset of herpetic vesicles.
Consider that the treatment will be at least somehow effective only if it is started before 48 hours after the appearance of the rash. After this period and / or after the opening of herpetic vesicles - the use of antiviral cream or tablets will not allow you to somehow greatly affect the rate of healing. Below you will find a list of the best means for local application on the lips (in the form of ointment / cream), and also tell you what you can use herpes tablets on the lips in severe cases of the disease.
The best ointment for herpes on the lips -
Herpes on the lips - treatment is traditionally carried out with antiviral drugs used topically in the form of an ointment or cream containing Acyclovir or Penciclovir. Please note that different means have different efficacy - depending on the start of treatment. But in case of a severe course of herpes, antiviral drugs may already be required in the tab.
1. Cream Zovirax Duo-Aktiv (UK) -
We consider this herpes cream on lips as the best (for adults and teenagers from the age of 12). Zovirax Cream® Duo-Active is the original drug acyclovir. The drug contains a combination of 5% acyclovir and 1% hydrocortisone. Acyclovir blocks the reproduction of the virus, and hydrocortisone reduces inflammation and swelling. If the application of the cream begins even before the appearance of herpetic vesicles, hydrocortisone sometimes even allows you to prevent their formation.
If the application begins after the appearance of the rash - the presence of hydrocortisone will significantly reduce the healing time (compared with creams containing only acyclovir). Therefore, we believe that this is the best remedy for herpes on the lips of quick action. The cream also contains propylene glycol - to facilitate the penetration of acyclovir into virus-infected cells, as well as components that allow women to apply makeup after it has dried.
Another important advantage of a combination of acyclovir and hydrocortisone showed clinical studies. It turned out that the addition of hydrocortisone to acyclovir contributed to a decrease in the frequency of new outbreaks of herpes on the lips. However, such a decrease was significant only in those patients whose immunity was in a normal, unmitigated state (24stoma.ru).
apply a thin layer on the herpetic eruptions and the skin bordering with them 5 times a day (at intervals of about 4 hours) for 5 days. At Zovirax Duo-Aktiv, the price for a 2-gram tube is about 290 rubles. The important point - the cream will really have an excellent effect in the absence of resistance of your herpes virus to acyclovir. Most often, resistance occurs with weakened immunity and / or against the background of regular use of acyclovir in the past. In these cases, it is better to choose the cream Fenistil-Penzivir.
2. Cream Fenistil-Pentsivir (Switzerland) -
Fenistil-Penzivir cream contains penciclovir 1%, which is one of the best antiviral agents against herpes on the lips (much stronger than acyclovir). Penciclovir is a famciclovir derivative, i.e. one of the most powerful antiviral drugs. Can be used from 12 years. The peculiarity of the drug is that there are practically no resistant strains of the herpes virus, so it is effective even in cases when acyclovir does not help you.
An important point is that if acyclovir-based drugs are especially effective, only when you start using them in the first 12 hours after the appearance of the rash, then Fenistil-Pentsivir does not lose its effectiveness even at later periods. Those. if more than 12 hours have passed since the rash, and even more than 24 hours, it is better to purchase Fenistil-Pentzivir. The cream also contains polypropylene glycol and macrogol - to improve the penetration of penciclovir into virus-infected cells.
the only drawback of the drug is an inconvenient regimen, because cream should be applied every 2 hours (only 8 times during the day). However, the drug should be used usually only 4 days, because penciclovir has a long half-life of cells. Due to this, the antiviral effect of the cream is maintained even up to 2 days after the end of its application. The price of Fenistil-Pentsivir for a tube of 2 g will be from 350 rubles. Option cream with toning effect - from 430 rubles.
3. Cream Zovirax (UK) -
This is the original drug acyclovir in the form of 5% cream. Unlike Zovirax Duo-Active cream - regular Zovirax does not contain hydrocortisone and therefore it can be used without age limit. We repeat that Zovirax contains exactly the original formula of acyclovir, which guarantees high efficacy of the drug (provided that your herpes virus does not have resistance to acyclovir).
The preparation contains dimethicone, which allows, after drying, to apply cosmetics (for example, lipstick), as well as polypropylene glycol, which facilitates the penetration of acyclovir into the cells affected by the virus. The drug is used 5 times a day at intervals of 4 hours, usually within 5-6 days. The cost in pharmacies - from 190 rubles per tube 5 g.
More affordable drugs -
We immediately say that there are simply no alternatives to Fenistil-Pencivir or Zovirax Duo-Active, which contain penciclovir or acyclovir in combination with hydrocortisone - in Russian pharmacies. But there is a large group of creams and ointments that contain just 5% acyclovir.
The cheapest tool is 5% Acyclovir Akrikhin ointment. Its price is from 35 rubles. It should be noted that the ointment is much worse absorbed than the cream, which impairs the penetration of acyclovir through the skin epidermis. Therefore, choose the form in the form of a cream (for example, Acyclovir-Sandoz, Acyclovir-Belupo, Acyclovir-Hexal), the price of which starts from 70 rubles.
Herpes on the lips: treatment quickly in 1 day
Tablets of antiviral drugs, such as Valaciclovir or Famciclovir, can also be used to treat chronic recurrent herpes in adults. Compared with acyclovir, these drugs have a high bioavailability, a convenient regimen, and in addition to them there are practically no resistant strains of the herpes simplex virus. On the other hand, these drugs are more expensive and are not recommended for children.
- Valaciclovir -
Clinical studies have shown that a short 1 day course of taking high doses of valaciclovir is even more effective than a long course of usual average dosages. The best results of treatment of herpes on the lip were achieved when the drug was taken in 2000 mg twice a day (with an interval of 12 hours) - you only need to take the drug for 1 day.
Valtrex (UK) is the original drug of valaciclovir. Packing 10 tab. 500 mg - will cost you about 1250 rubles. However, there are cheaper generics. For example, Valaciclovir pharmaceutical company Canon-Pharma (Russia) costs from 420 rubles - for 10 tabs of 500 mg, which is just enough for a short 1 day course of therapy.
- Famciclovir -
This is one of the most effective and modern antiviral preparations for the herpes virus. Famciclovir, entering the body, turns into penciclovir there, i.e. is a preformed analogue of the cream Fenistil-Pentsivir. There are 2 variants of the regimen: 1) 1500 mg is drunk once, 2) 750 mg 2 times a day - with a 12 hour interval between doses.
The second method of administration is most effective. Famciclovir products are not so numerous, and usually only Famvir can be found in Russian pharmacies (Novartis, Switzerland). Packing 3 tab. 500 mg will cost you from 1400 rubles, which is enough for a short one-day course of therapy.
Important: The most effective treatment with these drugs will be if you start taking them either during the prodromal stage of the disease (when itching and tingling appear on the lip, but there are still no herpetic bubbles), or during the first 12 hours after the onset of herpetic eruptions. If these drugs are used at a later date (up to 72 hours), then their effectiveness, of course, will be lower. By the way, at a later date, the use of famciclovir would be preferable.
Can I use Acyclovir -
As for acyclovir tablets, the effective regimen of its administration is 400 mg 5 times a day, for 5 days. The dosage of 400 mg is the only effective in adults and children from 2 years of age. This, however, contradicts the official Russian instructions, where the dosage of 400 mg is prescribed only for severe cases, and the basic dosage is only 200 mg. Clinical studies (source) showed that the dosage of 200 mg has virtually no effect on the duration of the symptoms or on the healing time.
Medical organizations in the US and the UK do not recommend taking tab. acyclovir for the treatment of herpes on the lips in adult patients with chronic recurrent form of herpes, preferring valacyclovir and famciclovir. The fact is that resistance to acyclovir in immunocompromised patients and / or regular courses of using drugs with acyclovir in the past can reach from 10 to 27%, which often makes treatment with acyclovir simply ineffective.
Тем не менее в детской практике таблетированный Ацикловир является незаменимым препаратом, и достаточно хорошо работает, однако применять его стоит только при тяжелом течении вируса герпеса. For children under 2 years old, half the effective dosage of adults is usually used, i.e. 200 mg 5 times a day (for 5 days).
How to treat herpes on the lips of children -
When an outbreak of herpes on the lip occurs, it is important to examine the oral cavity of the child for the appearance of a herpetic stomatitis on the mucous membrane, since children often have associated lesions. The oral cavity must be examined very carefully, because rashes there can also be found on hard-to-reach surfaces — the lateral and lower surfaces of the tongue, the mucous membrane of the cheeks, on the inside of the lips, the tonsils, the soft palate
In the absence of damage to the oral cavity - shows the use of cream with Acyclovir 5%. It can be either an agent with an original acyclovir molecule (for example, Zovirax), or in any pharmacy there is a large selection of inexpensive generics for a reasonable 50-100 rubles. With severe damage to the lips and skin around the mouth - start taking Acyclovir tablets. For children under 2 years of age according to the scheme - 200 mg 5 times a day, 5 days. For children older than 2 years and adults - 400 mg 5 times a day, 5 days.
With a combination of herpes on the lips and oral mucosa, the strategy will be as follows. In young children with moderate severity of the disease - rashes on the oral mucosa are treated with Miramistin in the form of a spray and Holisalom. Lip rash - Aciclovir Cream 5%. To enhance therapy, you can use the drug Viferon in the form of candles. To relieve symptoms of intoxication - Nurofen syrup. With severe disease - all the same, only remove Viferon, replacing it with preformed Acyclovir.
Herpes on the lips during pregnancy -
How to treat herpes on the lips during pregnancy - everything is very simple and ordinary creams with 5% Acyclovir for external use are used to treat non-severe forms of herpes. It is possible to use even stronger Phenistil-Penzivir, but after consulting with a doctor (this remedy is better to choose if you usually have severe herpes outbreaks). Perhaps the use of tablets and forms of Acyclovir, but again only in severe cases, and only after the recommendations of the doctor.
Complications of Herpes -
1) One of the frequent complications of herpes on the lips is the spread of the virus to the eye area. Herpetic eye damage is usually caused by the fact that a sick person first rubbed his lip with herpes or spat on his fingers, and then rubbed his eyes with the same hand. Also, the spread of infection is possible while wiping with a towel. Small children are especially susceptible to this problem, and untimely treatment here can even lead to blindness.
2) No less often a complication in children - the spread of herpes on the oral mucosa. In adults, it is rare. The disease is called herpetic gingivostomatitis. Manifested by the formation of bubbles at first on the mucous membrane of the oral cavity, which burst with the formation of ulcerations (aft).
3 and 4) The consequence of herpes in the mouth of the mouth may be the appearance of a crack in the corner of the mouth (in this case, the crack should be treated with antifungal creams). And of course you should not engage in oral sex, because a consequence can be severe genital herpes with your partner.
Prevention of herpes on the lips -
Prevention of herpes on the lips includes:
- avoid direct contact with people who have herpes sores,
- wash your hands regularly
- wash towels and pillow cases on the pillow - after each use,
- do not use any personal belongings of a person who has become sick with herpes,
- if your lips become dry - use a moisturizing balm / cream,
- use a sunscreen or lip balm containing zinc oxide if you plan to stay in the sun for a long time.
For patients with severe recurrent outbreaks of herpes, you can use the vaccine "Vitagerpavak" (Russian-made; for the prevention of herpes simplex type 1 and 2). We can not say how effective it is, because large-scale independent studies have been conducted. The vaccine is available only in some clinics in Moscow and St. Petersburg. We hope that our article: Herpes on the lips treatment quickly and efficiently - turned out to be useful to you!
Author: dentist Kamensky K.V., 19 years experience.