Definition
Herpes labialis is colloquially known as cold sores. It is an infection with the herpes simplex virus type I, which leads to painful small blisters around the nose and mouth, although other areas such as the eye or cheeks can also be affected. Lip herpes starts with a tingling sensation in the affected area and after a few hours a blister filled with clear fluid forms, which eventually bursts and crusts. Antiviral creams or gels should be used immediately at the first symptoms to contain the infection as quickly as possible and stop the fever blister from bursting.
Which ones are there?
In the meantime, a large number of creams for lip herpes are available on the market. One of the best known medicines for lip herpes is acyclovir. Creams containing the active ingredient acyclovir are available from Ratiopharm (Aciclovir-ratiopharm®), Dermapharm (Elac®) or Stada (Aciclostad ®), for example, and promise rapid relief from the symptoms.
Fenistil Pencivir® contains the antiviral penciclovir, which stops the spread of cold sores and ensures rapid healing of the painful blisters. Erazaban® cream contains the active ingredient docosanol and can be used to treat the early stages of cold sores, which accelerates the healing of the fever blister. Triapten® containing foscarnet is an antiviral cream, but experts advise against its use by lip herpes experts, as the ingredients can cause skin irritation and the active ingredient contained may be carcinogenic.
Tromantadin (Viru-Merz® Serol) is an antiviral agent used for recurrent herpes simplex infections, but should only be used in the early stages of lip herpes. There are also herbal-based lip herpes creams. Lomaherpan® from Lomapharm contains natural balm extract. Early treatment at the first sign of the disease is intended to stop the spread of the viruses, but there are no studies to date to prove its effectiveness. Ointments containing zinc can also be used to treat cold sores.
Which active ingredients are available?
The treatment of lip herpes is based on substances that inhibit the reproduction of the viruses, so-called antivirals. The most frequently used creams against cold sores contain acyclovir as the active ingredient. This is an antiviral drug that is particularly effective against herpes viruses by inhibiting the metabolism of infected cells and thus preventing the viruses from multiplying. Penciclovir stops the spread of the infection by also inhibiting the formation of new viruses in infected cells. The active ingredient docosanol inhibits the penetration of the virus into the cell and thus prevents the herpes viruses from multiplying.
Which cream works best?
The most important substances for the treatment of cold sores are acyclovir and penciclovir, which are recommended for self-medication. Both substances are characterized by a high efficacy and very good tolerability. Aciclovir was the first active ingredient used in the modern therapy of herpes simplex diseases and is now available under many trade names.
In order to have a positive effect on the course of the disease, Aciclovir should be used at an early stage, even before the actual blistering occurs. Penciclovir, on the other hand, can also be used at a more advanced stage, when a cold sore has already formed, and lead to accelerated healing. In general, however, all antiviral drugs work via a similar mechanism and can only stop the reproduction of the viruses, but not kill them.
Nevertheless, therapy with acyclovir and penciclovir promises rapid pain relief and accelerated crust formation. Prescription foscarnet sodium, which prevents viruses from entering the cells, has been available in Germany since 2008. However, therapy with this active ingredient is only recommended for patients who do not respond to treatment with the proven antivirals.
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