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.
Recently, due to the spread of infections of viral etiology, including respiratory viral diseases, the question arises: does chlorhexidine digluconate (CHB) have antiviral activity?
Chlorhexidine is used in the form of salts, mainly as bigluconate. CHB is most soluble in water and alcohols, and hence this form is used to make antimicrobial agents. CHB is a universal skin antiseptic that kills many pathogenic microorganisms, but is safe for humans. Currently, in clinical practice, CHB is preferred not only when treating the skin (hands, surgical field), but also as an oral antiseptic. The therapeutic activity and safety of CGB have been studied in dozens of international clinical studies. It is characterized by antimicrobial activity against gram-positive and gram-negative bacteria, fungi, and also negatively affects the causative agents of certain viral infections.
Many scientific papers have been published studying the antiviral activity of CGD. At the same time, some sources confirm the virucidal effect of CHB, while others question this effect in relation to some viruses.
Karpinski T.M. and Szkaradkiewicz AK in an article describing a wide range of pharmacological activity of CHB, indicate that under the influence of CHB, complex viruses surrounded by a lipoprotein shell (herpes simplex virus, HIV, influenza virus, cytomegalovirus) are quickly inactivated [1]. Wood A. and Payne D. in their study confirm the inactivating effect of chlorhexidine on herpes simplex virus type 1 and HIV type 1 [2].
In addition, Bernstein D. et al. in a study of the antiviral effectiveness of Peridex mouth rinse (in vitro), containing 0.12% CHB, they proved the virucidal activity of the drug against several viruses: herpes simplex (HSV), cytomegalovirus (CMV), influenza A, parainfluenza and hepatitis B (HBV) ) and the ineffectiveness of the drug against the polio virus [3]. Antiviral activity increased with increasing time of exposure of the drug to the mucous membranes of the oral cavity. Thus, it has been suggested that CGB exerts an antiviral effect by targeting the enveloped herpes simplex, influenza A, parainfluenza, hepatitis B, and cytomegalovirus viruses, but has no effect on the nonenveloped poliovirus.
CHB acts at the level of the cell membrane, increasing its permeability [4]. First of all, it destroys the capsid - the protein shell of the virus.
A new study conducted in 2022 confirmed the susceptibility of the SARS-CoV-2 virus to the effects of a 0.05% CHB solution. Viral culture testing showed that the SARS-CoV-2 virus was undetectable after a 5-minute incubation at room temperature (22°C). This conclusion was reached by scientists from the Medical University of Hong Kong, whose work was published in the scientific journal The Lancet Microbe [5].
Based on the above, we can conclude that CHB has a certain antiviral activity against complex (enveloped) viruses and is currently one of the main antiseptics in the range of drugs for treating the oral cavity, skin, and hands of medical personnel.
- Karpinski T.M., Szkaradkiewicz AK Chlorhexidine — Pharmaco-biological activity and application. European Review for Medical and Pharmacological Sciences, 2015; 19: 1321-1326.
- Wood A, Payne D. The action of three antiseptics/disinfectants against enveloped and non-enveloped viruses. J Hosp Infect 1998; 38: 283-295.
- Bernstein D., Schiff G., Echler G., Prince A., Feller M., Briner W. In vitro virucidal effectiveness of a 0.12%-chlorhexidine gluconate mouthrinse. J Dent Res. 1990 Mar; 69(3):874-6.
- Zverkov A.V., Zuzova A.P. Chlorhexidine: past, present and future of one of the main antiseptics. Scientific and practical journal “Clinical microbiology and antimicrobial chemotherapy”. – Smolensk: Interregional Association of Public Associations “Interregional Association for Clinical Microbiology and Antimicrobial Chemotherapy”, 2013. – T. 15, No. 4, pp. 279-285.
- Chin A., Chu J., Perera M. et al. Stability of SARS-CoV-2 in different environmental conditions. Lancet Microbe 2020; published online, April 02, 2022.
Technologist for drug development at Retinoids JSC Krot S.L.
Seal
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].
Lip massage after augmentation
It is strictly not recommended to massage your lips immediately after the procedure. This is fraught with infection. You must wait at least a day. It is better to slightly increase this period. However, in general, massage is beneficial. It will help the drug to be evenly distributed on the lips. As a result, the risk of unevenness will be significantly reduced. Additionally, this effect helps restore blood circulation. Overall, it will be possible to significantly shorten the healing period. It is better to massage after the swelling subsides. Until this moment, there is an active recovery period, and massage can cause harm.
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.
How to prevent getting genital herpes
People with outbreaks of genital herpes are highly contagious. During the active phase of the disease, any sexual contact should be avoided, especially if there are ulcers. Using a condom does not prevent the spread of the disease because not all sores are covered by a condom.
Although the likelihood of infection is greatest when ulcers are present, people who have had HS can always be contagious to some extent, even if they have received medical treatment. The virus can be activated and transmitted to a sexual partner even when the skin looks completely normal.
For this reason, safe sex practices (using a condom) should be practiced between outbreaks to reduce the risk of spreading the disease to a sexual partner. There is no vaccine to prevent genital herpes infection.
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.
Diagnosis of genital herpes
Which doctor should I see for genital herpes?
At the Yauza Clinical Hospital, this disease begins with a clinical examination by a specialized specialist (gynecologist or urologist), and is confirmed by laboratory tests. If necessary, consultation with related specialists (immunologist) is carried out.
What tests should be taken for genital herpes?
Laboratory diagnostics solves 2 problems:
- determine the presence of the herpes simplex virus or contact with it: to do this, study the blood, vaginal discharge, urethra, sperm, urine of the patient for the presence of antibodies to the herpes simplex virus, or particles of the virus itself;
- to prove the “involvement” of these rashes with genital herpes: material taken directly from blisters or ulcers is examined.
Also, to select effective therapy, it is necessary to accurately determine the type of pathogen - this question is answered by polymerase chain reaction (PCR).
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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.
Complications of GG
People with genital herpes face an increased risk of contracting and passing on other STDs. This is because the ulceration that occurs as a result of a herpes infection makes the skin and mucous membranes of the genitals more vulnerable to sexually transmitted infections. Patients with symptomatic HH face a 2-4 times higher risk of acquiring and transmitting HIV infection.
Complications are rare:
- In some cases, the infection can spread to other parts of the body, such as the liver and eyes, even to the lining around the brain, causing meningitis.
- 1% of patients with primary HH develop autonomic dysfunction with urinary retention, erectile dysfunction, constipation, and sensory loss. Sometimes (intermittent) catheterization is necessary over several weeks.
- Mild meningitis is relatively common in primary herpes (13-20%). Herpetic encephalitis occurs less frequently and has a mortality rate of about 70%.
- Neonatal herpes simplex may develop after vaginal delivery and may be accompanied by local infection (skin, eyes, or mouth), disseminated manifestation (visceral organs), or central manifestation (CNS).
Symptoms may be especially severe in people with weakened immune systems due to existing HIV infection or immunodeficiency. An infection that affects the eyes can lead to blindness. This occurs mainly in people with weak immune systems who have had the virus for a long time. With a weak immune system, herpes increases the risk of bacterial infections, which can lead to further complications.
Another possible complication affects pregnant women. During childbirth, women can pass the virus to their newborn. Women at risk for STIs often get tested in the early weeks of pregnancy to prevent complications. A pregnant woman with symptomatic genital herpes is at risk of miscarriage or premature birth.
The infection can be transmitted to the fetus, and the baby may develop neonatal herpes. The risk of complications is especially high if a woman contracts the infection in the last trimester of pregnancy. If she has active genital ulcers near the time of delivery, a cesarean section is usually recommended to avoid exposing the newborn to the virus.
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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.
Treatment of genital herpes during pregnancy
First of all, it should be noted that there is a group of antiviral drugs that can be used with complete safety for the developing fetus.
Indications for treatment:
- primary infection during pregnancy,
- relapses of the disease and
- prevention of relapses before childbirth.
Taking into account the possibility of an asymptomatic course of the disease during a relapse, it is necessary to conduct periodic examinations of the woman throughout pregnancy and, especially in the last weeks before childbirth.
By contacting the Clinical Hospital on Yauza, you are guaranteed to receive qualified advice from a specialized specialist, an accurate diagnosis of your condition, effective treatment of the identified disease, and prevention of exacerbations of genital herpes and its complications. Take care of your health - make an appointment with a gynecologist or urologist right now!
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.
Forecast and prevention of genital herpes
As a preventative measure to prevent primary infection of HS, it is recommended to use condoms during sex, especially during casual sexual intercourse. But you should know that the use of protective contraception does not reduce the risk of infection through microcracks and other damage in areas of the skin not covered by a condom. If you suspect the penetration of a virus, you can treat the skin with local antiseptic preparations.
GG is characterized by relapses with decreased immunity. To prevent the disease, you should adhere to the following recommendations:
- adhere to a healthy lifestyle;
- take vitamins;
- get enough rest and eat right;
- observe the rules of personal hygiene;
- the area of blisters and ulcers should be dry and clean to avoid infection;
- If symptoms appear, consult a doctor promptly.
People infected with this virus should try to avoid direct contact with others to protect them from infection. Avoid scratching or touching herpes lesions as this may spread the infection to other areas of the skin.
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