What is the treatment regimen for recurrent herpes labialis using Xerese (acyclovir and hydrocortisone)?

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From the Research

Xerese (acyclovir 5% and hydrocortisone 1% cream) is applied 5 times per day for 5 days to treat recurrent herpes labialis (cold sores). Treatment should begin at the earliest sign of a cold sore (during the prodrome or when redness first appears), ideally within 1 hour of symptom onset 1. Apply a thin layer to cover the affected area, including the outer margin of the lesion. Wash hands before and after application to prevent spreading the infection. The combination of acyclovir and hydrocortisone works through dual mechanisms: acyclovir inhibits viral DNA replication to reduce viral shedding and accelerate healing, while hydrocortisone decreases inflammation, reducing redness, swelling, and pain 2.

Key Considerations

  • For maximum effectiveness, patients should keep the medication readily available to start treatment immediately when symptoms begin, as early intervention significantly improves outcomes 3.
  • Avoid applying the medication in or near the eyes, and do not use it for more than 5 days per outbreak.
  • The treatment is well-tolerated in adolescents and adults, with minimal adverse events reported 4.
  • The use of Xerese has been shown to reduce the frequency of ulcerative and nonulcerative recurrences, shorten healing time, and decrease lesion size and tenderness 5.

Application and Dosage

  • Apply a thin layer of Xerese to the affected area, including the outer margin of the lesion, 5 times a day for 5 days.
  • Start treatment at the earliest sign of a cold sore, ideally within 1 hour of symptom onset.
  • Wash hands before and after application to prevent spreading the infection.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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