From the Guidelines
HSV lesions do not have to crust over before applying a topical emollient, and in fact, applying a gentle emollient can help soothe discomfort and prevent cracking of the lesions. When managing HSV lesions, it's essential to prioritize measures that promote healing, reduce discomfort, and prevent complications. Applying a topical emollient can be beneficial in achieving these goals. According to the European guidelines of care for congenital ichthyoses, emollients are recommended to decrease transepithelial water loss (TEWL) and can be applied three to eight times a day 1. For HSV lesions, a gentle, fragrance-free emollient like petroleum jelly (Vaseline) or a moisturizing ointment can be used.
- Key considerations when applying emollients to HSV lesions include:
- Using clean hands or a cotton swab to avoid spreading the virus to other areas
- Applying a thin layer of emollient 2-3 times daily to keep the area moisturized
- Avoiding active substances like urea, salicylic acid, or silver sulfadiazine due to the risk of percutaneous absorption 1
- Continuing any prescribed antiviral medications as directed by a healthcare provider
- Emollients work by creating a protective barrier that helps retain moisture and can reduce friction on the sensitive lesions. If the lesions worsen, become infected, or if severe pain, fever, or spreading of the outbreak occurs, seeking medical attention promptly is crucial.
From the Research
HSV Lesions and Topical Emollients
- There is no direct evidence in the provided studies to suggest that HSV lesions must crust over before applying a topical emollient 2, 3, 4, 5, 6.
- The studies primarily focus on the antiviral activity, pharmacokinetic properties, and therapeutic efficacy of valacyclovir and other antiviral agents in treating herpes simplex and herpes zoster infections.
- However, one study mentions the management of oral and perioral herpes simplex virus infections, including the use of topical and systemic therapies to accelerate healing and decrease symptoms associated with lesions 5.
- Another study discusses alternative anti-HSV agents from natural products, including marine organisms, but does not specifically address the use of topical emollients on HSV lesions 6.
Treatment of HSV Infections
- The provided studies suggest that valacyclovir is an effective treatment for herpes simplex and herpes zoster infections, with benefits including reduced duration of viral shedding, hastened lesion healing, and decreased lesion-associated pain 2, 3, 4.
- Valacyclovir has been shown to be at least as effective as acyclovir in treating genital herpes and herpes zoster, with the added convenience of a simpler dosing regimen 3, 4.
- However, none of the studies provide guidance on the use of topical emollients on HSV lesions, and it is unclear whether crusting over is a necessary step before applying such treatments.