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Herpes Labialis — SCE Dermatology MCQ

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ModerateCutaneous InfectionHerpes LabialisSCE Dermatology

A 28-year-old woman has recurrent cold sores (herpes labialis). She asks about suppressive antiviral therapy. According to guidelines, when is suppressive therapy indicated?

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Correct answer: C — For patients with ≥6 recurrences per year causing significant morbidity

Suppressive (prophylactic) antiviral therapy with oral Aciclovir 400 mg twice daily (or Valaciclovir 500 mg once daily) is indicated for patients with frequent recurrences (generally ≥6 per year) causing significant morbidity or psychosocial impact. Treatment is typically given for 6-12 months then reassessed. It reduces recurrence frequency by approximately 80%. Episodic treatment (oral Aciclovir at first prodromal symptoms for 5 days) is appropriate for less frequent recurrences. Suppressive therapy is also indicated before known triggers (e.g., cosmetic procedures on the lips, UV exposure). Topical Aciclovir cream alone is minimally effective.

Reference: BAD/BASHH 2014 HSV Guidelines; BNF