HSV Prophylaxis — SCE Dermatology MCQ
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Correct answer: B — Prophylactic oral Aciclovir or Valaciclovir starting 1-2 days before the procedure and continuing for 5-10 days after
Prophylactic oral Aciclovir (400 mg BD) or Valaciclovir (500 mg BD) starting 1-2 days before facial resurfacing procedures (chemical peels, laser resurfacing, dermabrasion) and continuing for 5-10 days after is recommended in patients with a history of orolabial HSV. This prevents potentially devastating HSV reactivation and dissemination in the denuded skin, which can cause widespread scarring, prolonged healing, and disfigurement. The recommendation applies regardless of the time since last cold sore — the virus remains latent in the trigeminal ganglion indefinitely. Some centres offer prophylaxis to ALL patients undergoing ablative facial procedures regardless of HSV history.
Reference: BAD Dermatological Surgery; BASHH