Herpes creams

Popular external remedies used in cases of skin lesions on the face and body caused by the Herpes simplex virus include herpes cream.

Indications for the use of such creams are inflammation of skin areas of various localizations (in particular, on the lips and in the nasolabial folds), caused by the herpes simplex viruses HSV-I, HSV-II and VZV (causing shingles).

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Pharmacodynamics of herpes creams

Herpes creams Acyclovir (Zovirax, Virolex, Acigerpin, Vivorax, Agerp, Lipster, Acik) are effective due to the fact that acyclovir has a great similarity with the structure of the guanine nucleotide of the DNA of the virus deoxyguanidine and can be built into its virion. When biochemically interacting with the enzyme of the virus thymidine kinase (ensuring the synthesis of viral DNA), acyclovir is converted into an active form - acyclovir triphosphate. It is this substance that causes a complete stop in the processes of DNA replication Herpes simplex.

The cream for herpes Fenistil Pencivir has the active substance penciclovir (ATC J05AB13), close to acyclovir, therefore its pharmacodynamics are similar.

The cream for herpes on the lips Epigen Labial contains glycyrrhizic acid (АТС A05BA08), which has a carboxyl group and blocks the processes of oxidative phosphorylation of proteins in virus-infected cells, inhibits the formation of ATP and anti-inflammatory prostaglandins in macrophages, increasing the activity of leukocytes and the capture of viral virions by phagocytes.

Pharmacokinetics

Since the creams for herpes Acyclovir (Zovirax, Virolex, Acigerpin, Vivorax, Agerp, Lipster, Acik) act locally, the pharmacokinetics characteristic of systemic use of acyclovir are not suitable for external agents and are not covered by manufacturers.

Although acyclovir is a poorly soluble substance, even when tablets containing it are taken orally, it has a low level of bioavailability (no more than 25%). And when acyclovir is administered intravenously, its binding to plasma proteins does not exceed 33%.

Thus, there is virtually no systemic absorption of acyclovir and penciclovir, which are part of the said creams. The pharmacokinetics are not presented in the instructions for Epigen Labial cream.

Names of creams for herpes

Today, it is considered that the best cream for herpes, that is, the most effective, contains acyclovir: 5% Acyclovir cream (based on propylene glycol). Identical ointments have a greasy base, and it should be noted that ointments are best used when crusts have already formed on the inflamed areas, and the cream is more easily absorbed, and it is more appropriate to use it at the initial stages of infection. See also - Treatment of simple herpes

Trade names of herpes creams, the active substance of which is acyclovir (ATC – J05AB01): Zovirax (GSK, UK), Virolex (KRKA, Slovenia), Acigerpin (Agio Pharmaceuticals, India), Vivorax (Cadila Pharmaceuticals, India), Agerp (Ukraine), Lipster (Ukraine), Acik (Sandoz, Switzerland).

Each of the named drugs can be used as a cream for genital herpes, that is, they also represent a cream for the labia for herpes.

There are herpes creams with a different composition (1% Fenistil Pencivir cream), Epigen Labial (Cheminova Internacional, Spain) - cream for herpes on the lips (herpes labialis). Some people use Spasatel cream or Chinese cream 999 PiYanPing Cream (Sanju Medical & Pharmaceutical Co) to treat herpes rashes on the skin, although neither of them is a cream for herpes on the body (see - Treatment of shingles ).

How to use creams for herpes

Herpes creams Acyclovir (Zovirax, Virolex, Acigerpin, Vivorax, Agerp, Lipster, Acic) should be applied to the affected area at least five times a day for four days in a row. Herpes cream on the lips Fenistil Pencivir is applied every two hours (also four days). Acyclovir for external use should not be applied to the mucous membranes of the mouth or vagina.

Epigen Labial cream is recommended to be used three to five times a day; the minimum duration of treatment is three days, but the course of therapy can be longer (until all symptoms disappear).

According to official instructions, overdoses of these drugs have not been observed. Also, their interactions with other drugs have not been noted.

The storage conditions for these creams are within the temperature range of +10–25°C, and the shelf life is three years (36 months).

About Rescuer Cream and Chinese Cream

Rescuer Cream (Forte) from a Polish manufacturer is a regenerating and bactericidal agent, which contains: oils (ghee, olive, sea buckthorn), turpentine oil (i.e. turpentine), beeswax, purified naphthalene, essential oils (lavender, rose and tea tree).

That is, according to the instructions, this is a product intended not for the treatment of herpes, but for the healing of various injuries and acute inflammations of the skin of traumatic origin (abrasions, superficial wounds, burns, hematomas), as well as sprains.

And although it is recommended to use it for inflammation of the mucous membranes, the presence of turpentine calls this statement into question: local products containing turpentine are irritants, and they should not be applied not only to mucous membranes, but also to any damaged tissue.

The Spasatel cream of Ukrainian production (Kievmedpreparat) contains a derivative of pantothenic acid (vitamin B5) dexpanthenol, which has anti-inflammatory, antipruritic and regenerating properties, as well as the antiseptic chlorhexidine.

As you can see, this is not a cream for herpes, but a remedy for the treatment of skin lesions, bedsores, infected eczema, as well as bullous dermatitis, trophic ulcers and boils.

Chinese cream 999 PiYanPing Cream (Sanju Medical & Pharmaceutical Co) is intended to relieve symptoms (in particular, itching) of neurodermatitis, contact and seborrheic dermatitis and chronic eczema. Its active ingredients are: synthetic glucocorticosteroid dexamethasone acetate, camphor and menthol. So this remedy is not an antiherpetic one.

We have described how the herpes cream works and how to use it, and information about ointments for this viral infection can be found in the publication - Ointment for cold sores: what, when and what to apply?

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Use during pregnancy

All manufacturers of these drugs note that during pregnancy, even local use of creams or ointments with acyclovir and Fenistil Pencivir cream with penciclovir is possible only under the condition that the expected benefit to the mother and fetus will significantly exceed their possible negative effects, especially with increased sensitivity of the pregnant woman to the components.

Regarding the use of Epigen Labial cream during pregnancy and lactation, its instructions indicate that this product can be used only according to absolute indications.

Also read – Herpes During Pregnancy

Contraindications to the use of creams for herpes

Creams for herpes with acyclovir, as well as with penciclovir, are contraindicated for use in case of hypersensitivity to these substances or other components. It is not recommended to use Acyclovir (and all synonymous drugs) and Fenistil Pencivir for children under 12 years of age. It is also not recommended to use them for the treatment of genital herpes.

Epigen Labial cream for herpes on the lips is also not used if there is increased sensitivity to its components.

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Side effects

Considering the minimal absorption of active substances (acyclovir and penciclovir) included in the composition of herpes creams, side effects most often manifest themselves in the form of rashes on the skin at the site of application, itching and burning, as well as slight pain in the treated area.

If any of the acyclovir-containing products are used as a cream for genital herpes, women may develop inflammation of the external genitalia (vulvitis).