Nerve Pain with Herpes
Herpes simplex is a viral disease from the herpesviridae family caused by both Herpes simplex virus type 1 (HSV-1) and type 2 (HSV-2). Infection with the herpes virus is categorized into one of several distinct disorders based on the site of infection. Oral herpes, the visible symptoms of which are colloquially called cold sores or fever blisters, is an infection of the face or mouth. Oral herpes is the most common form of infection. Genital herpes, known simply as herpes, is the second most common form of herpes. Other disorders such as herpetic whitlow, herpes gladiatorum, ocular herpes, cerebral herpes infection encephalitis, Mollaret’s meningitis, neonatal herpes, and possibly Bell’s palsy are all caused by herpes simplex viruses.
- Fever blisters
- Fever — especially during the first episode
- Genital lesions — there may first be a burning or tingling
- Blisters or ulcers — most often on the mouth, lips and
gums, or genitals
- Enlarged lymph nodes in the neck or groin (usually only at
the time of the initial infection)
There is no method to eradicate herpes virus from the body, but antiviral medications can reduce the frequency, duration, and severity of outbreaks. Analgesics such as ibuprofen and acetaminophen can reduce pain and fever. Topical anesthetic treatments such as prilocaine, lidocaine, benzocaine or tetracaine can also relieve itching and pain.
- Antiviral – The antiviral medication acyclovir
- There are several antivirals that are effective for treating herpes including: aciclovir (acyclovir), valaciclovir (valacyclovir), famciclovir, and penciclovir. Aciclovir was the first discovered and is now available in generic. Valacyclovir is also available as a generic.
- Evidence supports the use of aciclovir and valaciclovir in the treatment of herpes labialis as well as herpes infections in people with cancer. The evidence to support the use of acyclovir in primary herpetic gingivostomatitis is less strong.
Topical – A number of topical antivirals are effective for herpes labialis including acyclovir, penciclovir, and docosanol
- Alternative medicine – Certain dietary supplements and alternative remedies are claimed to be beneficial in the treatment of herpes. There is however insufficient evidence to support use of many of these compounds including echinacea, eleuthero, L-lysine, zinc, monolaurin bee products and aloe vera. While there are a number of small studies showing possible benefit from monolaurin, L-lysine, aspirin, lemon balm, topical zinc or licorice root cream in treatment, these are preliminary studies that have not been confirmed by higher quality randomized controlled studies.