Acute (primary) herpetic gingivostomatitis is when you 1st get an outbreak of herpetic lesions; this coincides with the 1st encounter of your body with the herpes virus. The majority of cases of primary herpetic gingivostomatitis occurs between the ages of 1 and 5. But know that as many as 80% of patients do not experience any symptoms.
The primary infection is the introductory phase to following recurrent infections, because the herpes virus, once in your bloodstream, it migrates on the involved nerve to a structure known as the sensory nerve ganglion, which is a group of nerve cells. There, the virus lays dormant; this is known as the latent phase, as opposed to the active phase where the virus produces symptoms. Reactivation, which occurs in approximately 40% of patients who harbor the herpes virus, leads to recurrent infection with shedding of HSV. Reactivation can happen spontaneously, or be induced by a number of factors including fatigue, stress, menstruation, and ultraviolet light.
Herpetic infections cannot be cured, not yet at least, so what we aim with treatment is to control symptoms and prevent outbreaks.
A person with an intact immune system usually recovers fully from a herpes outbreak within 1-2 weeks. Topical therapy, such as acyclovir 5% cream and ointment, penciclovir, and over-the-counter docosanol 10% cream are effective in shortening the time period to full recovery and the
duration of symptoms of recurrent herpes labialis.
Recurrent herpes labialis infection rarely requires systemic treatment with acyclovir tablets, although this mode of therapy may be effective in reducing the duration of symptoms of recurrent HSV-1 infection, but the optimal timing and dose of the treatment is not well established.
Some investigational therapies to shorten healing time and reduce pain and irritation include:
- Waveband light
- Rhubarb-sage based cream
- Zinc oxide/glycine combination cream
Famciclovir is another drug that has been shown to be as effective as acyclovir in preventing the appearance of new lesions, and the dosing of this drug is less frequent. The use of prophylactic acyclovir (to prevent outbreaks) is still controversial. Protecting the lips from ultraviolet exposure with sunscreen also is beneficial in preventing oral herpetic outbreaks.