Localised lesions of herpes simplex have been treated with a variety of medications from zinc sulphate to iodoxuridine. Topical acyclovir—a drug that inhibits herpes virus DNA polymerase—is effective but only shortens the duration of illness by a day or so. It is useful in primary infection but should be used as soon as the patient is aware of symptoms.
Severe, recurrent, herpes simplex, or herpes zoster can be treated with oral or intravenous aciclovir as early in the course of the illness as possible. Ganciclovir is an alternative.
Secondary infection may require antiseptic soaks, such as 1/1000 potassium permanganate, or topical or systemic antibiotics.
Steroids (prednisolone 40-60 mg/day) given during the acute stage of herpes zoster may diminish pain and postherpetic neuralgia.
Rest and analgesics are recommended treatment for extensive herpes simplex or herpes zoster infections.
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