Combination treatment with famciclovir and a topical corticosteroid gel versus famciclovir alone for experimental ultraviolet radiation-induced herpes simplex labialis: A pilot study

To investigate the efficacy of corticosteroids for the treatment of herpes labialis, we compared famciclovir (Famvir, 500 mg 3x/day po [per os] for 5 days) and topical fluocinonide (0.05% Lidex Gel 3x/day for 5 days) with fam ciclovir and topical vehicle control for experimental ultraviolet radiation -induced herpetic recurrences. We irradiated 49 volunteers, and 29 (60%) of 48 developed signs or symptoms of a recurrence. They self-initiated treatm ent, and we were able to evaluate them. There was a trend in the combinatio n group toward more aborted lesions, compared with those who received antiv iral therapy alone (7 [41%] of 17 vs. 1 [8%] of 12; P = .09). Combination t herapy significantly reduced the median maximum lesion size (48 vs. 162 mm( 2); P = .02) and the number of patients who experienced lesion pain (10 [59 %] of 17 vs. 12 [100%] of 12; P = .02). Adverse events were minimal. Cortic osteroids in combination with an antiviral agent may be safe and beneficial for episodic treatment of herpes labialis. Larger studies are needed to co nfirm these findings.