Cochrane · systematic review · CD010095
Interventions for prevention of herpes simplex labialis (cold sores on the lips)
Chi, CC, Wang, SH, Delamere, FM, et al. · Cochrane Database of Systematic Reviews · 2015 · Cochrane Library
SkinAMSTAR 2: not assessed
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
72
current version
GRADE rated
72
No studies
0
Included studies
NR
No studies 0 · 0%Ungraded 0 · 0%Very low 20 · 27.8%Low 18 · 25%Moderate 34 · 47.2%High 0 · 0%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
Oral aciclovir (short‐term) compared with placebo for prevention of herpes simplex labialis
Population: participants with recurrent herpes simplex labialis (cold sores on the lips)
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Incidence of herpes labialis during use of the preventative intervention (by clinical evaluation) ‐ aciclovir 800 mg twice daily Oral aciclovir (short‐term) vs placebo | RR 1.08 [0.62, 1.87] | 1 study · 237 participants | Moderate Downgraded: risk of bias, imprecision |
Incidence of herpes labialis during use of the preventative intervention (by clinical evaluation) ‐ aciclovir 400 mg twice daily Oral aciclovir (short‐term) vs placebo | RR 0.26 [0.13, 0.51] | 2 studies · 177 participants | Low Downgraded: risk of bias, imprecision |
Incidence of herpes labialis during use of the preventative intervention (by clinical evaluation) ‐ aciclovir 200 mg 5 times/day Oral aciclovir (short‐term) vs placebo | RR 0.46 [0.2, 1.07] | 1 study · 66 participants | Low Downgraded: risk of bias, imprecision |
Incidence of herpes labialis during use of the preventative intervention (by culture) ‐ aciclovir 400 mg twice daily Oral aciclovir (short‐term) vs placebo | RR 0.05 [0, 0.7] | 1 study · 30 participants | Low Downgraded: risk of bias, imprecision |
Adverse effects during use of the preventative intervention ‐ aciclovir 800 mg twice daily Oral aciclovir (short‐term) vs placebo | RR 0.98 [0.7, 1.38] | 1 study · 239 participants | Moderate Downgraded: risk of bias, imprecision |
Adverse effects during use of the preventative intervention ‐ aciclovir 400 mg twice daily Oral aciclovir (short‐term) vs placebo | RR 2.3 [0.62, 8.58] | 2 studies · 183 participants | Low Downgraded: risk of bias, imprecision |
Oral aciclovir (long‐term) compared with placebo for prevention of herpes simplex labialis
Population: participants with recurrent herpes simplex labialis
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Incidence of herpes labialis during use of the preventative intervention (by culture) Oral aciclovir (long‐term) vs placebo | no estimate extracted | 1 study · 40 participants | Low Downgraded: risk of bias, imprecision |
Incidence of herpes labialis during use of the preventative intervention (by clinical evaluation) Oral aciclovir (long‐term) vs placebo | no estimate extracted | 1 study · 40 participants | Low Downgraded: risk of bias, imprecision |
Duration of attack of herpes labialis during use of the preventative intervention Oral aciclovir (long‐term) vs placebo | no estimate extracted | 1 study · 40 participants | Low Downgraded: risk of bias, imprecision |
Rate of adherence to the regimen of the preventative intervention Oral aciclovir (long‐term) vs placebo | no estimate extracted | 1 study · 40 participants | Low Downgraded: risk of bias, imprecision |
Valaciclovir (short‐term) compared with placebo for prevention of herpes simplex labialis
Population: participants with recurrent herpes simplex labialis
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Incidence of HSL during use of the preventative intervention (by clinical evaluation) Valaciclovir (short‐term) vs placebo | RR 0.55 [0.23, 1.28] | 1 study · 125 participants | Moderate Downgraded: imprecision |
Incidence of HSL during use of the preventative intervention (by culture) Valaciclovir (short‐term) vs placebo | RR 0.47 [0.21, 1.08] | 1 study · 125 participants | Moderate Downgraded: imprecision |
Adverse effects during use of the preventative intervention Valaciclovir (short‐term) vs placebo | RR 1.33 [0.71, 2.5] | 1 study · 125 participants | Moderate Downgraded: imprecision |
Viral load (shedding) in saliva Valaciclovir (short‐term) vs placebo | RR 0.16 [0.02, 1.26] | 1 study · 120 participants | Moderate Downgraded: imprecision |
Valaciclovir (long‐term) compared with placebo for prevention of herpes labialis
Population: participants with recurrent herpes labialis
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Incidence of herpes labialis during use of the preventative intervention Valaciclovir (long‐term) vs placebo | no estimate extracted | 1 study · 95 participants | Moderate Downgraded: imprecision |
Adverse effects during use of the preventative intervention Valaciclovir (long‐term) vs placebo | RR 0.86 [0.51, 1.46] | 1 study · 95 participants | Moderate Downgraded: imprecision |
Valaciclovir (suppressive regimen compared with episodic regimen) for prevention of herpes labialis
Population: participants with recurrent herpes labialis
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Incidence of herpes labialis during use of the preventative intervention (number of recurrences per participant per month) Valaciclovir (suppressive regimen vs episodic regimen) | no estimate extracted | 1 study · 120 participants | Very low Downgraded: risk of bias, imprecision |
Adverse effects during use of the preventative intervention Valaciclovir (suppressive regimen vs episodic regimen) | RR 1.21 [0.78, 1.87] | 1 study · 152 participants | Very low Downgraded: risk of bias, imprecision |
Duration of attack of recurrent herpes labialis during use of the preventative intervention Valaciclovir (suppressive regimen vs episodic regimen) | no estimate extracted | 1 study · 120 participants | Very low Downgraded: risk of bias, imprecision |
Severity (pain) of attack of recurrent herpes labialis during use of the preventative intervention Valaciclovir (suppressive regimen vs episodic regimen) | no estimate extracted | 1 study · 120 participants | Very low Downgraded: risk of bias, imprecision |
Severity (maximum total lesion area) of attack of recurrent herpes labialis during use of the preventative intervention Valaciclovir (suppressive regimen vs episodic regimen) | no estimate extracted | 1 study · 120 participants | Very low Downgraded: risk of bias, imprecision |
Famciclovir compared with placebo for prevention of herpes labialis
Population: participants with recurrent herpes labialis
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Incidence of herpes labialis during use of the preventative intervention (by clinical evaluation) ‐ famciclovir 125 mg Famciclovir vs placebo | RR 0.74 [0.5, 1.11] | 1 study · 120 participants | Moderate Downgraded: imprecision |
Incidence of herpes labialis during use of the preventative intervention (by clinical evaluation) ‐ famciclovir 250 mg Famciclovir vs placebo | RR 0.69 [0.45, 1.04] | 1 study · 122 participants | Moderate Downgraded: imprecision |
Incidence of herpes labialis during use of the preventative intervention (by clinical evaluation) ‐ famciclovir 500 mg Famciclovir vs placebo | RR 0.82 [0.56, 1.21] | 1 study · 121 participants | Moderate Downgraded: imprecision |
Duration of attack of recurrent herpes labialis during use of the preventative intervention ‐ famciclovir 125 mg Famciclovir vs placebo | HR 1.63 [0.84, 3.15] | 1 study · 47 participants | Moderate Downgraded: imprecision |
Duration of attack of recurrent herpes labialis during use of the preventative intervention ‐ famciclovir 250 mg Famciclovir vs placebo | HR 1.59 [0.79, 3.2] | 1 study · 45 participants | Moderate Downgraded: imprecision |
Duration of attack of recurrent herpes labialis during use of the preventative intervention ‐ famciclovir 500 mg Famciclovir vs placebo | HR 2.39 [1.23, 4.63] | 1 study · 51 participants | Moderate Downgraded: imprecision |
Levamisole compared with placebo for prevention of herpes labialis
Population: participants with recurrent herpes labialis
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Incidence of herpes labialis during use of the preventative intervention Levamisole vs placebo | no estimate extracted | 1 study · 72 participants | Very low Downgraded: risk of bias, imprecision |
Adverse effects during use of the preventative intervention (leading to withdrawal) Levamisole vs placebo | no estimate extracted | 1 study · 99 participants | Very low Downgraded: risk of bias, imprecision |
Duration of attack of recurrent herpes labialis during use of the preventative intervention Levamisole vs placebo | no estimate extracted | 1 study · 72 participants | Very low Downgraded: risk of bias, imprecision |
Lysine compared with placebo for prevention of herpes labialis
Population: participants with recurrent herpes simplex labialis (cold sores on the lips)
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Incidence of herpes labialis during use of the preventative intervention (number of recurrences per participant per month) Lysine vs placebo | no estimate extracted | 1 study · 26 participants | Very low Downgraded: risk of bias, imprecision |
Topical aciclovir (short‐term) compared with placebo for prevention of herpes labialis
Population: participants with recurrent herpes labialis
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Incidence of herpes labialis during use of the preventative intervention Topical aciclovir (short‐term) vs placebo | RR 0.91 [0.48, 1.72] | 2 studies · 271 participants | Moderate Downgraded: risk of bias, imprecision |
Adverse effects during use of the preventative intervention Topical aciclovir (short‐term) vs placebo | RR 1.17 [0.59, 2.32] | 1 study · 191 participants | Low Downgraded: risk of bias, imprecision |
Severity (aborted lesions) of attack of recurrent herpes labialis during use of the preventative intervention Topical aciclovir (short‐term) vs placebo | RR 1.02 [0.19, 5.57] | 1 study · 52 participants | Low Downgraded: risk of bias, imprecision |
Incidence of herpes labialis after use of the preventative intervention Topical aciclovir (short‐term) vs placebo | RR 0.35 [0.13, 0.94] | 1 study · 181 participants | Low Downgraded: risk of bias, imprecision |
Topical aciclovir and 348U87 cream (short‐term) compared with placebo for prevention of herpes labialis
Population: participants with recurrent herpes labialis
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Incidence of herpes labialis during use of the preventative intervention (by culture) Topical aciclovir and 348U87 cream (short‐term) vs placebo | RR 0.78 [0.19, 3.14] | 1 study · 51 participants | Very low Downgraded: risk of bias, imprecision |
Incidence of herpes labialis during use of the preventative intervention (by clinical evaluation) Topical aciclovir and 348U87 cream (short‐term) vs placebo | RR 1.46 [0.53, 3.99] | 1 study · 51 participants | Very low Downgraded: risk of bias, imprecision |
Duration of attack of recurrent herpes labialis during use of the preventative intervention Topical aciclovir and 348U87 cream (short‐term) vs placebo | no estimate extracted | 1 study · 9 participants | Very low Downgraded: risk of bias, imprecision |
Severity of attack of recurrent herpes labialis during use of the preventative intervention (maximum lesion area) Topical aciclovir and 348U87 cream (short‐term) vs placebo | no estimate extracted | 1 study · 9 participants | Very low Downgraded: risk of bias, imprecision |
Topical foscarnet compared with placebo for prevention of herpes labialis
Population: participants with recurrent herpes labialis
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Incidence of herpes labialis during use of the preventative intervention Topical foscarnet vs placebo | RR 1.08 [0.82, 1.4] | 1 study · 295 participants | Moderate Downgraded: imprecision |
Adverse effects during use of the preventative intervention (leading to discontinuation) Topical foscarnet vs placebo | RR 2.96 [0.12, 72.11] | 1 study · 302 participants | Moderate Downgraded: imprecision |
Adverse effects during use of the preventative intervention (application site reactions) Topical foscarnet vs placebo | RR 2.47 [0.79, 7.69] | 1 study · 302 participants | Moderate Downgraded: imprecision |
Duration of attack of recurrent herpes labialis during use of the preventative intervention (healing time) Topical foscarnet vs placebo | no estimate extracted | 1 study · 125 participants | Moderate Downgraded: imprecision |
Severity of attack of recurrent herpes labialis during use of the preventative intervention (mean lesion area) Topical foscarnet vs placebo | no estimate extracted | 1 study · 124 participants | Moderate Downgraded: imprecision |
Severity of attack of recurrent herpes labialis during use of the preventative intervention (maximum lesion area) Topical foscarnet vs placebo | no estimate extracted | 1 study · 124 participants | Moderate Downgraded: imprecision |
Severity of attack of recurrent herpes labialis during use of the preventative intervention (duration of pain) Topical foscarnet vs placebo | no estimate extracted | 1 study · 113 participants | Moderate Downgraded: imprecision |
Topical 1,5‐pentanediol compared with placebo for prevention of herpes labialis
Population: participants with recurrent herpes labialis
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Incidence of herpes labialis during use of the preventative intervention Topical 1,5‐pentanediol vs placebo | no estimate extracted | 1 study · 102 participants | Moderate Downgraded: imprecision |
Adverse effects during use of the preventative intervention Topical 1,5‐pentanediol vs placebo | no estimate extracted | 1 study · 102 participants | Moderate Downgraded: imprecision |
Severity (blistering, swelling, or pain) of recurrence Topical 1,5‐pentanediol vs placebo | RR 1.05 [0.91, 1.2] | 1 study · 224 participants | Moderate Downgraded: imprecision |
Sunscreen compared with placebo for prevention of herpes labialis
Population: participants with recurrent herpes labialis
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Incidence of herpes labialis during use of the preventative intervention (by clinical evaluation) ‐ solar radiation Sunscreen vs placebo | RR 1.12 [0.25, 5.06] | 1 study · 51 participants | Low Downgraded: risk of bias, imprecision |
Incidence of herpes labialis during use of the preventative intervention (by clinical evaluation) ‐ experimental ultraviolet light Sunscreen vs placebo | RR 0.07 [0.01, 0.33] | 2 studies · 111 participants | Very low Downgraded: risk of bias, imprecision |
Incidence of herpes labialis during use of the preventative intervention (by culture) Sunscreen vs placebo | no estimate extracted | 1 study · 73 participants | Very low Downgraded: risk of bias, imprecision |
Interferon compared with placebo for prevention of herpes labialis
Population: participants with recurrent herpes labialis
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Incidence of herpes labialis during use of the preventative intervention ‐ presurgical Interferon vs placebo | RR 1.59 [1.05, 2.41] | 1 study · 32 participants | Low Downgraded: imprecision, inconsistency |
Incidence of herpes labialis during use of the preventative intervention ‐ postsurgical Interferon vs placebo | RR 0.99 [0.59, 1.66] | 1 study · 44 participants | Low Downgraded: imprecision, inconsistency |
Incidence of herpes labialis during use of the preventative intervention ‐ pre‐ and postsurgical Interferon vs placebo | RR 0.57 [0.34, 0.95] | 1 study · 37 participants | Low Downgraded: imprecision, inconsistency |
Adverse effects during use of the preventative intervention (fever) ‐ presurgical Interferon vs placebo | RR 2.45 [1.26, 4.78] | 1 study · 32 participants | Moderate Downgraded: imprecision, inconsistency |
Adverse effects during use of the preventative intervention (fever) ‐ postsurgical Interferon vs placebo | RR 1.96 [1, 3.84] | 1 study · 44 participants | Moderate Downgraded: imprecision, inconsistency |
Adverse effects during use of the preventative intervention (fever) ‐ pre‐ and postsurgical Interferon vs placebo | RR 11.76 [0.71, 195.11] | 1 study · 38 participants | Moderate Downgraded: imprecision, inconsistency |
Gamma globulin compared with histamine (control) for prevention of herpes labialis
Population: participants with recurrent herpes labialis
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Duration of attack of recurrent herpes labialis during use of the preventative intervention Gamma globulin vs histamine (control) | no estimate extracted | 1 study · 72 participants | Low Downgraded: risk of bias, imprecision |
Severity of attack of recurrent herpes labialis during use of the preventative intervention (less severe recurrences than usual) Gamma globulin vs histamine (control) | RR 0.97 [0.74, 1.28] | 1 study · 73 participants | Low Downgraded: risk of bias, imprecision |
Thymopentin compared with placebo for prevention of herpes labialis
Population: participants with recurrent herpes labialis
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Incidence of herpes labialis during use of the preventative intervention Thymopentin vs placebo | no estimate extracted | 1 study · 36 participants | Moderate Downgraded: imprecision |
Adverse effects during use of the preventative intervention Thymopentin vs placebo | RR 2 [0.42, 9.58] | 1 study · 36 participants | Moderate Downgraded: imprecision |
HSV vaccination compared with placebo for prevention of herpes labialis
Population: participants with recurrent herpes labialis
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Incidence of herpes labialis during use of the preventative intervention HSV vaccination vs placebo | no estimate extracted | 1 study · 64 participants | Moderate Downgraded: imprecision |
Adverse effects during use of the preventative intervention HSV vaccination vs placebo | RR 0.33 [0.01, 7.45] | 1 study · 64 participants | Moderate Downgraded: imprecision |
Yellow fever vaccination compared with placebo for prevention of herpes labialis
Population: participants with recurrent herpes labialis
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Incidence of herpes labialis during use of the preventative intervention Yellow fever vaccination vs placebo | no estimate extracted | 1 study · 1 participants | Moderate Downgraded: imprecision |
Adverse effects during use of the preventative intervention Yellow fever vaccination vs placebo | RR 0.33 [0.01, 7.45] | 1 study · 24 participants | Moderate Downgraded: imprecision |
Laser compared with no interventions for prevention of herpes labialis
Population: participants with recurrent herpes labialis
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Incidence of herpes labialis during use of the preventative intervention Laser vs no interventions | no estimate extracted | 1 study · 71 participants | Very low Downgraded: risk of bias, imprecision |
Adverse effects during use of the preventative intervention Laser vs no interventions | no estimate extracted | 2 studies · 119 participants | Low Downgraded: risk of bias, imprecision |
Hypnotherapy compared with control for prevention of herpes labialis
Population: participants with recurrent herpes labialis
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Incidence of herpes labialis during use of the preventative intervention (change in frequency of recurrence) Hypnotherapy vs control | no estimate extracted | 1 study · 21 participants | Very low Downgraded: risk of bias, imprecision |
Severity of attack of recurrent herpes labialis during use of the preventative intervention (change in intensity) Hypnotherapy vs control | no estimate extracted | 1 study · 21 participants | Very low Downgraded: risk of bias, imprecision |
Change in severity (pain) of herpes labialis Hypnotherapy vs control | no estimate extracted | 1 study · 21 participants | Very low Downgraded: risk of bias, imprecision |
Change in severity (impairment of appearance) of herpes labialis Hypnotherapy vs control | no estimate extracted | 1 study · 21 participants | Very low Downgraded: risk of bias, imprecision |