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    Spruance S, Overall J, Kern E, Krueger G, Pliam V, Miller W. Up To Date version 12.2, last updated February 25, 2004. Recurrent lesions progress quickly through several stages (prodrome, erythema, papule, vesicle, ulcer, crust, residual swelling, healed). The natural history of recurrent herpes simplex labialis. Spruance S, Stewart J, Rowe N, Mc Koeugh M, Wenerstrom G, Freeman D. London: BMJ Publishing Group, last updated December 2002. This evidence supports early (prodrome or erythema stage) but not late (macule, papule, vesicle, or crusted stage) treatment of HSV 1 with oral acyclovir. Treatment of recurrent herpes simplex labialis with oral acyclovir. Spruance S, Nett R, Marbury T, Wolff R, Johnson J, Spaulding T. High-dose, short-duration, early valacyclovir therapy for episodic treatment of cold sores: results of two randomized, placebo-controlled, multicenter studies. Topical application of 5% acyclovir cream significantly decreases clinician-assessed duration of the episode and duration of patient-reported pain, based on 2 double-blind, multicenter RCTs that used a vehicle control. Acyclovir cream for treatment of herpes simplex labialis: results of two randomized, double-blind, vehicle-controlled multicenter clinical trials. In these trials, 686 and 699 patients self-initiated treatment 5 times a day for 4 days beginning within 1 hour of the onset of a recurrent lesion. Treatment and prevention of herpes simplex virus type 1 infection. Evidence summary Cold sores, or herpes labialis, are caused by HSV. If started at the onset of symptoms (during the prodrome stage), acyclovir (400 mg 5 times daily for 5 days) decreases pain and healing time to loss of crust and valacyclovir (2 g twice daily for 1 day) reduces the lesion duration and time to healing and may prevent lesion development (SOR: A, based on RCTs). However, topical acyclovir 5% cream applied 5 times a day decreases pain and the duration of hard crust (SOR: B, extrapolated from randomized controlled trials [RCTs]). Spring Valley Dietary Supplement buy valtrex for cheap Acyclovir Zovirax®Valacyclovir Valtrex® MotherToBaby Valtrex and Other Antivirals That Treat Cold Sores - Verywell Health
     
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