Topical acyclovir in the treatment of genital herpes: a comparison with systemic therapy

Controlled trials of acyclovir cream were conducted in the treatment of initial and recurrent genital herpes. For 54 patients with the first episode of genital infection (initial disease) treated with acyclovir the duration of viral shedding, formation of new lesions, times to crusting and healing and duration of symptoms were significantly reduced compared with the results obtained in 47 placebo recipients. When applied early in the course of recurrent episodes in 44 patients, acyclovir cream significantly reduced viral shedding, a new lesion formation, time to healing and the duration of symptoms compared with the effects in 41 control patients. Topical therapy with acyclovir cream is well tolerated and compares quite favourably with systemic treatment, especially for recurrent genital herpes.