P RECURRENT HERPES LABIALIS X RING ID REG JRH

• A 13-year-old girl presents with recurrent herpes labialis (HL) on her face. She gives a history of painful episodes occurring approximately monthly since the age of 9 years. Since becoming a teenager, she has missed a lot of school due to her worry about the cosmetic appearance of recurrences. Her parents ask whether long-term antiviral medication will prevent recurrences.
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• Oral long-term suppressive therapy with acyclovir or valacyclovir reduces the frequency, severity and duration of episodes in adults with recurrent herpes labialis (RHL) (grade A) but has not been the subject of a trial in children.
• Oral valacyclovir reduces the frequency of episodes and increases quality of life in teenagers with RHL (grade C).
• The optimal indication to start, choice of antiviral, as well as dosage and duration of long-term antiviral therapy is unknown.