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. 2022 Jun 14;5(2):e38322. doi: 10.2196/38322

Table 1.

Treatment comparison from the Cochrane review [2] for herpes simplex labialis (HSL) with respective results, risk ratio (RR) with CI, comparative risk (CR) with or without P value, or mean difference (MD) with CI.

Comparison Measurement (primary outcome) Result Statistical results Quality of evidence
Oral acyclovir vs placebo (short term ≤1 month): (1) 800 mg 2×/day; (2) 400 mg 2×/day; (3) 200 mg 5×/day Incidence of HSL during use of the preventive intervention Unclear. No preventative effect; not currently recommended

  • (1) RR 1.08 (0.62 to 1.87)

  • (2) RR 0.26 (0.13 to 0.51)

  • (3) RR 0.46 (0.20 to 1.07)

  • (1) Moderate

  • (2) Low

  • (3) Low
Oral acyclovir vs placebo (long term >1 month): 400 mg 2×/day Incidence of HSL during use of the preventive intervention (clinical recurrences) Acyclovir was slightly superior. Recommended (small effect)

  • CR 0.85 vs 1.80 episodes per participant per 4-month period

  • MD –3.6 (–7.2 to 0)

  • Low
Oral valaciclovir vs placebo (short term ≤1 month): 2 g 2×/day for the first day, 1 g 2×/day for the second day Incidence of HSL during use of the preventive intervention No significant difference. No preventative effect; not currently recommended

  • RR 0.55 (0.23 to 1.28)

  • Moderate
Oral valacyclovir vs placebo (long term >1 month): 500 mg 1×/day Incidence of HSL during use of the preventive intervention Valacyclovir was slightly superior. Recommended (small effect)

  • CR 0.12 vs 0.21 episodes per participant per month

  • MD 0.009

  • Moderate
Oral famciclovir vs placebo (short term ≤1 month): (1) 125 mg 3×/day; (2) 250 mg 3×/day; (3) 500 mg 3×/day Incidence of HSL during use of the preventive intervention No significant difference. No preventative effect; not currently recommended

  • (1) RR 0.74 (0.5 to 1.11)

  • (2) RR 0.69 (0.45 to 1.04)

  • (3) RR 0.82 (0.56 to 1.21)

  • (1) Moderate

  • (2) Moderate

  • (3) Moderate
Oral levamisole vs placebo (long term >1 month): 2.5 mg/kg 2×/week Incidence of HSL during use of the preventive intervention No consistent data. No preventative effect; not currently recommended

  • MD –2 (–2.24 to –1.76)

  • Very low
Oral lysine vs placebo (long term >1 month): 1000 mg 1×/day Incidence of HSL during use of the preventive intervention No significant difference. No preventative effect; not currently recommended

  • MD –0.04 (–0.37 to 0.29)

  • Very low
Topical acyclovir 5% cream vs placebo (short term ≤1 month): 5×/day Incidence of HSL during use of the preventive intervention No significant difference. No preventative effect; not currently recommended

  • RR 0.91 (0.48 to 1.72)

  • Moderate
Topical acyclovir 5% and 348U87 3% cream vs placebo (short term ≤1 month): 1×/2 hours during awake hours Incidence of HSL during use of the preventive intervention (by culture) No significant difference. No preventative effect; not currently recommended

  • RR 0.78 (0.19 to 3.14)

  • Very low
Topical foscarnet 3% vs placebo (short term ≤1 month): 8×/day Incidence of HSL during use of the preventive intervention No significant difference. No preventative effect; not currently recommended

  • RR 1.08 (0.82 to 1.4)

  • Moderate
Topical 1,5 pentanediol vs placebo (long term >1 month): 2×/day Incidence of HSL during use of the preventive intervention No significant difference. No preventative effect; not currently recommended

  • CR 120 episodes out of 53 (topical) vs 109 episodes out of 50 (placebo);P>.05

  • Moderate
Sunscreen vs placebo (short term ≤1 month); 1× prior to immediate exposure to (1) solar radiation and (2) experimental ultraviolet light Incidence of HSL during use of the preventive intervention Unclear. Not currently recommended; further research warranted

  • (1) Under sunlight: RR 1.13 (0.25 to 5.06)

  • (2) Under experimental ultraviolet light: RR 0.07 (0.01 to 0.33)

  • (1) Low

  • (2) Very low
Interferon injection (70,000 U/kg) vs placebo (short term ≤1 month): (1) presurgical 2×/day; (2) postsurgical 2×/day; (3) pre- and postsurgical 2×/day Incidence of HSL during use of the preventive intervention Unclear. No preventative effect; not currently recommended

  • (1) RR 1.59 (1.05 to 2.41)

  • (2) RR 0.99 (0.59 to 1.66)

  • (3) RR 0.57 (0.34 to 0.95)

  • (1) Low

  • (2) Low

  • (3) Low
Gamma globin injection vs histamine (control, dilute 1:5000) (short term ≤1 month): 0.2 ml 1× dose Duration of HSL outbreak No significant difference. No preventative effect; not currently recommended

  • MD 0.7 (–0.55, 1.95)

  • Low
Thymopentin injection vs placebo (long term >1 month): 50 mg 3×/week Incidence of HSL during use of the preventive intervention Thymopentin was superior. Not currently recommended; further research warranted

  • CR median 0.2 for thymopentin vs 0.9 for placebo;P=.0027

  • Moderate
Herpes simplex virus type I vaccine injection vs placebo (short term ≤1 month): 1× dose Incidence of HSL during use of the preventive intervention No significant difference. No preventative effect; not currently recommended

  • CR 1.6 vs 1.3 recurrences in 4 months (P=.1)

  • Moderate
Laser (low intensity, 690 nm, 80 mW/cm2, 48 J/cm2) vs no intervention (short term ≤1 month): 1×/day Time to first occurrence Low-intensity diode laser was superior but low-energy gallium-aluminum-arsenide laser was not. Not currently recommended; further research warranted

  • Low-energy gallium-aluminum-arsenide laser: CR 0.076 vs 0.116 recurrences per month (P=.076)

  • Low-intensity diode laser, median recurrence-free interval: MD 30 (21.42 to 38.58)

  • Very low
Hypnotherapy vs control (long term >1 month): 1×/week Change in the frequency of recurrence Hypnotherapy was superior. Not currently recommended; further research warranted

  • MD –6.5 (–8.76 to –4.24)

  • Very low