How is a herpes simplex virus infection addressed during the dermatologic preoperative evaluation and management?

Updated: Mar 16, 2020
  • Author: Robert A Schwartz, MD, MPH; Chief Editor: Dirk M Elston, MD  more...
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Answer

A history of herpes simplex virus infection is important when surgery in the genital or perioral areas is considered. Trauma or stress, which includes surgery itself, can precipitate an active infection and antiviral prophylaxis is required. Doses differ depending on whether or not a history of herpes simplex virus infection is known. In general, persons with frequent outbreaks need higher doses. For most perioral procedures, acyclovir is sufficient (400 mg tid beginning 2 d preoperatively and continued until reepithelialization occurs, approximately 10-14 d). Lysine at 1500 mg/d is a naturopathic supplement effective for stabilizing the lip mucosa preoperatively to avoid herpes breakouts.


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