Suppression therapy for 5yo with HSV-1

[catscherer]

My son had is primary outbreak at 18 months and typically has an oral outbreak every few months - same spot on his lip 1 lesion, usually after a cold.  He has had about 6 outbreaks in the last 60 days and the most recent was more than 4 lesions all over his bottom lip.  Besides the zovirax ointment, which is difficult to administer since his lips are so sore, are their oral meds vs. topical that would be effective and safe?  My pediatrician says he's too young for suppression therapy, but I've read other places that it's available for children under 12.  Very frustrated, and just want to give my son some relief.

[gracefromHHP]

Yep - best to be seen when he has symptoms so she can do cultures of them if needed and actually see what is going on.

grace

[catscherer]

Thanks for the info.  I will go the derm route.  He already has one that we see somehwat regularly.  Will eval by the derm be better while he's got an active outbreak, or would going in between still be helpful?  I'm guessing she's going to need to observe the lesions . . .

[gracefromHHP]

Zovirax ointment doesn't do a lot for cold sores anyways and it's incredibly overpriced unless you have good insurance.

At this point - if your child's doctor is unconcerned, ask for a consult to a pediatric dermatologist. Confirm that indeed this is hsv1 related - 6 recurrences in 2 months is incredibly high even for oral herpes so it needs a further evaluation to make sure that it really is herpes going on.  this might just be chapped lips, an allergic reaction or even a bacterial infection/fungal infection going on that needs different treatment.  Also ask about oral acyclovir or oral valtrex ( both come in liquid forms now ) to treat your son's cold sores when they occur. Liquid acyclovir would be the cheapest option - very easy to give it 3x/day for 2 days.

Yes you can put 5 year olds on daily suppressive therapy but at this point he needs a better work up than it sounds like he's gotten so far.

grace