Synopsis

Source of validity: Scientific
Rating (out of 5): 4

Docosanol is an over-the-counter topical antiviral agent approved by the FDA for the treatment of recurrent oral-facial herpes simplex virus (HSV) infections, commonly known as cold sores. Its use is supported by multiple randomized, double-blind, placebo-controlled clinical trials. Docosanol acts by inhibiting the fusion between the HSV envelope and the human cell plasma membrane, thereby preventing viral entry into cells and subsequent replication.

A pivotal study published in the Journal of the American Academy of Dermatology (1997) demonstrated that 10% docosanol cream significantly reduced the duration of symptoms and accelerated healing of herpes labialis lesions compared to placebo. Subsequent reviews and meta-analyses have reinforced these findings, though the benefit is modest—typically reducing healing time by about 18 hours compared to placebo. The safety profile of docosanol is favorable, with local skin irritation being the most commonly reported side effect.

Docosanol is not effective for genital herpes or systemic HSV infections, and its use is specifically indicated for early treatment of cold sores in immunocompetent individuals. Overall, the use of docosanol for herpes labialis is scientifically validated with moderate to strong evidence, reflecting its FDA approval and support in clinical guidelines.

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