Guideline sources The following summarized guidelines for the management of orolabial herpes are prepared by our editorial team based on guidelines from the American Association of Family Physicians (AAFP 2010). 1 Guidelines 1. Medical management Oral treatment for primary herpetic gingivostomatitis: offer acyclovir suspension for the treatment of pediatric patients with primary herpetic gingivostomatitis. B Oral treatment for recurrent herpes labialis: offer oral acyclovir, valacyclovir, or famciclovir for the treatment of patients with acute recurrences of herpes labialis. A Topical treatment for recurrent herpes labialis: consider topical acyclovir, penciclovir, or docosanol for the treatment of patients with recurrent herpes labialis. B Prevention of recurrent herpes labialis: offer daily oral acyclovir or valacyclovir to suppress recurrences of herpes labialis. A Clinical findings Symptoms Past medical history Burning sensation around lips Herpetic keratitis https://web.pathway.md/diseases/recaCn9cCxGvMv2f1 1/2 6/30/23, 1:23 AM Orolabial herpes Pathway Burning sensation around lips Herpetic keratitis Fever Herpetic whitlow Headache Head and neck exam Lip sores Malaise Oral mucosal erythema Mouth sores Oral vesicles Painful lesions around lips Swollen gums Painful oral lesions Integument exam Tingling around lips Blisters around lips Neurological exam Crusts around lips Facial nerve palsy Erythema multiforme Erythema of lips Lymphatic exam Papulovesicular rash Cervical lymphadenopathy Swelling of lips Submandibular lymphadenopathy References 1. Richard P Usatine, Rochelle Tinitigan. Nongenital Herpes Simplex Virus. Am Fam Physician. 2010 Nov 1;82 9 1075 82. Open https://web.pathway.md/diseases/recaCn9cCxGvMv2f1 2/2