Lidocaine
Place in Therapy
Place in Therapy
Lidocaine is one of the local anesthetics suggested for temporary relief of pain and itching associated with cold sores(1). To date there have been no trials conducted regarding lidocaine for reduced duration of symptoms or reduced size and time to healing of lesions. According to the authors of a study regarding tetracaine for the treatment of cold sores, early laboratory studies have shown that lidocaine is unable to inhibit the replication of herpes simplex virus. The authors suggested that even at a 10-fold greater concentration lidocaine would not produce the same positive results as tetracaine(2). Local anesthetics in general have been shown to reduce symptoms of cold sores such as pain and itching however further research is needed as to their ability to treat. Lidocaine can be less sensitizing than benzocaine, making lidocaine a better option between these two anesthetics. Anesthetics and topical analgesics have not been studied head-to-head. Both agents could be considered first line options for symptomatic relief of pain and itching(1).
Bottom Line:
Lidocaine should be reserved for temporary symptomatic relief of pain and itching associated with cold sores. Lidocaine is not recommended for treatment and eradication of the herpes simplex infection.
References
1 – Conklin, JS. (2010). Chapter 92 cold sores (herpes labialis). In Patient self-care, 2nd ed. (889-896). Ottawa, ON: Canadian Pharmacists Association.
2 - Kaminester LH, Pariser RJ, Pariser DM, et al. A double-blind, placebo-controlled study of topical tetracaine in the treatment of herpes labialis. J Am Acad Dermatol. 1999;41:996-1001.
3 - Lexicomp. Lidocaine (topical). Updated 2014. Available from: http://online.lexi.com.proxy.lib.uwaterloo.ca/lco/action/doc/retrieve/docid/patch_f/1797833. Accessed July 20, 2014.
Lidocaine is one of the local anesthetics suggested for temporary relief of pain and itching associated with cold sores(1). To date there have been no trials conducted regarding lidocaine for reduced duration of symptoms or reduced size and time to healing of lesions. According to the authors of a study regarding tetracaine for the treatment of cold sores, early laboratory studies have shown that lidocaine is unable to inhibit the replication of herpes simplex virus. The authors suggested that even at a 10-fold greater concentration lidocaine would not produce the same positive results as tetracaine(2). Local anesthetics in general have been shown to reduce symptoms of cold sores such as pain and itching however further research is needed as to their ability to treat. Lidocaine can be less sensitizing than benzocaine, making lidocaine a better option between these two anesthetics. Anesthetics and topical analgesics have not been studied head-to-head. Both agents could be considered first line options for symptomatic relief of pain and itching(1).
Bottom Line:
Lidocaine should be reserved for temporary symptomatic relief of pain and itching associated with cold sores. Lidocaine is not recommended for treatment and eradication of the herpes simplex infection.
References
1 – Conklin, JS. (2010). Chapter 92 cold sores (herpes labialis). In Patient self-care, 2nd ed. (889-896). Ottawa, ON: Canadian Pharmacists Association.
2 - Kaminester LH, Pariser RJ, Pariser DM, et al. A double-blind, placebo-controlled study of topical tetracaine in the treatment of herpes labialis. J Am Acad Dermatol. 1999;41:996-1001.
3 - Lexicomp. Lidocaine (topical). Updated 2014. Available from: http://online.lexi.com.proxy.lib.uwaterloo.ca/lco/action/doc/retrieve/docid/patch_f/1797833. Accessed July 20, 2014.