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Cold Sore Creams – Buy Antiviral Cream for Cold Sores

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Best Herpes Pills for Adults

Many people know that when the lips get cold, there will be a tingling, prickling and unpleasant sensation. Choosing herpes pills that are optimal for adults can avoid illness and greatly reduce severe illness. You need to take it with the first symptoms

It is said that about 90% of the adult population of Japan is infected with the herpes label. It is caused by the herpes simplex virus type 1 (VPG-1). Dable herpes is transmitted despite being a child, although most people are closely related to kissing, relatives and friends.

Generally speaking, herpes is called "fever" or "chill lips", but this is not the correct definition of the disease. Herpes label symptoms often appear on the lips, surroundings and nose, but the rash is not always limited to this part. Some may have symptoms between the upper lip and nose, inside, chin, and cheeks. In such a case, the condition is called oral shingles.

The infected site, damaged skin (cut or cracked) and mucous membranes (mouth, genitals, etc.) are in direct contact with the virus. Help can be infected without symptoms. From a year, people may not be consistent for several days when the virus recombines.

Since this is a viral infection, several approaches are used to treat it. First, a specific antiviral agent is prescribed. Herpes is one of the few viruses that has some valid direct antivirals. This is a treatment that complements the immunosuppressive effects of agents and interferon. This should prevent the exacerbation from prolonging. Along with antiviral cream, it is popular as an adult herpes pill. If the cream only works on the skin, the pills block the activation of the virus in the body and “rest” again.

Medicines have the function of suppressing viral activity, but tablets have many advantages.

• It's convenient, easy to use and can be carried anywhere so it doesn't disrupt your appointment schedule.
• Because the pills last a lifetime, herpes activity is faster.
• It can also be used prophylactically before specific treatments and interventions and also has some immune adaptation effect.

KP top 10 herpes pills

We discussed the best herpes pills that are widely used in adults with experts. However, the following information is not a guideline for action, so please consult your doctor first for all treatments.

1

There are various doses of tablets sold according to a doctor's prescription. The main active substance is Famshicroville, which is effective in treating shingles, but has a strong viral effect on herpes simplex types 1 and 2, which has the worst effect. This occurs in people over 18 years of age, plans are chosen individually and can prevent rashes in the early stages of infectious diseases.

Antiviral effect lasts up to 12 hours, so take it twice a day. Compatibility with other drugs, especially effective in preventing recurrence with many rashes.

Some side effects include headaches with nausea and diarrhea, skin rashes and severe abdominal pain. Contraindicated in pregnancy, lactation and children. Do not use if you have liver or kidney problems.

2.

It is sold in tablet form and by prescription. The main active ingredient is valaciclovir. Actively affects various types of herpes viruses. It is effective against herpes labialis, genital herpes, eye infections caused by viruses, and ringworm. Take this medication twice a day.

Side effects, nausea and headache may include an allergy to the ingredients. Prohibited during pregnancy, lactation, liver damage, against the background of HIV infection.

3. Aciclovir

This drug is available in tablets containing Fort, available without a prescription. The main active ingredient is acyclovir, which is effective against the viral type. With other types of herpes, it is less effective.

Take immediately after meals up to 4 times a day and use with caution in the elderly. When taking acyclovir, you should drink plenty of fluids.

If you have kidney problems, adjust the dosage individually, usually about 2 times lower. It should be used with caution in people with neurological diseases. Use with caution if you are pregnant or breastfeeding. Among the side effects are headaches, dizziness, allergies, shortness of breath, swelling, blurred vision, etc. The drug is incompatible with alcohol.

4. Isoprinosine

Tablets containing the active ingredient Ininosa Planovex are dispensed by prescription. It has an antiviral effect, activates lymphocytes, increases the synthesis of protective immunoglobulins and strengthens the body's immune defenses. It enhances the activity of acyclovir, which allows it to be used to treat severe herpes.

It should be taken up to 4 times a day, and in severe cases, double the dose. The maximum duration of treatment is 10 days. Preventive methods are also possible.

Contraindicated in urolithiasis, arrhythmia, gout, renal failure. Side effects - exacerbation of digestive disorders, headaches, joint pain, gout.

5. Minker

Prescription antiviral drug sold in tablet form. The main active ingredient is famdiclovir. It can be used for any stage of herpes types 1 and 2, as well as for taste lice. Once inside the body, it thickens and acts up to 12 hours, inhibiting the reproduction of viral particles and DNA replication in cells.

This drug is effective in the treatment and prevention of herpetic neuralgia and recurrent infections.

Do not take if you are breastfeeding, pregnant, or if you have kidney or liver problems. In the context of the introduction, indigestion is a serious headache.

6. Amixin

Amixin is an over-the-counter antiviral drug in the form of tablets. This drug is suitable for the treatment of herpes infections, including recurrent herpes infections. It contains tilorone, which acts as an immunosuppressant, that is, an inducer of interferon formation.

Do not use if you are pregnant, nursing or have an allergic reaction to any component of Amiksin. For use by persons over 18 years of age. Due to the possibility of allergic reactions, treatment should be carried out under the supervision of a specialist.

7. Zovirax

Another drug that uses aculovir as part of a simple treatment for the herpes virus. It is often used as an ointment for external use, but also comes in tablet form.

Under the guidance of a physician, it can be used during pregnancy. This drug passes into breast milk, so it is especially carefully prescribed during breastfeeding.

If you have kidney disease, Zobirax is contraindicated. In the case of a tablet device, it can be used from a 3-year-old child.

8. Normal

It is provided as syrup and tablets as a treatment for herpes in children and adults. Inodine Planobex, a synthetic derivative of Purina, is included. It stimulates the body's defenses and is released by a prescription drugstore with a non-specific antiviral agent.

Effects on pregnant and nursing women have not been studied, therefore avoid use. Contraindications are as follows.

• arthritis
• Stone disease disease.
• Castle; urinary tract disease; urinary incontinence; obstruction of the urinary tract.
• Target age up to 3 years.
• Weight must be less than 20 kg.
• 9. Alpine

Alpine flu tablets are taken after repeated infections. The active ingredient is Sea Ezhville, which has antiviral and immunomodification.

It cannot be used for children under 3 years of age or for those who have galactose intolerance. You do not need a prescription at the time of purchase, but it is recommended that you determine the use, dosage, and treatment period with your physician.

10.

Antiviral agent for herpes virus type 1 and type 2. Includes three phosphoric acids in ACI Cloville and inhibits viral DNA synthesis. There are two types of launches: external cream agents and oral tablets.

Contraindications include hypersensitivity to the ingredients of this medicine. Safety and efficacy in children under 12 years of age have not been fully studied.

The course of treatment is at least four days, and the doctor chooses the exact dosage and treatment plan.

Infection helps - a serious problem. Therefore, you can choose a medicine with your doctor. Doctors evaluate the frequency of relapses, their severity and the speed of the rash and choose the most effective medicine.

How to choose adult herpes pills

It is also important to consider the age of the patient, the state of attachment, ease of administration, possible side effects and contraindications.

We spoke with Lidia Gorbenko, head of internist, endoscopic doctor, and Cabinet, internist, endoscopic doctor and herpes treatment.

Frequently Asked Questions

Chronic lifelong learning is typical for this viral infection. Over 90% of people worldwide have at least one type 1 or type 2 HSV. Symptoms, in principle, seem noticeable when they first get into herpes. It progresses to internal inflammation and flu infection (usually when you were a child).

After the first onset, the body must produce the antibody and does not recur. However, many people suffer from recurring herpes.

At least one quarter of herpes of the labial labia is experiencing a recurrence. Again, as in the first episode, the symptoms are different for each person. Damage can appear in deluxe blistered or blistered form. Symptoms of recurrence with a rash for listening last an average of about 8-10 days.

The frequency of recurrence decreases over time. And due to factors that reduce immunity, such as ultraviolet rays, colds, overwork and stress, lips can be rash.

Many people end up experiencing "productive" or preventive symptoms before the outbreak. This is itching, tingling, or pain in the area where the ulcer occurs. Proprix often appears after 1-2 days. At this time, treatment should be started to shorten the time of illness.

Antivirals may speed healing, especially if taken at the first sign of hot flashes. Your doctor will advise you.

Wound cream. Take pills from the first hours of exacerbation.

There are also home remedies to help you feel better during your treatment.

Apply a cool wet compress to the wound area. Painkillers such as paracetamol and ibuprofen. Anesthetic cream with benzocaine or lidocaine (if you are not allergic to anesthetics). Balms and lip balms to keep your skin hydrated.

Doctors should focus on treatment, and the patient's task should be to prevent an aggravation. To reduce the risk of new outbreaks.

Lack of sleep weakens the immune system, making it easier to get flare-ups. Apply sunscreen to your lips - make sure the label says SPF.

Talk to your doctor. If you have frequent ulcers, you can take a course of antivirals.

To prevent the spread of the virus when you have herpes.

Do not kiss children and adults. Separate dishes, glasses and towels. Do not give lipstick, lip balm or razors (to men).

Statistics show that approximately 90% of the population is infected with one or more herpes viruses1. The reason for this prevalence is simple: once it enters the human body, herpes remains there forever2. At the same time, 70% of those infected are carriers and do not feel the presence of the pathogen, since it is in a "sleeping" state3. Activation of the infection occurs under favorable conditions for the virus, for example, during periods of weakened immunity. Flare-ups usually result in the classic symptom of small sores (which many refer to as “cold lips”)3.

Herpes is the second most common human viral disease after influenza3. However, there are more than 80 different representatives of this virus3. In the article we will talk about the most common of them.

The most common herpes infections, including herpes and genital herpes, are caused by the herpes simplex virus (HSV).

Types of herpes

The first type of HSG most often affects the mucous membrane of the mouth, nasopharynx, eyes and lips.

• HSG type 2 more aggressively affects the genital mucosa, perineal skin, anus, buttocks and lower extremities.
• According to WHO, labial herpes affects 67% of the world's population under the age of 50 years, genital infections - 11%3.

In addition to the herpes simplex virus, there are other viruses from the herpes family, the most common of which is the herpes simplex virus.

Hematopox virus (chickenpox): Causes varicella (chickenpox) in children. Adults can get sick for a long time without feeling the pathogen, but under certain conditions, for example, when the immune system is impaired, the virus causes a disease around skin lichen. This is accompanied by a rash of bubbles on the skin of the chest and along the intercostal space and a burning sensation.

• Epstein-Barr virus is a fecal product of infectious mononucleosis with sore throat, nasal dyspnea and lymphadenopathy of concern 1.
• Cytomegalovirus: affects upper respiratory tract, reproductive system and, in severe cases, internal organs 4.
• Let's take a closer look at types 1 and 2 of the herpes simplex virus.

HSV can be present in virtually any body fluid, including saliva, urine, blood, semen, cerebrospinal fluid, nasopharyngeal, urethral, ​​cervix and vaginal rash extracts, and even tears. This explains the different routes of transmission of the virus.

Why does herpes appear?

Communication - close contact, kissing.

• Sex is the time of all kinds of intimate contacts.
• Household - through personal care products, dishes and household goods.
• by airborne droplets when coughing and sneezing 3.
• Infection can also occur during organ/tissue transplantation or blood transfusion. The presence of the herpes virus in a pregnant woman creates a risk of transmission from mother to child through the common route 3 infection in the uterus (through the placenta) or during childbirth.

However, self-reproduction is possible. That is, the herpes virus spreads within the same organ by moving viral particles from the primary focus to other organs, for example, from the lips to the mucous membranes of the eyes 3 .

The entry gates of infection are the skin and mucous membranes of the oral cavity, nasopharynx, gastrointestinal tract, reproductive organs, eyeballs 3. Damage to these organs - cracks, abrasions, corrosion and other defects increase the risk of infection 3.

Symptoms and routes of transmission of erosive infections vary depending on the introduced pathogen.

"cold lips"

In childhood, children usually do not get herpes, since antibodies received from the mother remain in their body for up to 2-5 years. When this passive immunity fails, the herpes virus is free to enter the body5. The first "meeting" with the first generation herpes simplex virus can go completely unnoticed for both children and their parents. Rarely, infection can be avoided during childhood. When HSV type 1 is first contracted from an adult, symptoms appear immediately 3.

A typical symptom of labial herpes is a blistering rash on the skin of the face (lips, nose, cheeks).

If the rash is in the mouth, speak of oral stomatitis. They can also be found on the palms and tonsils. These changes are very similar to angina pectoris. At the same time, fever, headache, often enlarged lymph nodes can be added to local symptoms. Without treatment, recovery can take up to 2 weeks or more. Up to 50% of primary genital infections are associated with herpes type 1 (usually causing a "runny nose"), but subsequent flare-ups are usually genital type 3.

Genital herpes outbreaks in non-sexual adults are due to the fact that HSV can spread through the blood vessels and lymphatics.

Genital herpes is transmitted not only through sexual contact, but also through everyday contact and movement (self-reproduction)3.

With the course of the infection there is a rich rash such as blisters, bending over and fluttering (table sores) leading to itching, passion and pain in the genitals. 2. Enlarge lymph nodes, pain during urination and fever.

After infection, the herpes simplex virus grows in the insertion part and invades the nerve (nerve cells). Here, a latent (dormant) state is maintained, and the effects of immune cells and other protective factors are successful. Type 1 often becomes infected with the trigeminal plexus, and in type 2, the sacral plexus becomes infected.

Why does herpes become chronic?

In addition, the way the disease progresses depends on the immune system. If control is inadequate or the body's defenses are compromised, HSV will be able to multiply actively. Thus, the disease has worsened and recurrence of serum infections occurs 5.

The worse the immune system, the higher the relapse and the more difficult it is to stop the infection process.

The following factors contributing to herpes simplex virus infection include:

5. Mental and physical stress 5.

• Physical/mental stress or emotional/mental stress 5?
• He hits the sunlight for a long time 5?
• 3. When the skin or mucous membrane is damaged.
• Surgical treatment 3;
• Beyond steroids 3;
• 3. Cryotherapy (facial skin rejuvenation treatment using liquid nitrogen)
• Sexual herpes rash can be easily known to provide a diagnosis, but it is best to consult a specialist. After the test, a dermatologist can accurately determine if you really have herpes and prescribe an effective treatment.

Diagnosis of herpes simplex in adults

Help is an important criterion for diagnosing herpes recurrence.

Deviation days (6 hours). There is a general malaise and itching that strikes where the rash will occur in the future. Basically, every time you get worse, you get a rash in the same place.

1. Red Maddy-Paws Studio (24 hours). The skin of the rash appears compact and reddish.
2. Blister formation period (up to 3 days). The inflammatory site has blisters containing fluid.
3. Ulcerative stage (several days). Traces of bubbles have a slightly painful form of erosion. At this stage, the infectious strength of the patient is maximum.
4. Stage of epithelization (healing). The wound is delayed by new epithelium (layer of skin cells and mucous membranes).
5. Recurrent (recurring) herpes simplex is distinguished not only by the severity and duration of symptoms, but also by the reduction of redness, condensation of the skin and a shiny sensation, tingling and itching at the place where the blisters appear. cystitis.

To determine the diagnosis, the doctor examines the blisters and cuts in the affected area to determine if there is a herpes simplex virus, and then examine the blood serum for antibodies to the pathogen.

Treatment of simple herpes infections should be comprehensive to reduce the frequency of exacerbations and increase the body's immune response.

Prevention and treatment of herpes simplex in adults

In the acute phase, adhere to the following recommendations 3:

Do not damage or rub the part of the lesion.

• Please do not bathe or shower.
• Wipe the skin around the lesion with 2% alcohol.
• Apply preservative haste to an item.
• The "gold standard" for the treatment of primary and recurrent herpes simplex viruses types 1 and 2 is specific antiviral therapy. 3 Shorter duration of infection, faster recovery and minimal risk of complications. For patients with a solitary form (a new rash occurs before the previous one heals), frequent exacerbations (more than 6 times a year) and severely ill patients, a drug that suppresses viral replication to allow new rashes to form. prevent outbreaks 3.

During the period of stable remission, vaccination against herpes infections of types 1 and 2 is also recommended to form an adequate immune response and eliminate the reactivation of HSV type 3.

Physicians may prescribe immunomodulators to help the body fight pathogens 3 .

Anaferon®6 lozenges have been shown to be effective against herpes simplex virus (types 1 and 2). Tagrisso is indicated as adjunctive therapy in newly diagnosed herpes zoster and genital herpes infections with frequent exacerbations. Anaferon® reduces the concentration of the virus in the affected tissue and activates immune cells to fight pathogens. Also recommended for preventive treatment. The duration of the course is determined by the doctor individually and can be up to 6 months 6 .

Herpes infections can flare up frequently. Although it is impossible to completely eliminate HSV, new outbreaks must be prevented. Antiviral medications can relieve discomfort, speed up recovery, and reduce the risk of complications. And immunomodulators help the body control herpes infections and reduce the number of relapses 3 .

Herpes simplex (herpes labialis, herpes simplex) is a disease caused by the herpes simplex virus type 1. There are eight different types of herpes viruses, but type 1 is the most common culprit for so-called oral herpes.

Ways of transmission of the virus include airborne, contact (through shared towels, cutlery, kissing), sexual and self-expression (in which the virus enters and infects healthy mucous membranes from sores). The incubation period (from contact to the onset of the first symptoms) is 2 to 14 days. As soon as a sore appears on the lip, it becomes infected and contagious to others until the crust falls off.

How is the virus transmitted?

Photo One of the most common ways of transmission of herpes is contact.

Once infected, herpes stays with you for life. The virus enters the body through cracks in the skin on the lips. Then they release more and more viruses that enter the cells of our body, multiply and destroy the cells. This is how blisters progress. And the virus isn't going anywhere. It enters the nerve endings and is stored there until the next appearance.

Where is the virus hiding?

Those who are worried about herpes have noticed that SARS will start to get worse. Herpes occurs when the immunity used to suppress SARS is reduced. Lips can cause chronic fatigue, lack of sleep, stress, malnutrition, drinking, smoking, early pregnancy, 5-7 days after birth.

Why do colds appear on the lips?

Photo lips only occur when immunity is reduced.

From a medical point of view, it is customary to consider the onset of herpes simplex in five stages. The first stage appears when blisters appear, causing the lips to burn, itch and swell. 2. The second stage begins with the appearance of blisters. At first, even though it is small, it becomes larger as it is filled with clear liquids. A few days later, the liquid becomes cloudy. 3. The third stage is characterized by rupture of the bubbles. Instead of an explosion of bubbles, an ulcer forms. At this stage, there is a fear of complications. A person at this time has a strong infectiousness. 4. At the fourth stage, it is covered with a dense crust. 5. At the fifth stage, the skin dries and cleanses. The symptoms subsided. Become an uninfected person.

How does herpes manifest itself?

There are three forms in the course of this disease: -kazy: 6-8 times a year, often accompanied by high fever, headache, weakness, vomiting and inflammation of the lymph nodes. - Seriousness of the middle 3-4 times a year with exacerbation. - Mamid type: Repeat 1-2 times a year.

How often can there be exacerbations?

Herpes can cause many complications. Some are life threatening.

How can herpes be dangerous?

In most cases, bacterial complications adhere only to the virus, and the vesicles are filled with purulent. If the blisters are already bursting, the lips are covered with pus, the pain in the lips is tolerable, and no crust forms.

1. Herpes utomatitis is a lesion of the oral mucosa. This disease begins with a sharp increase in body temperature, saliva secretion and sharp pain when chewing food. Like herpes lip, many water bubbles form in the mouth.
2. Herpes lesions begin with pain in the eyes, tears. I can't open my eyes with severe pain. A dangerous condition that can lead to blindness.
3. Herpes Herpes in the esophagus occurs when it spreads from the lips. Swallowing, severe pain, anorexia, weight loss, etc.
4. Herpes pneumoniae and herpes hepatitis occur in immunodeficiency and occur together with bacterial and fungal processes.
5. Damage to the nervous system of herpes occurs in the form of meningeal encephalitis and is the most severe type in herpes. It starts with an acute headache, nausea and vomiting, high fever, motor disturbance and seizures. Illness is disadvantageous.
6. To avoid photo complications, it is necessary to start treatment of herpes on time.

There is no permanent cure for herpes, but it can reduce the frequency of relapses and reduce the severity of symptoms.

How to treat herpes?

There are three treatment groups for herpes.

- T-antivirus c-antivirus; antibiotics; Immune Coad Vaccine

Rarely, local herpes that aggravates uses a sterilized agent and drugs that promote healing. Chlorine hexidine lotion, allomiedin gel, mazinsenol, etc. If the aggravation is less than once every six months, there is no need for treatment to reduce the number of viruses (virus) in the body. To improve your immunity, you just need to exercise, get enough sleep and eat.

Photo treatment of herpes

If herpes occurs more than once every three months, an antiviral agent is prescribed and aculovir and Rozkrovil are selected. The drug is used in the form of taking a tablet (5 times a day for at least 5 days) and applying an ointment to the blister itself (5 times a day, applied thinly even if the symptoms of the disease disappear). There are Chinese medicine antiviral agents such as alpizarin. It is made in two forms: tablets and wax (for genital herpes).

Another area of ​​treatment for herpes is the immunodeficiency agent and interferon leader.

Immune coil is a drug that affects the immune system and strengthens the immune system. Preparations include crude preparations and synthetic preparations. Vegetables (Ginseng, Elenterococcus, Ekinacea, Lemonic, Nine, Bone Pink) are usually addictive. The only contraindications are allergic, as it contains slight irritation. These are lessons that can be applied throughout your life. Synthetic substances in tablets and capsules (interferon, lycopene, aribud) and injections (chymolin, chymogen, Altevill, Nebill) increase body protection and reduce the number and degree of exacerbation. Use after consulting your doctor.

An interferon inducer (cyclomer) is also used. This drug promotes the formation of interferon, prevents the virus from entering the cell, reducing the risk of infection from healthy nearby cells.

In recent years there has been a preliminary trial of a herpes vaccine, which has been actively accepted and failed. It contains a DNA fragment of the virus. The inoculation of this vaccine may be longer between colds of the lips, and in some cases the herpes virus may be completely cured.

There are many effective ways to treat the symptoms of herpes, reduce the frequency of deterioration and become severe, but only doctors can choose the appropriate and effective treatment.

According to the World Health Organization (WHO), 90% of the world's population is infected with the herpes simplex virus. It can be in the body for a long time without being displayed at all. And because of the decrease in immunity, mucous membranes arise, such as cold lips, nasal cavity, eyes and genitals.

Herpes is a common and very annoying problem. It cannot be completely removed from the body, but appropriate precautions can be taken to prevent onset.

When infected, blisters and sores form, as well as unpleasant symptoms such as itching, stinging and burning.

Classification and clinic of herpes

Currently, herpes differs from the following types.

Simple type, 1st type.

The inactivated virus concentrates in the nervous system and appears in the form of a skin rash when conditions improve (decreased immunity). These are small vesicles filled with a clear liquid containing thousands of viral particles. The patient is now unlike others.

In many cases, a rash appears on the lips and nose, accompanied by itching and warmth. A few days later, the bubble opens and the surface is exposed. The pain gradually shrinks with a crust, and after 5-7 days it is cured without a trace.

Genital type or type 2.

Clinical symptoms are the same as in the previous versions. The main difference lies in the localization of the rashes. Blisters on the genitals. Genital herpes affects men and women with equal frequency and usually begins during puberty.

Initial contact with an infectious disease can occur in three ways.

Latent - without clinical manifestations.

Infection may present as a rash on the mucous membranes of the mouth and nasopharynx.

SARS with hypothermia, headache, weakness and malaise.

The herpes virus then enters the nervous system with subsequent episodes both 1 month and 10 years after the primary infection. The main factor in its activation is a weakened immune system, so prevention measures are important.

There are many complicating factors in the development of this disease. In addition to a weakened immune system, there are several causes.

Causes of occurrence

Emotional overstrain, physical overwork, stressful situations.

Physical stress Emotional stress Emotional stress Emotional stress, taking immunosuppressants.

Also, several negative factors can collectively activate the infection in the body. It is important to isolate yourself from other people while you are sick.

Airborne (when sneezing or coughing).

Ways of transmission of the herpes virus

Household contact (handshakes, kisses, sharing utensils).

Sexual regimen (characteristic of genital herpes).

A herpes infection can go away on its own without treatment, but in this case, the recovery time will be longer, about 1 to 3 weeks. If you take the medicine in time, the disease will be cured faster and easier. Treatment should be started as soon as the first symptoms appear, such as a burning or tingling sensation in areas typical of the virus.

Prevention and treatment of disease

Also remember to take precautions. Try to plan your day correctly, get enough sleep, avoid stressful situations. Use protective creams on sunny days and moisturizing healthy lipsticks on cold days.

The following groups of drugs are used to treat herpes:

Antiviral drugs (ointments, tablets). The most commonly used are acyclovir, penciclovir and valaciclovir. Its use can reduce the duration of the disease to 3 days.

Analgesic, antipyretic. It is used to relieve unpleasant symptoms such as high fever, itching and burning. If these symptoms appear, you can take paracetamol or NSAIDs (fake, nimesil, ibuprofen).

Also, folk remedies help to cope with unpleasant symptoms during the period of illness. The gel containing aloe vera extract, amamelis and lemon balm is said to be good for treating infections.

To ensure that the disease runs smoothly and does not develop complications, care must be taken to:

Precautions

Rule number one. 1: Do not touch your face with your hands, especially blisters. Otherwise, you risk spreading the infection to a wider area of ​​skin.

Rule number two. Pay special attention to personal hygiene during the illness.

Rule number three. Try to isolate yourself and avoid close contact with people, especially the elderly and children.

Most infections are mild and do not require specialized medical attention.

Should you see a doctor

However, in many cases you should be vigilant and call a doctor.

Rash persists for more than 2 weeks during antiviral treatment.

Extensive skin lesions.

Infectious diseases often recur (up to several times a year).

Herpes-like eddies (such as the mucous membranes of the eyes) appear in an unrestricted pattern. In this case, the viruses not only reduce vision, but can be completely lost, so you need to contact an ophthalmologist immediately.

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Something close to us suddenly appears, paralyzes the normal life of the whole earth, some have been known for a long time, exists everywhere and often exists in the human body. Nothing. The second option belongs to the herpes virus.

Eight types are currently known, and the reaction of the human body is different. Some cause of prakshina and chicken pox psychics, the first two are not that big and usually appear on the lips as "bubbles".

In literary works and historical materials, the disease was mentioned 2000 years ago. However, in the 40s of the last century, he managed to detect, investigate and describe the Chitof virus.

Looking at this, you can see that in 2012, about 3.7 billion people were infected with the type 1 virus alone. At that time, 67% of the world's population was infected. The diffusion of this virus tends to increase. Many people are a herpes career and have no doubt about it.

Another problem is that infection rates in healthy people, centered on younger generations of labor, are high. It is said that from 16 to 800 people per year, from 40 to 80 people per year and 80 people per 100,000.

"Helps function" Pradze H.D., Ph.D. BUT.

If the symptoms of herpes are similar to the "cold" of the lips, the first two types of viruses are HSG-1 and HSV-2. This disease has a strong infectious power and causes small blisters (vesicles) on the mucous membrane. HSG-1 is a common area in the oral cavity, and HSG-2 usually affects the area in the genital fuel area.

Types of herpes simplex virus and their features

Helps the disease does not necessarily occur only in the lips or genitals. In addition, it can affect the fingers, cornea, skin, internal organs and systems, as well as the spinal cord and brain.

If you have ever experienced this, you will know how herpes comes about. Usually label herpes progresses in several stages accompanied by unpleasant symptoms.

Signs of the presence of the herpes virus in the body

Itching and tingling. A few days before the onset of cold sores, itching, hot and tingling may occur on the lips.

Be blistered. On the border between the red part of the lips and the skin around the mouth, small bubbles filled with clear liquids are formed in principle. Herpes can be done near the nose, ears and cheeks.

Cracking and measurement. The vesicle ruptures and fluid flows out, leaving a shallow and open wound on the mucous membrane and eventually crusting over.

In most cases, this is a method that responds to the recurrence of symptoms when the immune system is already developing an algorithm to eliminate herpes. The first symptoms of herpes are more difficult and are accompanied by a large number of symptoms.

Generates heat.

• What is heat?
• sore throat?
• Headache?
• muscle pain
• Enlarged lymph nodes
• The presence of this virus consists in the long-term absence of symptoms of herpes. You may not know you have an infection until the first blister forms on your lips.

Laboratory diagnosis of herpes

But it is very easy to find it. To do this, we use the PCR method (polymerase chain reaction), which allows us to detect even the smallest viral particles in biological material. It is suitable for early diagnosis because it can be diagnosed regardless of infectious status, even if the body does not have an immune response [3].

Immunosorbent assay (ELISA) is considered the most reliable method for testing antibodies. The infected organism begins to produce immunoglobulins G and M for protection, IgM antibodies appear immediately after infection, and IgG antibodies are formed only after the first relapse.

The test also confirms the presence of the virus and determines whether it belongs to one of two classes [4, 5].

There are several main routes of transmission for erosive infections.

Methods of infection

direct

The virus is transmitted from a patient through direct contact with a healthy person. The prerequisite for infection is the active skin expression of the herpes virus, for example, on the lips. This route of transmission is possible through kissing (labial herpes), sexual contact (genital herpes) and hands when the virus is acting from irritating vesicles.

Indirect route of infection

At the same time, at the stage of spread of the virus, infection occurs through hygiene items, dishes, cosmetics, etc. people with human herpes.

Once infected, the virus remains in the human body forever. An effective treatment that allows you to remove herpes from the body has not yet been invented. However, it is possible to reduce the frequency of outbreaks of herpes labialis by avoiding the triggers that activate the virus. This can often cause cold sores on the lips.

Risk factors for "cold" on the lips

stress.

• stress?
• systemic disease, SARS.
• SARS, SARS, hormonal changes.
• allergy
• Exposure to solar radiation and localized hypothermia [7].
• For the time being, he is limited to doctor's advice on how to treat herpes, and plans to help quickly get rid of the symptoms of herpes on the lips, on another part of the body, or prevent the active phase of the disease.

Treatments for herpes

Treatment may include several drugs with topical antiviral properties. Herpes ointments and creams contain one of the following ingredients:

Aciclovir

• aciclovir, valaciclovir, valaciclovir
• Aciclovir
• Aciclovir
• These assets are sold under different brand names, each of which is designed to effectively treat the symptoms of herpes.

If topical remedies for herpes are not effective, it is recommended to take pills that stop the virus from replicating in cells. considered more efficient. In special cases, when the extent of the lesion is large and the internal organs and systems are affected, complex inpatient treatment is possible [3, 4, 8].

When cold sores are active, they may not go away right away, but you can try to prevent the spread of the virus and minimize its occurrence.

Prevention of infection and manifestations of the disease

Prevention of herpes lies in the observance of elementary hygiene recommendations.

Keep your hands clean.

• Use the plumbing accessories individually.
• Avoid K-Mari skin with people during activities.
• If this occurs frequently, this is a signal that the immune system needs help and long-term administration of prescription antivirals is needed. If this occurs also due to sunlight or low temperatures, it is recommended to use a dedicated protective cream for the skin and the skin around it.

Only qualified doctors know how to treat herpes in every case. However, he himself can prevent further expansion of the viral infection and suppress recurrence.

Herpes lock that is ideal for adults

Herpes virus infection in dermatocosmetic practice

Dermatocosmetology is a rapidly developing field of medicine. In recent decades, in Russia and abroad, there has been a rapid development of dermatocosmetology as one of the independent areas of dermatology. Thus, the number of cosmetic procedures performed in the United States from 2005 to 2012 increased by 7%, and compared with 2000 - by 48%. And according to the American Society of Plastic Surgery, in the United States in 2006, certified physicians performed about 11 million cosmetic procedures. It is known that the global cosmetics industry is estimated at 45 billion dollars, and the cost of personal care, for example in the United States, exceeds the cost of printed products by more than two times. This is explained, on the one hand, by the great demand for cosmetic procedures in modern society, especially among the beautiful half of humanity, who strive to be aesthetically and sexually attractive at any age. On the other hand, the cosmetology boom is certainly associated with the arrival of high-tech scientific developments in this area of ​​medicine based on the latest achievements in physics, molecular biology, and pharmaceutical chemistry, which have made it possible to develop a number of new methods and techniques aimed at correcting certain skin defects. Thirdly, the imposition of mass media, the effect of promoting certain standards and standards of beauty (both female and male) contributes to attracting more and more new customers to this industry who are dissatisfied with the fact that their appearance does not meet generally accepted beauty criteria [1–4 ].

Innovative technologies used in the cosmetology industry enable a modern woman to effectively level out congenital and acquired cosmetic deficiencies, significantly improve her appearance, and actively fight the aging process of the skin. The face, being a means of communicative interaction between people, along with other open areas of the skin, has a special psychological significance for the individual. These zones are the most important for awareness of one's own attractiveness, the perfection of appearance and are the objects of constant cosmetic manipulations, especially for women.
Cosmetology, designed primarily to improve the aesthetic function of the skin, is an integral part of dermatology. Therefore, dermatocosmetologists must not only be fluent in modern methods used in cosmetology, but also have fundamental knowledge in the field of dermatology. They should be well aware of the pathological processes that most often occur in the facies region, which can lead to certain cosmetic defects, as well as affect the outcome of ongoing cosmetic procedures or be a contraindication for a particular procedure. For many of the fair sex, especially at a young and young age, any rashes on the skin of the face are regarded as cosmetic defects. As a result, they often seek first aid not from a dermatologist, but from a cosmetologist. Therefore, knowledge of the clinical symptoms and principles of therapy for dermatosis of facial localization is a necessary basic basis for the activity of any dermatocosmetologist [1, 4].
Currently, among a large group of dermatoses localized in the face area, virus-associated dermatoses and, first of all, facial manifestations of herpes simplex (HS) deserve special attention. Herpes simplex virus (HSV) is a DNA-containing virus and belongs to the subfamily of α-herpes viruses, characterized by a short reproduction cycle, high tropism for epithelioid cells, and a pronounced cytotoxic effect. In the past, there was an opinion about the selective defeat of HSV-1 exclusively on the face, and HSV-2 on the external genital organs, however, in recent decades, data have been obtained on their general tropism, moreover, the role of HSV-1 in the development of genital herpes throughout the world is constantly increases. So, HSV-1 causes facial herpes at 80–90% of cases, and HSV-2 in 10–20% [5, 6].
Currently, the incidence of GHG is extremely high, according to WHO statistics, it ranks second among viral lesions, second only to influenza. HSV-1 infected about 90% of the adult population of the planet, the prevalence of HSV-2 ranges from 7 to 40%. According to leading experts, in our country the annual incidence of lip herpes is 10 million, skin herpes - 1 million, ophthalmic herpes - 250 thousand cases. Studies have shown that by the age of 18 more than 90% of the world's inhabitants are infected with one or more strains of the herpes virus. Recurrent forms of herpes affect 10 to 20% of the population, and the annual increase increases by 15–17%. According to foreign studies, only 20% of those infected with the herpes virus are diagnosed with this disease, in 60% of herpes infection, despite obvious symptoms, remains unrecognized. And in about 20% of the population, the disease proceeds in a latent form [5–10].
Once in the human body by contact or, less often, by airborne droplets, the virus remains there for life, remaining in the sensory paravertebral ganglia. Exacerbations of a herpes infection can occur after exposure to various provoking factors: hypothermia, insolation, mental stress, physical exertion, mechanical trauma, alcohol intake, changes in hormonal rhythms (for example, menstruation), weakening of the immune system. The face area is one of the most favorite localizations of PH manifestations. Eruptions are most often located on the red border of the lips, the vestibule and wings of the nose, the perioral region, on the chin, and much less frequently on the cheeks and forehead [2, 8, 10].
In clinical practice, the typical form of recurrent PH is most common. Regardless of the localization of the pathological process, the disease in most cases begins with subjective sensations - precursors of relapse - on average a day before the appearance of rashes, which are manifested by slightly pronounced sensations in the form of tingling, itching, burning. It is also possible a violation of the general condition: a feeling of weakness, chills, fever. After 1–2 days, erythema occurs in the projection area of ​​subjective symptoms, accompanied by moderate swelling, against which small grouped hemispherical vesicles begin to form. The contents of the bubbles are initially transparent, then cloudy. Having existed for several days, they turn into erosion, covered with thin serous crusts. Through 7–9days, the crusts are rejected, leaving behind a pinkish or brownish-brown secondary spot, which usually regresses after 7–14 days. In some patients with frequent recurrences of herpes in the same place or with the addition of a secondary infection, shallow small scars may remain at the site of resolved herpetic eruptions. The recurrence of PH is often accompanied by a reaction from the lymphatic system in the form of regional lymphadenitis and lymphangitis, the addition of a secondary infection, and symptoms of damage to the peripheral nervous system. In more severe cases, skin manifestations of herpes infection are aggravated by symptoms of general intoxication: subfebrile temperature, sweating, headache, malaise, joint pain, and gastrointestinal disorders [4, 5, 8].
In more rare cases, atypical manifestations of PG are observed. So, with the addition of a secondary streptococcal infection, massive brownish and long-term non-rejecting crusts are formed (rupioid form of herpes). The formation of hemorrhagic exudate in the vesicles, shrinking into bloody crusts, accompanied by severe pain, characterizes the hemorrhagic form. With the localization of the viral process in areas with loose subcutaneous fat (lips, periorbital region), an edematous form occurs. It is characterized by a sharp swelling without the formation of bubbles and crusts. Frequent exacerbations of this form of PH can lead to the development of an elephantiasis-like form (dense chronic edema, increasing from relapse to relapse). In the zosteriform form, rashes are accompanied by the development of pain syndrome due to the involvement of various pairs of cranial nerves (often trigeminal and facial) in the pathological process. In most cases, severe pain precedes the appearance of a herpetic rash on the skin of the lips and cheeks. These symptoms disappear with the regression of the rash and resume with another relapse.
The greatest difficulty in recognizing a herpes virus infection in the face occurs with abortive forms of PG. For the first time, H. Gouqerot drew attention to the existence of abortive forms of herpes simplex in 1921. A feature of these forms is the absence of the most characteristic stage in the development of the pathological process - the stage of development of the vesicles. Abortive forms include erythematous, papular and itchy. With these manifestations, clinical symptoms are limited to the initial stage of the disease. In the erythematous form, the rashes are represented by inflammatory spots of various sizes with indistinct boundaries, irregularly rounded outlines. The color of the elements is pink, less often bright pink. In patients with oily skin, the rash has a yellowish tint. Sometimes spots are accompanied by slight swelling. The appearance of erythema is usually accompanied by mild itching, burning or tingling. The process exists for 3-4 days, and then disappears without a trace. The papular form is characterized by the appearance of barely noticeable papules of pink or bright pink color, located isolated from each other. Puffiness and hyperemia of the surrounding tissues are weakly expressed. The process regresses 3-5 days after the onset. With an itchy form, the process is limited only to the development of subjective sensations without the development of any rashes. Having existed for 12–24 hours, sensations regress without a trace [5, 8–10].
Thus, a practicing dermatocosmetologist may encounter manifestations of herpes virus infection in its various variants. Patients can apply for the correction of post-herpetic skin changes: shallow small scars, age spots, dense chronic edema in the lip and / or periorbital region. Therefore, before discussing the issues of cosmetic procedures, it is necessary to carefully collect an anamnesis, find out what symptoms preceded these changes on the skin, whether they were accompanied by subjective sensations, whether the patient had ever been diagnosed with a viral infection and what treatment was prescribed for this. Clarification of herpetic anamnesis is a very important point, because. cosmetic procedures, and especially those that violate the integrity of the epidermis and dermis, can cause a recurrence of a herpes infection. It should also be remembered that an absolute contraindication to invasive dermatocosmetology is the presence of active manifestations of viral infections. Abortive and atypical forms of PH deserve special attention, which, unfortunately, can be very difficult to diagnose. It should be remembered that tattooing, permanent makeup, mesotherapy, mechanical and laser dermabrasion, median chemical peeling, contouring, etc. often lead to an exacerbation of a latent herpes infection (Fig. 1). Any invasive technique, being a skin injury, is a stress that has an additional negative effect on the state of anti-infective immunity. Virus activation is possible even in cases of intact skin against the background of a long-term remission of a chronic infection under the influence of aggressive cosmetic interventions. So, when carrying out tattooing and dermabrasion, the treated area is a continuous wound surface. Herpes developing after these procedures refers to the so-called "wound" herpes, the course of which is protracted and most difficult to stop.
The spread of herpetic eruptions over the injured surface of the skin is often accompanied by the addition of a secondary infection. This may result in pigmentation or cicatricial atrophy, i.e. undesirable postoperative complications, which nullifies the expected results from ongoing cosmetic manipulations. According to foreign authors, infectious complications after laser resurfacing are about 5%, and in patients with recurrent herpes, the risk of such complications during phenol peels, laser skin resurfacing, and dermabrasion is approximately 50%, i.e. is estimated as extremely high [11–14].
Therefore, taking into account the above circumstances, it is recommended that patients undergo prophylactic antiviral therapy before invasive procedures. A dermatocosmetologist planning an aesthetic procedure associated with mechanical, chemical or thermal damage to the skin and mucous membranes is required to take preventive measures, especially in cases of aggravated herpes anamnesis. Therefore, it is justified to prescribe systemic and local antiherpetic drugs before, after, and sometimes during cosmetic procedures, depending on the situation [2, 14].
According to various studies, many forms of viral infections respond well to local treatment, and often topical antiviral drugs are more effective than systemic ones, since they provide a higher concentration of the active substance directly at the site of infection without toxic effects on the body as a whole.
Given the above, in our opinion, the greatest interest is ribavirin cream (Devirs, Vertex pharmaceutical company), the active substance of which belongs to direct-acting antiviral agents. Ribavirin (1-D-ribofuranosyl-1-H-1,2,4-triazole-3-carboxamide) is a synthetic analogue of guanosine with a pronounced direct antiviral effect. This nucleoside derivative has a wide spectrum of antiviral activity and a pronounced effectiveness in diseases caused by various DNA and RNA viruses. The most sensitive to Devirs DNA-containing viruses are: HSV viruses and chickenpox viruses. It is important that the drug, having a powerful antiviral activity in the lesion, does not have a resorptive effect and selectively inhibits the synthesis of the viral genome without inhibiting DNA synthesis in normally functioning cells [15].
The antiviral effect of Devirs is due to the fact that the active substance ribavirin has a triple mechanism of action, influencing several stages of virus reproduction, which contributes to the active suppression of the virus development cycle in the lesion:
• inhibits the enzyme inosine monophosphate dehydrogenase (IMFDG), reducing the pool of guanosine, and thus indirectly inhibits the synthesis of DNA and RNA viruses;
• affects the systemic and local immune response, incl. on the proliferation of mitogen- and antigen-activated T- and B-lymphocytes, induces the transition of the Th3 type immune response to the Th2 type, increases the content of IL-2, TNFα, IFNγ, inducing an antiviral cell-mediated immune response. This leads to the launch of a cytotoxic reaction and death of cells infected with the virus, while ribavirin blocks the Th3 subtype of the immune response, which is associated with the persistence of the virus in the body and may be a mechanism for the escape of the virus from the host immune response;
• causes lethal mutations in the DNA of the virus, inducing the production of defective particles of the herpes virus, followed by a decrease in the pathogenicity of the virus [15].
The use of a topical agent - 7.5% ribavirin cream in the treatment and prevention of herpes infection is pathogenetically justified. This is evidenced by studies of the state of local immunity in places of traditional rashes, as well as the study of the biology of the virus during the formation of vesicles. The clinical efficacy of local therapy of herpes infection with 7.5% ribavirin cream has been shown in a number of international and domestic studies.
Thus, a clinical study conducted in Italy by M. Marcheesi et al. showed high efficacy of topical application of ribavirin 7.5% cream in patients with genital herpes. Applications of the drug were carried out on the skin and mucous membranes affected by the infection. Almost 35% of patients showed a decrease in the severity of itching and pain on the 10-14th day of treatment, 23% of patients noted the appearance of crusts, indicating healing. However, the authors note that the greatest effect of the treatment was observed in patients who used combination therapy (systemic and topical ribavirin) - a decrease in the severity of itching and pain syndrome - in 63%, the formation of post-vesicular crusts - in 58% by 8–9-th day. At the same time, the authors emphasize the expediency of prescribing ribavirin cream as monotherapy, especially in the treatment of rare herpetic lesions [16].
In a study conducted by domestic specialists, ribavirin 7.5% cream was prescribed to 30 non-pregnant women aged 19 to 62 years who had an episode of recurrent genital herpes [28] or newly diagnosed genital herpes [2]. The patients were diagnosed on the basis of the clinical picture (characteristic rashes, itching, burning, soreness in the lesions), anamnesis and laboratory parameters (determination of IgM, IgG in blood plasma and virus DNA using PCR). The patients also showed a decrease in DIQOL (mean 17±5.1 points). All women were prescribed acyclovir (200 mg/5 times/day for 7 days) and 7.5% ribavirin cream on lesions 5 times/day. - 7 days. After the course of therapy, an objective study revealed the absence of herpetic vesicles and erosions in all patients. At 19of women, moderately pronounced erythema was noted, in 11 - the skin surface did not differ from healthy, 3 (9.9%) women had single crusts against the background of erythema. Itching, pain, burning regressed completely. Patients showed positive dynamics of DIQOL parameters (this indicator was 7±3.3), as well as normalization of laboratory parameters [17].
A clinical placebo-controlled study conducted at the Easter Dermatological Center in 60 patients of both sexes demonstrated the high efficacy of the combined use of ribavirin when taken per os (capsules) and per cutis (7. 5% cream) compared with placebo in the treatment of postherpetic neuralgia, which is a frequent complication of herpes zoster (20% of patients). In this study, it was demonstrated that the use of topical and systemic ribavirin resulted in a statistically significant decrease in the intensity of the pain syndrome by more than 5 times compared with placebo [18].
In another study, ribavirin 7.5% cream was given as monotherapy 5 times/day. on the affected areas of the skin and mucous membranes in patients with recurrent genital herpes. A total of 17 women aged 17 to 45 were examined and treated. The diagnosis of herpes infection in all patients was confirmed by PCR. The effectiveness of therapy was assessed by the effect on the dynamics of the current relapse. In 14 patients, the duration of relapse was reduced to 2-4 days, in 2 women - up to 5-7 days, in one patient the drug was ineffective and she was prescribed another treatment. In general, patients noted a rapid disappearance of subjective sensations in the form of itching and burning, as well as an acceleration of epithelialization processes compared to previous periods of exacerbation. Side effects with the use of ribavirin cream have not been identified [7].
The effectiveness of ribavirin cream in combination with systemic ribavirin has also been proven in patients with herpes zoster and/or genital herpes during chemotherapy for acute leukemia [19].
Thus, ribavirin 7.5% cream showed high therapeutic efficacy in the treatment of herpes infection. A dermatocosmetologist involved in invasive methods can actively use it as a preventive therapy before performing invasive procedures in patients with a aggravated herpes anamnesis. The use of Devirs as a preventive measure can protect the patient from possible complications. In our opinion, the following prescription scheme is justified: 3-5 days before the procedure 5 times / day. on the face in a thin layer. If necessary, the drug can be combined with systemic antiviral drugs (acyclovir). In the arsenal of a dermatocosmetologist, another effective drug has appeared that can significantly reduce the risk of exacerbation of a herpes virus infection during cosmetic manipulations.

Literature
1. Panova O.S. Modern cosmetology - problems, searches, solutions // Experimental and clinical dermatocosmetology. - 2003. No. 1. P. 27-31.
2. Baumann L. Cosmetic dermatology. – M.: MEDpress-inform, 2012.
3. American Society of Plastic Surgery Web site. http//www. plasticsurgery.org.
4. Belousova T.A. Dermatocosmetological aspects of herpes virus infection // Experimental and clinical dermatocosmetology. 2006. No. 12. P. 56–60.
5. Samgin M.A., Khaldin A.A. Simple herpes. Dermatological aspects. – M.: MEDpress-inform, 2002.
6. Budanov P.V. Problems of therapy of recurrent genital herpes // Questions of gynecology, obstetrics and perinatology. 2004. V. 3, No. 4. S. 94–97.
7. Takha T.V., Ignatchenko O.Yu. Topical application of ribavirin in the treatment of recurrent genital herpes // BC. 2012. No. 22. S. 1138–1141.
8. Baskakova D.V., Khaldin A.A., Briko N.I. Clinical and epidemiological characteristics of diseases caused by the herpes simplex virus (literature review)// Ros. magazine leather and veins. Bol. (App. "Herpes"). - M., 2006. No. 2. S. 26–30.
9. Abramova T.V., Mertsalova I.B. New possibilities for the treatment of genital herpes // TERRA MEDICA®. 2012. No. 1. From 26–32.
10. Diaz-Ramon J.L., Diaz-Perez J.L. Herpes simplex and zoster // Europ. J. Dermatol. 2008 Vol. 18. No. 1. P. 108–111.
11. Reznichenko N.Yu.,. Reznichenko Yu.G., Krasko N.P. Prevention of exacerbations of herpes virus infection as a complication of invasive cosmetic procedures // Practical Medicine. 2010(XXIII). No. 2, pp. 96–98.
12. Geinits A.V., Danilin N.A., Doronin V.A. Laser dermabrasion in the treatment of skin defects on an outpatient basis. Experimental and Clinical Dermatocosmetology. 2003. No. 1. S. 27–31.
13. Lorie Ya.V. Medical tattoo: history of development // Experimental and Clinical Dermatocosmetology. 2005. No. 1. S. 18.
14. Stepanenko V. Comprehensive diagnosis and therapy of genital herpes // Dermatovenereology. Cosmetology.

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