Clinical recommendation
Evidence
rating References
When treating recurrent herpes labialis with systemic antivirals such as
acyclovir (Zovirax) or valacyclovir (Valtrex), therapy should be initiated
during the prodrome. Topical penciclovir (Denavir) may help speed
healing and reduce pain even if started after the prodrome.
B 10, 12-14
Patients with severe recurrent aphthous stomatitis should be evaluated
for possible underlying systemic diseases and vitamin deficiencies.
B 16, 34
A = consistent, good-quality patient-oriented evidence; B = inconsistent or limited-quality patient-oriented evi-
dence; C = consensus, disease-oriented evidence, usual practice, expert opinion, or case series. For information
about the SORT evidence rating system, see page 453 or http://www.aafp.org/afpsort.xml.