Medications can promote healing, ease pain of sores

I am wondering about oral herpes. Have there been any advances made for treating or preventing oral herpes? I know about and use Abreva, but is there anything that works better?

Herpes simplex virus type one is the cause of oral herpes, usually called “cold sores” or “fever blisters.” These often start as a clear fluidfilled blister on the lips or in the mouth. Many people carry the virus, and some people experience periodic outbreaks of these painful lesions.

Docosanol (Abreva) is an over-the-counter cream that prevents viral entry and replication of the virus. Several, but not all, studies show that it is effective at speeding healing.

However, it is not as effective as the prescription cream penciclovir at reducing the size and number of herpes lesions. Unfortunately, the cost of penciclovir cream is prohibitive for many, with a single 5-gram tube retailing for around $800 in the U.S. Another over-the-counter medication, benzalkonium (Viroxyn), was shown to be about as good as or better than Abreva at making cold sores go away faster, and it also contains an anesthetic to ease the pain.

We really need better treatments for this common, painful condition. There is hope for a vaccine in the future.

I have a problem that you might not have heard about. I had shoulder surgery on my left shoulder two years ago and developed strong body odor on that side.

A year later, I had surgery on my right shoulder and developed body odor on that side. I never had strong body odor before. I did an online search for this problem and found out that it’s not that uncommon. One article suggested not to use bar soap but to use shampoo instead. I tried this, and now I’m body-odor free. What do you think about this?

I have two thoughts about this, but I’m not sure either of them is right. The first is that, after surgery, you are likely in a sling or, at the very least, less able to move your shoulder. You also may be bandaged. I suspect that has changed the bacteria that live on your skin, which is what causes body odor (sweat itself has an inoffensive odor in absence of bacteria).

The second possibility is that you may have had a nerve block at the time of the surgery. This can change the way you sweat, which in turn can lead to changes in your body’s normal flora (meaning the bacteria and yeast that live on healthy skin).

In either event, the goal is to get rid of the bad bacteria. Soap and shampoo have different abilities to kill bacteria. I sometimes recommend a topical antibacterial, chlorhexidine (sold as Hibiclens and other brands), which is very effective at reducing bacteria counts.

— L.P. — B.C.