2017 HCHB_digital

CONTINUING OTC EDUCATION
answers yes to any appropriate Refer to pharmacist questions (see opposite
page), refer the customer to a pharmacist. For all other customers, explain the
treatment options available to them.
Treatment
Most cold sores heal themselves within seven to 10 days; however, customers
who wish to shorten the duration of treatment or hide the cold sore may request
over-the-counter topical products.
Topical antivirals such as aciclovir and penciclovir help shorten symptom
duration if started early (at the first tingle). Effectiveness of iodine-based
preparations such as idoxuridine and povidone-iodine is questionable; however,
one product also contains an anaesthetic that can help relieve pain and itching
associated with the sore. Hydrocolloid patches create a beneficial healing
environment for the cold sore, help reduce viral transmission, and also keep nerve
ending moist, helping to relieve pain. Make-up can also be applied over the
patch, helping to hide the cold sore.
Prescription oral antiviral agents such as aciclovir and valaciclovir are more
likely to be prescribed for people with genital herpes, although may be used to
treat severe facial infection or infection in immunocompromised people. They
stop HSV from multiplying so can shorten and prevent attacks; however, cannot
eradicate it from its resting state within nerve cells. Valaciclovir is converted
into aciclovir in the body and has the advantage of two to three times daily
dosing instead of the five times daily dosing required for aciclovir. People with
a weakened immune system are more prone to developing severe and recurrent
cold sores.
Advice for customers
• Use a lip balm containing sunscreen on your lips before going outside if you
find sunlight tends to reactivate the virus.
• Have treatment on hand, ready to use at the first “tingle”.
• Keep the cold sore moisturised to prevent the affected area drying out and
cracking, and do not pick off the scab.
• People who get repeat attacks of severe cold sores may need to see their
doctor for a prescription medicine.
Tips to avoid spreading a cold sore
• Cold sores are easily spread from person to person, especially when the sore
is still weeping. Advise your customers that while they have the cold sore they
should:
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avoid kissing or other intimate contact
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avoid sharing towels, face flannels, or eating and drinking utensils
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take care not to touch the cold sore, then touch or rub their eyes. Extra care
should be taken if they wear contact lenses
Refer to
PHARMACIST
The following questions aim to identify customers who would
benefit from further input from a pharmacist. Your initial assessment
or a caregiver's history may have already provided some answers.
Decide if any further questions still need to be asked and refer any
“yes” answers to a pharmacist.
• Does the person have any other health conditions (eg,
immunosuppression, diabetes, is pregnant or breastfeeding)?
• Does the cold sore cover a large area, eg, as big as a 10 cent piece,
or does the person have more than one cold sore?
• Are the cold sores recurring frequently?
• Are there any cold sores in the mouth?
• Are there similar lesions elsewhere on the body?
• Are there any other symptoms (eg, fever, feeling unwell)?
• Do the cold sores look infected (eg, pus or swelling)?
• Have the sores spread near to or into the eyes?
• Is the customer a young child?
• Does the customer also have dermatitis or other skin conditions
near the cold sore?
• Has the cold sore lasted more than 10 days or persisted despite
treatment?
• Does the person have any allergies to topical medicines?
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wash their hands before and after applying cold sore products, before
preparing food or eating, and before attending to other people
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avoid using the same finger when applying cold sore products as they may
contaminate the cream
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not share their cold sore cream with other people
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not share cosmetics, especially lipsticks.
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