Lasertherapie en herpes labialis

Herpesvirussen zijn berucht en moeilijk te bestrijden. Deze virussen hebben de neiging zich terug te trekken in de zenuwcellen van het lichaam en zijn onbereikbaar voor het afweersysteem. De virussen blijven levenslang achter in het lichaam en kunnen van tijd tot tijd actief worden en een nare en pijnlijke uitslag veroorzaken. Tandartsen hebben relatief vaak te maken met herpes labialis, bijvoorbeeld in de vorm van koortslippen en aften. Tegenwoordig wordt voor behandeling veelal een zalf met de werkzame stof aciclovir geadviseerd. Mogelijk kan in de toekomst lasertherapie een oplossing zijn voor deze aandoening.

Recurrent herpes labialis is a worldwide life-long oral health problem that remains unsolved. It affects approximately one third of the world population and causes frequent pain and discomfort episodes, as well as social restriction due to its compromise of esthetic features. In addition, the available antiviral drugs have not been successful in completely eliminating the virus and its recurrence. Currently, different kinds of laser treatment and different protocols have been proposed for the management of recurrent herpes labialis. Therefore, the aim of the present article was to review the literature regarding the effects of laser irradiation on recurrent herpes labialis and to identify the indications and most successful clinical protocols. The literature was searched with the aim of identifying the effects on healing time, pain relief, duration of viral shedding, viral inactivation, and interval of recurrence. According to the literature, none of the laser treatment modalities is able to completely eliminate the virus and its recurrence. However, laser phototherapy appears to strongly decrease pain and the interval of recurrences without causing any side effects. Photodynamic therapy can be helpful in reducing viral titer in the vesicle phase, and high-power lasers may be useful to drain vesicles. The main advantages of the laser treatment appear to be the absence of side effects and drug interactions, which are especially helpful for older and immunocompromised patients. Although these results indicate a potential beneficial use for lasers in the management of recurrent herpes labialis, they are based on limited published clinical trials and case reports. The literature still lacks double-blind controlled clinical trials verifying these effects and such trials should be the focus of future research.

Bron

Paula Eduardo C de, Aranha AC, Simões A, et al. Laser treatment of recurrent herpes labialis: a literature review. DOI: 10.1007/s10103-013-1311-8 [Epub ahead of print].