Valacyclovir Prophylaxis for Herpes Simplex Virus Infection or Infection Recurrence Following Laser Skin Resurfacing

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Abstract
Background. The CO2 laser for cutaneous resurfacing has been associated with the reactivation of herpes simplex virus (HSV), causing delayed reepithelialization and scarring. Antiviral agents appear to be effective in reducing reactivation, however, the optimal therapeutic regimen has yet to be clearly defined. Objective. To assess the reactivation rates of HSV after CO2 laser resurfacing in patients who received prophylactic valacyclovir for either 10 or 14 days. Methods. One hundred twenty patients received valacyclovir 500 mg twice a day for either 10 or 14 days starting the day prior to facial laser resurfacing. Serology levels and consecutive Tzank preparations were obtained to determine past exposure to HSV and the presence of virus. Results. No patients in either group developed an HSV infection or had a recurrence. Conclusion. These results support the use of valacyclovir in a 10- or 14-day regimen as a preventive agent against HSV outbreaks following facial laser resurfacing.