title: Patterns of disease and treatment of cold sores.
abstract: BACKGROUND
  Cold sores are a common condition that can cause significant morbidity and mortality. Antivirals are the typical treatment for cold sores, but the ways in which these medications are used to treat cold sores are not well studied.
  
  
  OBJECTIVE
  To determine the main treatments prescribed for cold sores and trends in their management over time.
  
  
  METHODS
  A retrospective analysis of the National Ambulatory Medical Care Survey database was used to analyze outpatient visits for cold sores from 1993 to 2009. Patients were included in the data analysis if they had one of the following three diagnoses reported for their reason-for-visit codes: cold sores (CS), herpes simplex (HS) or herpes simplex with cold sores (HS/CS).
  
  
  RESULTS
  There was a decreasing trend in the number of annual patient visits for cold sores. The majority of patients were mainly young to middle adulthood, white women. The top two most commonly prescribed medications were acyclovir followed by valacyclovir. Valacyclovir use increased in all three populations, while acyclovir use decreased.
  
  
  CONCLUSIONS
  The trends observed may indicate that physicians are evolving their treatment strategies to implement newer antiviral medications. This may prove more efficacious for the treatment of cold sores.
authors.affiliation: Department of Dermatology, Center for Dermatology Research, , Wake Forest University School of Medicine, Medical Center Boulevard , Winston-Salem, NC 27157-1071 , USA.
authors.forename: Vanessa N
authors.initials: VN
authors.lastname: Richardson
authors.forename: Scott A
authors.initials: SA
authors.lastname: Davis
authors.forename: Cheryl J
authors.initials: CJ
authors.lastname: Gustafson
authors.forename: Cameron E
authors.initials: CE
authors.lastname: West
authors.forename: Steven R
authors.initials: SR
authors.lastname: Feldman
mesh_terms: D000212:Acyclovir / Q000031:analogs & derivatives / Q000627:therapeutic use; D000293:Adolescent; D000328:Adult; D000553:Ambulatory Care / Q000706:statistics & numerical data; D000998:Antiviral Agents / Q000627:therapeutic use*; D005260:Female; D019538:Health Care Surveys; D006560:Herpes Labialis / Q000188:drug therapy*; D006561:Herpes Simplex / Q000188:drug therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D010818:Practice Patterns, Physicians' / Q000639:trends; D012189:Retrospective Studies; D000077483:Valacyclovir; D014633:Valine / Q000031:analogs & derivatives / Q000627:therapeutic use
chemical_list: D000998:Antiviral Agents; D014633:Valine; D000077483:Valacyclovir; D000212:Acyclovir