Acyclovir Usage in Eczema
Herpeticum Treatment

Acyclovir is an antiviral drug that is used to treat medical conditions caused by herpes viruses. It's effective in treating cold sores, genital herpes, chickenpox, and shingles. It is also the first drug of choice used for treating eczema herpeticum, a potentially life-threatening condition usually caused by the herpes simplex virus.

Acyclovir does not work by attacking the virus itself; rather, it disrupts the replication process of the virus by embedding itself into the process. This doesn't completely remove the virus, but it keeps it from progressing and promotes healing of the sores related with herpes.

Orally, Intravenously Or Cream

The drug is administered either orally or intravenously. There are also creams for topical administration, as well as an ointment. It's usually taken orally, in the form of tablets. Cream preparations are used mostly for labial herpes simplex, and the ointment is used when herpes affects the eye. This condition is known as herpetic simplex keratitis.

Intravenous administration is reserved only for severe cases of infections, such as encephalitis caused by the herpes simplex virus. These infections require a high dosage of acyclovir, and since a small portion reaches the bloodstream when taken orally, it is generally more effective to deliver the drug directly into the bloodstream.

Eczema Herpeticum and Dermatitis Herpetiformis

Acyclovir is an antiviral, which means that it treats infections caused by viruses and that makes it an ineffective drug for treating eczema. However, in certain cases people with eczema may develop an infection caused by a herpes virus. That condition is known as eczema herpeticum, and if untreated it can be fatal.

Not to be confused with dermatitis herpetiformis (a skin condition that looks like herpes but isn't caused by a herpes virus), eczema herpeticum is an uncommon infection that can develop in people who suffer from atopic dermatitis. It is a disseminated infection, which means it can spread beyond the point in which it originated. With eczema herpeticum, large portions of the skin may become affected. This may cause further secondary infections.

Eczema herpeticum usually affects the face and the neck, although it can present itself on any part of the body. It starts off with small blisters both on normal and eczema-affected skin. Blisters can become bigger and appear in larger numbers over time, and they usually turn from being filled with clear fluid to be filled with pus. High fever, shivering, and swollen lymph glands are also among the symptoms.

Diagnosis and Treatment of Eczema Herpeticum

Eczema herpeticum can be diagnosed by its appearance, although it can be mistaken with other types of infections or even with a really severe case of eczema. It can also be diagnosed by testing a swab from a blister for viral infections. Once diagnosed, the treatment has to be started immediately.

If the condition has not progressed too much, treatment for eczema herpeticum can be administered at home in the form of tablets. If the condition has progressed to a more serious stage and it continues spreading rapidly, it has to be treated in a hospital by intravenous acyclovir.  In the past, up to three out of every four people with eczema herpeticum would succumb to the condition and die.

However, current antiviral therapy - acyclovir especially - is very effective in treating it, so the mortality rates are very low.

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