Dear Dr. Roach: I am wondering about oral herpes. Have there been any advances made for treating or preventing oral herpes? I know about and use Abreva, but is there anything out there that works better?


Dear L.P.: Herpes simplex virus type one is the cause of oral herpes, usually called “cold sores”’ or “fever blisters.” These often start as a clear fluid-filled blister on the lips or in the mouth. Many people carry the virus, and some people experience periodic outbreaks of these painful lesions.

Docosanol (Abreva) is an over-the-counter cream that prevents viral entry and replication of the virus. Several, but not all, studies show that it is effective at speeding healing. However, it is not as effective as the prescription cream penciclovir at reducing the size and number of herpes lesions. Unfortunately, the cost of penciclovir cream is prohibitive for many, with a single 5-gram tube retailing for around $800 in the U.S.

Another over-the-counter medication, benzalkonium (Viroxyn), was shown to be about as good as or better than Abreva at making cold sores go away faster, and it also contains an anesthetic to ease the pain.

We really need better treatments for this common, painful condition. There is hope for a vaccine in the future.

Dear Dr. Roach: Please tell me where I can find more information about the Mediterranean diet.


Dear V.P.: The Mediterranean diet is not a single diet; it’s a collection of several cuisines that share important elements and which have been shown to reduce rates of heart disease and obesity. Some common features are: mostly plant-based, with small amounts of meat; high consumption of fruits, vegetables and whole grains; low to moderate amounts of dairy products; relatively high amounts of olive oil, nuts and fish. Wine is an optional part of the diet in low to moderate amounts and with food.

The American Heart Association and the Mayo Clinic websites have more information about this diet, and your local bookstore will doubtless have some recipe books and cookbooks. If you don’t have a local bookstore, one large online site had 237 titles on this topic available when I looked.

There are many ways to eat healthy. I find the Mediterranean diet a great choice, but recommend a diverse diet for health and enjoyment.

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