Do Sunscreen Prevent Recurrent Herpes Labialis in Summer

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  Full Terms & Conditions of access and use can be found at  Journal of Dermatological Treatment ISSN: 0954-6634 (Print) 1471-1753 (Online) Journal homepage: Do Sunscreen Prevent Recurrent Herpes Labialis inSummer? Vittorio Mazzarello, Marco Ferrari, Gabriella Piu, Valeria Pomponi & GiulianaSolinas To cite this article:  Vittorio Mazzarello, Marco Ferrari, Gabriella Piu, Valeria Pomponi & GiulianaSolinas (2018): Do Sunscreen Prevent Recurrent Herpes Labialis in Summer?, Journal of Dermatological Treatment, DOI: 10.1080/09546634.2018.1481921 To link to this article: Accepted author version posted online: 28May 2018.Submit your article to this journal View related articles View Crossmark data    DO SUNSCREEN PREVENT RECURRENT HERPES LABIALIS IN SUMMER? Sunscreen preventing Herpes labialis Manuscript word: 2568 Tables: 2 Vittorio Mazzarello 1 , Marco Ferrari 1 , Gabriella Piu 1 , Valeria Pomponi 1 , Giuliana Solinas 2   1 Skinlab, Department of Biomedical Sciences, University of Sassari, Italy  2 Laboratory of Biostatistics, Department of Biomedical Sciences, University of Sassari, Italy Corresponding author : Vittorio Mazzarello MD, Skinlab, Department of Biomedical Sciences, University of Sassari, Viale San Pietro 43, 07100 Sassari, Italy. Tel: +39079228536 Fax: +39079228520 E-mail: Funding sources : This article has no funding source. Conflict of interest : The authors have no conflict of interest to declare.    Abstract  Background  : Research results on the efficacy of sunblock sticks in avoiding or reducing herpes labialis (HL) recurrences are contradictory and has shown mixed results, with some protection reported under experimental conditions that could not be replicated under natural conditions. Objective : The purpose of the present work was to carry out an in vivo test on the effectiveness of a  protective lip product in preventing recurrent HL in natural conditions during summer.  Methods : An exploratory randomized crossover study was performed on 20 adult volunteers who served as their own controls during the analysis. The study was conducted between May and July 2017 around the summer solstice. During the 2- month period, volunteers had to perform normal daily activities and go to the beach in Sardinia; thirty subjects applying SPF 30 protection and thirty without protection.  Results : In individuals with stick protection, the number of HL attacks was significantly reduced. Based on association between different parameters, which emerged from the medical history and the post-test questionnaire, it was found that male individuals over 44 years of age and with Fitzpatrick skin type 2 were the most exposed to recurrence. Conclusion : HL recurrence rate can be reduced by using sunblock stick in summer. Keywords: Herpes labialis; YV exposure; sunblock.      Introduction Herpes labialis (HL) is an infection of the mouth area that affects the area between the vermilion  border and the skin. The HL is caused by herpes simplex virus type 1 (HSV-1). The latter is a DNA virus, with a diameter of 150-200 nm, which is transmitted by direct inter-human contact of herpetic lesions or through healthy carriers saliva. Almost 100% of the adult population hosts the herpes simplex virus (HSV) at the latent state and are therefore potentially exposed to HL, but only 20%, due to a decline in cellular immunity, present with a form of recurrent herpes labialis (RHL) that may occur with variable frequency. Several factors triggering HRL have been described: physical stress (general infections, menstrual cycle) and mental stress, drugs and sun exposure. Under the influence of these causes the viral reactivation occurs: the viral genome passes from cell to cell up to the labial region where the virus replication will occur leading to the appearance of typical erythematous vesicular lesions. Several studies have shown a correlation between UV exposure and the onset of RHL. 1-2-3  A systematic epidemiological review carried out in 2008 identified 9 diseases that show sufficient evidence of a causal relationship with UV exposure: among these the HL reactivation is indicated. 4 The 25%-50% of RHL occurrences are believed to be attributed to UV exposure as a consequence of local immunosuppression. The UV dose capable of triggering the recurrence of the virus is equal to 4 MED. 3  The recurrence time of RHL after exposure may be immediate (within 48 hours) or delayed (after 2-7 days); 2  this is the time required for virus reactivation at the latency site, transport of the virus up to the skin surface (it is estimated that the speed, demonstrated in vitro, is 3-5mm/hour) and virus replication in the epithelium with  production of typical lesions (> 24 hours). 5-6-7  Due to these reasons numerous sunblock sticks can  be found on the market, formulated to protect the vermilion and the surrounding skin from the harmful effects of sun's rays, which are recommended as short-term preventive therapies. However, research results on efficacy of these sticks in avoiding or reducing RHL recurrences are contradictory and have shown mixed results, with some protection effect reported under experimental conditions that could not be replicated under natural conditions. In fact, there are two
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