Urgent: Eczema Herperticum

[Moonme]

My other half has eczema and has a severe breakout on her face. She also suffers from cold sores. She spoke with an online private GP this morning (our local GP is impossible to get an appointment for) and she diagnosed Eczema Herperticum and prescribed antivirals.
She’s very tired and has a really bad headache. Looking online it seems this can be quite serious. She started getting the spots a few days ago and the online GP (same service, different doctor) prescribed steroid cream. It got worse so she called again today and the antivirals were prescribed.
A few resources online seem to be saying that you should always go to the hospital with this? Does any one have any experience or advice as to whether we should be following this up further or is she okay just to take (the delayed) antivirals and see how she goes?

Anyone?

I've had this. Like your DP my initial outbreak was on my face which was quite frightening. Mine happened over a public holiday so I couldn't get to doctor and then was also misdiagnosed and given a steroid cream at a walk in clinic so it got really bad.

It's great that she's got the antivirals, they really do stop it in its tracks, however check that it's a much higher dosage (ie same as you get for shingles not just a cold sore) the healing process will take a few weeks once they crust over as it really damages the skin. Get a thick moisturiser as it will crack and bleed a lot. Valaciclovir worked better for me but aciclovir seems to be the (cheaper?) go to and does work.

To give you a positive - despite looking like something out of a horror film at the time (yes DM tactful as always asked if I would be permanently disfigured) mine healed completely and you would never know.

I have had repeat outbreaks but never as bad as the first one. Also she needs to see GP and get the antiviral on repeat. Always have it at home as speed of taking them can make all the difference when she feels it start.

One thing to watch which I'm sure the doctor told you. It's extremely dangerous if it gets into your eyes so if it spreads there go straight back.

Thank you @quine04 really appreciate your response. She has aciclovir - 5 times a day. Which I presume is a high dose? Really good advice about getting a repeat prescription to have on hand.
From a practical perspective any tips for applying cream without spreading to other parts of face?

I’m still concerned we didn’t catch it early enough 😬

Hi, my Daughter had this. She was covered. I think that starting on the aciclovir is the best thing to do but I would check it frequently and see if you think it is worsening and whether iv antivirals may be needed. Do watch out for evidence of it in the eye is another thing we were told in which case seek help. I would have thought most people go to hospital with it as it’s fairly rare but it sounds like your doctor has it under control. Get well soon.

Mine wasn't caught that fast due to the holidays and being away from home and it still started healing once I was on the antivirals.

I am not a HCP but if those tablets are the standard 200mg I would get a second opinion if it doesn't start to improve in 24h as it does sound a bit lower than I had. The shingles treatment is 5 x 800mg tablets. Google suggests it's more like 5x 400mg in milder cases of this.

No real tips on the cream other than extreme hand washing and towels over pillow. I think I used diprobase or similar aqueous cream. If any of it looks at all infected or hot, different to the crusty viral weepiness I mean actual pus or swelling, then an antibiotic may also be needed as it can get infected.

It's really grim, I feel for your DP. Try some cocodamol too for the pain, antihistamine for the itch and might help with sleep. I have a feeling ibuprofen might not be a good plan. But that's me thinking of chicken pox so a doctor can maybe advise.

I didn't get post-herpetic pain (I was early 20s when it first happened to me) but that's a danger for older people and can last months.

Checked and it’s 800mg tablets so that’s good. I’ve read online about lysine. Can that be taken alongside antivirals does anyone know?

L-lysine is a natural amino acid that can supposedly suppress the virus but it's preventative rather than cure as I understand. Would be fine I'm sure as it's just a supplement and in a lot of food anyway. The opposite is Arginine which may encourage outbreaks. From memory that's in things like Brazil nuts.

5 x 800g is good to hear and I am sure you will notice a real difference in 24-48h with that dosage.

The biggest triggers for my outbreaks are stress, being run down and excess direct sunlight. All the same things as regular cold sores. So try to avoid those. Also right before period it's more likely.