Antiviral therapy in prevention of complications of cosmetic procedures

The procedures of most medical cosmetic manipulations are accompanied by a violation of the integrity of the skin, which primarily increases the risk of infectious complications. Among other risk factors influencing the development of such complications, one can single out the action of the active components of the drugs, violation of the technology for performing procedures. Reactivation of herpes virus infection is one of the complications of minimally invasive cosmetic procedures (laser ablation, injection techniques, microneedling, peeling). Quite a lot of cosmetologists underestimate the increased risks of complications of cosmetic procedures, in particular the reactivation of a herpes infection, and are not aware of the need for preventive courses of antiherpetic therapy, including short-term (episodic) and long-term regimens of suppressive treatment with antiviral drugs. The best strategy for managing herpes virus infection in the context of cosmetic procedures with a potential risk of virus reactivation is prevention. Preventive measures should include a thorough history taking followed by an analysis of the risks of exacerbation of herpes virus infection and the selection of personalized suppressive therapy. In this regard, valaciclovir (Valcicon) is the most reasonable choice and can be recommended for use in wide clinical practice for suppressive short-term and long-term therapy. Therapy for exacerbations of herpes viral infection should include a 2-component scheme for the use of an antiviral systemic drug (valaciclovir) and an external drug (ribavirin).

1. Martinez-Zapata M. J. Autologous platelet-rich plasma for treating chronic wounds. M.J. Martinez-Zapata, A.J. Martí-Carvajal, I. Solà, J.A. Expósito, I. Bolíbar, L. Rodríguez, J. Garcia, C. Zaror. Cochrane Database Syst Rev. 2016. Vol. 25 (5).

2. Miller M.Q. Regenerative Medicine in Facial Plastic and Reconstructive Surgery: A Review. M.Q. Miller, A. Dighe, Q. Cui, S.S. Park, J.J. Christophel. JAMA Facial Plast Surg. 2016. Vol. 18 (5). Р. 391–394.

3. Mingazova L.R., Karpova E.I., Orlova O.R., Kotenko K.V., Kruglova L.S. Complications in the form of neuropathic disorders in the face after contour injection plastics. Russian Journal of Skin and Venereal Diseases. 2014. No. 2. P. 31–34.

4. Kotenko K.V., Karpova E.I., Kruglova L.S., Zhukova O.V., Mukhina E.S. The most common complications of contour injection plastics of facial tissue deformities and the possibility of their prevention by low-intensity laser radiation. Clinical Dermatology and Venereology. 2013. No. 3. P. 55–58.

5. Shahrabi FS, Sexton J, Stone JD, et al. Lip nodules caused by hyaluronic acid filler injection: report of three cases. J. Head Neck Pathol 2012; 6: 16–20.

6. Del Campo R, Mandy S. Commentary on delayed onset nodules secondary to a smooth cohesive 20mg/mL hyaluronic acid filler: cause and management. J. Dermatol Surg. 2015; 41: 940–1.

7. Cohen JL. Understanding, avoiding, and managing dermal filler complications. Dermatol Surg 2008; 34 (Suppl 1): S92–9.

8. Möller S, Schmidtke M, Weiss D, et al. Synthesis and antiherpetic activity of carboxymethylated and sulfated hyaluronan derivatives. Carbohydr Polym 2012; 90: 608–15.

9. Potekaev N.N., Kruglova L.S. Laser in dermatology and cosmetology. Moscow. MDV. 2012. 280 p.

10. Kruglova L.S., Sheptiy O.V. Ablative skin resurfacing using a CO2 laser: advantages of the method and procedure technique. Plastic Surgery. 2013. No. 1. P. 124–128.

11. Kotenko K.V., Kruglova L.S., Mimov A.V. Rehabilitation measures after various laser procedures. Plastic Surgery. 2013. No. 3. P. 353–355.

12. Global Burden of Disease Study 2013 Collaborators. Global, regional, and national incidence, prevalence, and years lived with disability for 301 acute and chronic diseases and injuries in 188 countries, 1990–2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet. 2015; 386 (9995): 743–800.

13. Kim B, Somia N. Herpes reactivation after injection of dermal fillers. ANZ J Surg 2013; 83: 998. Differential diagnosis of cheilitis. How to classify cheilitis? Acta Clin Croat 2018; 57: 342–51.

14. Dougherty AL, Rashid RM, Bangert CA. Angioedema-type swelling and herpes simplex virus reactivation following hyaluronic acid injection for lip augmentation. J Am Acad Dermatol 2011; 65: e21–2.

15. Gazzola R, Pasini L, Cavallini M. Herpes virus outbreaks after dermal hyaluronic acid filler injections. Aesthet Surg J 2012; 32: 770–2.

16. Khoo CS, Tan HJ, Sharis Osman S. A Case of herpes simplex virus type 1 (HSV-1) encephalitis as a possible complication of cosmetic nasal dermal filler injection. Am J Case Rep 2018; 19: 825–8.

17. Kelly B, Shimoni T. Reintroducing the Tzanck smear. Am J Clin Dermatol 2009; 10: 141–52.

18. Cernik C, Gallina K, Brodell RT. The treatment of herpes simplex infections: an evidence-based review. Arch Intern Med 2008; 168: 1137–44.

19. Le Cleach L, Trinquart L, Do G, Maruani A, Lebrun-Vignes B, Ravaud P, Chosidow O. Oral antiviral therapy for prevention of genital herpes outbreaks in immunocompetent and nonpregnant patients. Cochrane Database Syst Rev. 2014; (8): CD009036.

20. Chisholm C, Lopez L. Cutaneous infections caused by herpesviridae: A review. Arch Pathol Lab Med 2011; 135: 1357–62.

21. Spruance S.L., Tyring S.K., DeGregorio B., et. al., A Large-Scale, Placebo-Controlled, Dose-Ranging Trial of Peroral Valaciclovir for Episodic Treatment of Recurrent Herpes Genitalis, Valaciclovir HSV Study Group. Arch Intern Med. 1996 Aug 12–26; 156 (15): 1729–35.

22. Goryachkina M.V., Belousova T.A., Episodic and suppressive therapy of herpes simplex with acyclic nucleosides, Clinical dermatology and venereology. No. 4. 2014. P. 68–74.

23. Patel R, Bodsworth NJ, Woolley P et al. Valaciclovir for the suppression of recurrent genital HSV infection: A placebo-controlled study of once daily therapy. Genitourin Med, 1997; 73: 105–9.