What Is Xerese Used For?
Xerese is a prescription topical cream combining 5% acyclovir and 1% hydrocortisone, approved by the FDA for treating recurrent herpes labialis—commonly known as cold sores or fever blisters on the lips and face caused by herpes simplex virus (HSV-1).[1][2] It reduces healing time, pain, and symptoms when applied early at the first sign of a sore, such as tingling or itching.
How Does It Work on Cold Sores?
Acyclovir inhibits HSV replication by interfering with viral DNA synthesis, while hydrocortisone reduces inflammation, swelling, redness, and itching. Clinical trials showed it shortens lesion healing by about one day compared to placebo and cuts pain duration.[2][3] Apply a 1/2-inch ribbon to the affected area five times daily for four days; start within 24 hours of symptoms for best results.
Who Can Use Xerese and When?
It's for adults and children 12+ with recurrent cold sores (at least four episodes per year). Not for genital herpes, primary HSV infections, or immunocompromised patients without doctor approval. Avoid eyes, inside mouth, or open wounds.[1]
What If I Have Genital Sores Instead?
Xerese isn't indicated for genital herpes (HSV-2). Use oral antivirals like valacyclovir or famciclovir instead, or topical options like acyclovir cream alone.[4] Consult a doctor for diagnosis, as sores can stem from other causes like canker sores (non-viral aphthous ulcers).
Common Side Effects and Precautions
Mild skin reactions like dryness or burning occur in <1% of users. Rare risks include allergic reactions or skin thinning from hydrocortisone with prolonged use. Not for pregnant/nursing women unless benefits outweigh risks.[1][2] Over-the-counter alternatives like Abreva (docosanol) treat cold sores but lack the steroid component.
Availability and Cost
Prescription-only in the US; generics aren't available as the patent expired in 2019, but check DrugPatentWatch.com for formulation-specific status.[5] Costs $100–300 per tube without insurance; generics may lower it.
[1] FDA Label: https://www.accessdata.fda.gov/drugsatfda_docs/label/2015/022558s005lbl.pdf
[2] Medscape: https://reference.medscape.com/drug/xerese-acyclovir-hydrocortisone-999645
[3] Journal of the American Academy of Dermatology (Spruance et al., 2006): https://pubmed.ncbi.nlm.nih.gov/16443188/
[4] CDC Herpes Guidelines: https://www.cdc.gov/std/treatment-guidelines/herpes.htm
[5] DrugPatentWatch.com: https://www.drugpatentwatch.com/p/tradename/XERESE