Healing and Relief: Prescription Ointments for Viral Skin Infections After Mohs Surgery

What to Know About Ointments For Minimizing Discomfort and Promoting Recovery

Prescription ointments like penciclovir, acyclovir, and imiquimod are effective treatments for viral skin infections after Mohs surgery. Your healthcare provider can recommend the most suitable option based on the specific type of viral infection you have.

Mohs surgery is a highly effective treatment for skin cancer, but in some cases, it can lead to viral skin infections that require prescription ointment. 

If you've recently undergone Mohs surgery and suspect you may have a viral skin infection, it's crucial to understand the common types, symptoms, and treatment options available.

Common Viral Skin Infections After Mohs Surgery

Several types of viral skin infections can occur after Mohs surgery. These include:

HSV (herpes simplex virus)

Cold sores or fever blisters may appear around the surgical site, presenting as painful clusters of fluid-filled blisters. This is often caused by the reactivation of a dormant virus triggered by the stress of surgery.

VZV (varicella zoster virus)

Shingles, characterized by a blistering rash following a dermatome, may occur post-surgery. Patients may experience burning, itching, or tingling sensations. This is more common in older or immunocompromised individuals.

HPV (human papillomavirus)

Warts may appear around the surgical site due to viral infection of the top layer of skin. Many different strains of HPV exist.

Molluscum contagiosum virus (MCV)

Clusters of small, dome-shaped bumps with central depressions or dimples may develop. While common in children, MCV can also affect adults.

Recognizing the Symptoms

It's essential to be aware of the symptoms of a viral skin infection after Mohs surgery. These may include:

• Pain, itching, or burning sensations in the affected skin
• Redness and inflammation around the surgical site
• Clusters of small, fluid-filled blisters or vesicles
• Open sores or ulcerations as blisters rupture
• Weeping or crusted lesions
• Tender, swollen skin in the affected area
• Low-grade fever, chills, and fatigue in some cases
• Pain out of proportion to the appearance of the skin
• Non-healing wound or prolonged recovery after surgery

If you experience any of these symptoms, it's crucial to contact your healthcare provider promptly for proper diagnosis and treatment.

Prescription Ointments for Viral Skin Infections

Several prescription ointments are available to treat viral skin infections after Mohs surgery. These include:

Topical antivirals applied directly to the skin:

• Penciclovir 1% cream (Denavir) for HSV infections like cold sores, applied every 2 hours during waking hours for 4 days.
• Docosanol 10% cream (Abreva), an over-the-counter treatment for cold sores, applied 5 times per day until healed.

Oral antiviral medications taken by mouth:

• Acyclovir (Zovirax) for HSV and VZV infections, with dosage varying based on infection type and severity.
• Valacyclovir (Valtrex), a more bioavailable prodrug of acyclovir, typically dosed at 500mg-1g daily for 7-10 days.
• Famciclovir (Famvir), an alternative to acyclovir/valacyclovir for HSV and VZV, usually taken 250mg three times daily for 7-10 days.

Other prescription treatments:

• Cidofovir 1-3% topical gel for resistant HPV strains causing warts, applied 2-3 times per week after scraping, considered if standard treatments fail.
• Imiquimod 5% cream (Aldara), an immune response modifier for some viral warts and MCV, applied 2-3 times per week for up to 16 weeks.

How Prescription Antiviral Ointments Help

Prescription antiviral ointments work by inhibiting viral replication in infected skin cells. They prevent viruses from copying their genetic material, thus stopping the spread of infection to surrounding skin. By reducing the duration and severity of the outbreak, these medications promote faster healing of viral blisters or lesions while minimizing pain, itching, burning, and other symptoms.

Additionally, antiviral ointments decrease the risk of secondary bacterial skin infections. Open blisters can allow bacteria to enter the wound, but preventing blister formation reduces the chances of a secondary infection. 

Faster healing time also improves the appearance of the surgical wound, minimizing textural skin changes or discoloration, and helping avoid scarring or poor cosmetic outcomes.

Potential Side Effects

• Localized skin irritation at the application site is most common, including redness, dryness, itching, burning, and peeling. These effects typically resolve once the medication is discontinued.
• Systemic side effects from topical treatments are uncommon due to low absorption of the medication through the skin. However, oral antivirals are more likely to cause body-wide effects.
• Headache, nausea, fatigue, and dizziness are possible with oral medications. These are usually mild and resolve with time, but notify your doctor if severe or persistent side effects occur.
• Rare reports of allergic reactions to topical antivirals have been noted, including rash, hives, tongue/lip swelling, and difficulty breathing. Seek emergency medical care if an allergic reaction is suspected.

Seeking Further Help

If you suspect a viral skin infection after undergoing Mohs surgery, don't hesitate to reach out to your healthcare provider. Prompt diagnosis and treatment with prescription ointments can help speed up the healing process, minimize discomfort, and reduce the risk of complications. 

Through understanding the common types of viral skin infections, recognizing the symptoms, and knowing the available treatment options, you can take an active role in your post-surgery recovery and ensure the best possible outcome.