Acyclovir and Hydrocortisone (Topical)

Acyclovir and hydrocortisone is used to treat herpes simplex virus that affects the mouth, lips, and nose.


Acyclovir and hydrocortisone is a topical combination medicine that is dispensed in the form of a cream and is used for the treatment of painful, unsightly vesicles (cold sores) around the lips, mouth, nose, and nasal septum.

The medication will not cure the herpes simplex virus that causes the vesicles to develop, but it may help the sores to heal more quickly and it can also relieve the itching, tingling, pain, and discomfort that they cause to sufferers.

Acyclovir is an antiviral agent that treats the virus and works to prevent it from spreading. Hydrocortisone is a steroid preparation that aids the healing of the skin and relieves the pain and inflammation caused by the sores when they emerge.

This medication is known under the brand name Xerese in the U.S. and is available only on prescription from a doctor or other health professional.

Conditions treated

  • Herpes simplex virus ('cold sores')

Type of medicine

  • Antiviral topical cream

Side effects

This medication will ultimately help to control and manage your symptoms, however you may experience a few minor unwanted side effects when using it. Before you begin using Acyclovir and hydrocortisone cream, be sure to tell your prescribing physician if you have ever suffered any allergic reactions to any form of medication or if you have allergies to preservatives, dyes, animals or foods.

The following recognised side effects have been experienced by some people using Acyclovir and hydrocortisone but it should be noted that the list is not all-inclusive. If you notice anything unusual about your health or behavior after you begin using this medication, consult your pharmacist or doctor as soon as possible for advice.

Acyclovir and hydrocortisone is generally very safe to use and any side effects that may be experienced are rare. However you should check with your doctor if you experience any sensation of burning or tingling at the application site, or if the area becomes reddened or swollen and very sore. Any changes in the color of your skin at the application site, accompanied by flaking and dryness, or if the skin feels unusually warm should also be reported to your doctor. If your skin begins to blister or becomes crusty, you should stop using the medication and consult your doctor immediately.

If you notice signs of a serious allergic reaction, including the development of a widespread rash, swelling of the throat or tongue, severe dizziness or breathing problems, you should stop using the medication immediately and consult your doctor as soon as possible.


Acyclovir and hydrocortisone cream cannot be bought without a prescription from your doctor or other healthcare professional. The medication is dispensed in cream form for application directly to the affected area on your skin. Do not attempt to guess at the dosage and frequency of use of this medication; always follow your doctor's instructions or the directions given on the product label.

For the treatment of 'cold sores' (herpes simplex virus) in adults and children aged six years and over: apply Acyclovir and hydrocortisone cream to the affected area at regularly spaced intervals, five times each day for a period of five days.

For the treatment of 'cold sores' in children under six years of age, the use and dose of this medication must be determined by your medical professional.

Do not use this medication in greater quantity or for a longer period of time than is recommended by your medical professional. For more information and dosage instructions, read the patient information insert that is supplied with this product. Always complete the course of medication in full, even if your symptoms appear to be improving after a couple of days.

Do not miss any doses of your medication. In the event that you do miss a dose, do not apply double the quantity.

Do not use Acyclovir and hydrocortisone cream in your eyes, inside your nose or mouth, or around your genitals. If the cream does come into contact with these areas, wash it off with clean water immediately.

Application instructions

  • Before and after applying the cream, wash your hands thoroughly.
  • Make sure the affected area is clean and dry before application and wash towels immediately after use to avoid spreading the virus.
  • Gently apply a thin layer of cream over the area that covers the 'cold sore'. Avoid rubbing the cream as this could spread the virus to other areas around your mouth and lips or could make the existing sore worse.
  • Do not cover the affected area with a dressing; exposure to the air will aid the healing process.
  • Do not get the area wet (e.g. avoid bathing, showering or swimming) for at least 30 minutes after application of the medicine.

Major drug interactions

Although it should be noted that some medicines should never be used together, in other cases it may be applicable and safe to use two or more different medicines, even though an interaction may occur. In such circumstances, your doctor may decide to change the dose or may advise you to take other precautions. Always tell your doctor if you are currently taking any other medication or non-prescription medicines, vitamin supplements or herbal preparations.

Some medicines should not be used when you are eating food or certain types of food, as interactions may occur. The use of tobacco or alcohol with certain drugs may also cause interactions to occur. Before you begin using this medication, you should discuss the use of the product with tobacco, alcohol or food.

When using Acyclovir and hydrocortisone cream, you should wait until 30 minutes after eating before applying the product to your cold sores in order to prevent accidental ingestion of the medicine with your food.

Although there are no listed drugs that should not be used in tandem with Acyclovir and hydrocortisone cream, you should tell your doctor if you have any other medical problems. In particular, this medicine may not be completely effective if you suffer from a compromised or weakened immune system.


In addition to discussing any allergies and other drugs that you are using, it is vital that you also mention any existing health conditions that you have to your doctor.

Test results and studies carried out to date have revealed no issues with the use of Acyclovir hydrocortisone in children or the geriatric population. However, you should always follow your doctor's instructions when using this product in children or elderly people.

Similarly, the use of Acyclovir hydrocortisone cream in pregnant women has been determined as safe for use in all trimesters and the product has not been found to demonstrate a risk to the unborn baby. There is currently no evidence to suggest that the topical form of Acyclovir and hydrocortisone can present a risk to infants through breastfeeding. However, if you are pregnant or nursing, you should bring this to your doctor's attention and weigh the benefits of using this product against the potential risks, before using this medication.

When using this medicine, you should not apply any other skin products, including sunscreen, lip balm or make-up.

Do not share eating utensils, razors, cups, towels or face cloths during an outbreak of herpes simplex virus. Avoid touching the sores and always wash your hands immediately if you have done so. Avoid kissing until your cold sore has fully healed and the symptoms have cleared up.

If you blow your nose while you are suffering an outbreak of herpes simplex virus that has caused sores to form around your nasal area, dispose of the soiled tissues by placing them in a sealed bin or by burning them to ensure that others in your household do not come into contact with the virus.

If you need routine dental treatment, wait until your symptoms have cleared up before attending. In an emergency, ask your doctor or dentist for advice.

Do not share this medication with anyone as this could risk spreading the herpes simplex virus infection.


Keep your medication in an airtight, sealed container and at room temperature. After use, make sure that the tube's lid is tightly closed.

Do not freeze the medication.

Keep the medication away from direct sunlight and do not expose it to sources of extreme heat, such as radiators. Do not allow the medication to get wet.

Keep the medication well away from children and pets. In the event that a pet consumes Acyclovir hydrocortisone, always seek veterinary advice immediately.

Never use any medication that has exceeded its use-by date, and do not keep any opened tubes of cream after you have completed your course of treatment. If your condition recurs, consult your doctor to obtain a fresh supply of medication.

Ask your doctor or pharmacist for advice on how to dispose of any unwanted medication. Do not flush the leftover medication down the toilet or throw it out with your garbage, where it could be picked up by children.


Acyclovir hydrocortisone is a highly effective topical antiviral medicine that is used in the treatment of herpes simplex virus symptoms (cold sores). Although using Acyclovir hydrocortisone will not cure the virus, it will help to relieve the itching and discomfort that it causes. The medication will also help to speed up the healing of sores.

The medication is very safe to use and a limited number of side effects occur in a comparatively small number of patients. However, you should still mention any medical conditions that you have and the drugs that you are currently taking to treat them, including non-prescription herbal products and vitamin supplements.

Acyclovir hydrocortisone cream can control the symptoms of herpes simplex virus in adults and in children over five years of age. However, it is important that you work closely with your doctor if you suffer from repeated or severe outbreaks of the condition in order to identify any underlying cause, manage the condition, and to stop it from spreading to others.

Last Reviewed:
December 10, 2017
Last Updated:
April 26, 2018
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