RAG rating
Document type
Clinical policy
Hertfordshire and West Essex ICB
Output type
Clinical Policies & Evidence-based Interventions

Virulite Cold Sore Machine

July 2022 v1.0

The Virulite Cold Sore Machine works by emitting light of a wavelength that its developers claim heals 
cold sores twice as quickly as using an antiviral cream.

Following several refinements to the device and two clinical trials, Virulite CS has now been accepted 
as an addition to part IX of the Drug Tariff for England and Wales, (and part 3 of the Scottish Drug 
Tariff), prescribable on the NHS from 1 January 2008.

Virulite costs £18.50 per machine and they carry a three-year warranty. 
The evidence for the effectiveness of these machines either against placebo or topical 
aciclovir is very limited and no long-term safety data could be found on a search. The 
evidence relates to crusting or healing rates and not to prevention of recurrence or to use in 
combination with other treatments.

NHS Clinical Knowledge Summaries states that the benefits of topical antivirals (aciclovir or 
penciclovir) are small and require treatment to be initiated at the onset of symptoms 
(erythema or prodromal stage) before vesicles appear. They do not recommend that oral 
antivirals should be used in immunocompetent individuals for mild-to-moderate episodes 
given the self-limiting nature of the disease, the limited benefits of oral antivirals, and that 
treatment needs to be initiated at the onset of prodromal symptoms. They may be of most 
use in severe cases or in immunocompromised individuals at risk of developing further 

In terms of any one specific patient, prescribing the Virulite might be an option if an 
immunocompetent patient is unable to concord with the usual self-help advice and the 
administration schedules for more established therapies or is frequently presenting for repeat 
prescriptions. However, that this product should NOT be prescribed routinely for herpes 
labialis until such time more robust evidence of benefit is available.