First-ever HSV-1 recurrence following superficial facial chemical peel after 30-year latency following neonatal primary infection.

Recurrence of orofacial herpes simplex infection is a well-known potential complication of chemical peeling procedures. Risk of reactivation is believed to correlate with depth of peel, leading to the recommendation that all patients with history of primary orofacial herpes simplex infection or recurrent herpes labialis receive prophylactic antivirals prior to and after undergoing medium and deep peels. The following is a case of herpes labialis following a very superficial peeling procedure in an otherwise healthy 30-year-old male after primary infection as a neonate with no history of herpes simplex recurrence in the intervening 30 years. This case highlights the importance of history-taking and consideration of prophylactic antivirals in peels of all depths in patients with any history of primary infection, regardless of length of disease free period.