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Additionally, patients who received PBM were signi cantly more satis ed with the treatment method and
outcome than patients who received antiviral agents without PBM. It should be noted that in various
studies such as Schindl et al.[23], Sanchez et al. [36], and Ferriera et al. [37] it was shown that low diode

laser treatment reduces the recurrence of the lesion in patients, which were not evaluated in the recent
study. Apart from this, one of the important limitations of this study was that the PBM procedure was
expensive and timewasting for patients. In this regard, it can be noted that some recent studies on the
impact of devices with higher wavelengths that are sold without a prescription and are used by the
patient himself [4, 38].

Conclusion

In conclusion, we found that PBM along with standard topical treatment of RHL improves pain reduction,
healing time, and patients’ satisfaction.

Declarations

Authors’ contribution: All authors listed in the paper have contributed su ciently to ful ll the criteria for

authorship according to ICMJE guidelines. Seyyed Amir Seyyedi: Study concept and design. Zahra
Mirzaei Gobaran: Technical support and laser operator. Sepideh Yekani: Principal Investigator and data
collection. Saman Taram: Statistical Analysis, writing draft and correspondence.

Con ict of interest: The authors declare no con ict of interest

Funding Information: The study protocol was nancially supported by Urmia University of Medical
science (Iran, west Azerbaijan Province, Urmia, Resalat Ave. P.O. box 1138, 5714783734 Urmia, IRAN).
Despite of these, only the authors were responsible for study data.

Ethical consideration: Study protocol was reviewed and approved by Urmia University of medical science
ethical committee (IR.UMSU.REC.1400.048). Also, study protocol was conducted according to ethical
guidelines of Helsinki declaration.

Informed consent Informed consent was obtained from all individual participants included in the study

References

1. Al-Maweri, S.A., W.A. Al-Soneidar, and E.S. Halboub, Oral lesions and dental status among
institutionalized orphans in Yemen: A matched case-control study. Contemporary clinical dentistry,
2014. 5(1): p. 81.

2. Chen, F., et al., E cacy and safety of nucleoside antiviral drugs for treatment of recurrent herpes
labialis: a systematic review and meta-analysis. Journal of Oral Pathology & Medicine, 2017. 46(8):
p. 561–568.

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