Because ulcerated genital lesions are characteristically tender and sensitive to any contact or manipulation, patients may experience discomfort upon application of Vivir cream. Mild pain including transient burning or stinging, contact dermatitis, erythematous eruption, eczema, allergic reaction, vulvitis, facial edema, rash and vesicular exanthema may occur. Mild drying or flaking of the skin may occur. Erythema and itching have been reported in a small proportion of patients.