Treatment for Herpes and Genital Herpes

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Herpes, also known as herpes simplex virus (HSV), is an infection that can appear in various parts of your body, though it mainly affects your mouth and genitals.

According to the World Health Organization (WHO), an estimated 3.7 billion people under 50 years old (67 percent) have HSV-1 infection and 491 million who are 15 to 49 years old (13 percent) have HSV-2 infection worldwide.

Herpes symptoms are mainly treated by three major drugs taken in pill form: acyclovir (Zovirax), famciclovir (Famvir), and valacyclovir (Valtrex). In severe cases, treatment may include the intravenous (IV) drug acyclovir.

There is no cure for the herpes virus yet. A herpes vaccine does not currently exist because the herpes virus has more complicated DNA than most infections, creating challenges for researchers.

However, medication can help with symptoms like sores and outbreaks. Medication also reduces the risk of transmission to others. Most medications for herpes are taken orally, though they may also be applied as a cream or administered by injection.

Initial treatment

When you are first diagnosed with herpes and have symptoms of an active infection, a brief 7- to 10-day course of antiviral therapy is usually prescribed. This may help alleviate your symptoms and prevent them from worsening. If your symptoms don’t improve in that time, you may continue with the antiviral course for a longer duration.

After the initial treatment, your doctor may recommend one of two options depending on how frequently you experience a flare-up: intermittent or suppressive treatment.

Intermittent treatment

Once your symptoms subside from the initial treatment, your doctor may recommend intermittent therapy. This is when you keep medication on hand to treat a flare-up. Since herpes is a virus that stays in your body and may cause recurrent outbreaks, having an antiviral drug for when you feel an outbreak coming on can reduce the severity of the symptoms and make them heal faster.

Suppressive treatment

Taking the antiviral drug daily is a type of suppressive therapy, which may be recommended for people who experience very frequent outbreaks. This is a preventative measure as taking herpes medication daily may significantly reduce the number of outbreaks.

Daily medication is also associated with reduced risk of transmission. A 2004 study concluded that once-daily suppressive therapy with valacyclovir significantly reduces transmission of HSV-2 (genital herpes) among couples.

Treatment options for herpes symptoms include prescription medication, over-the-counter (OTC) medication, and home remedies. The best herpes treatment for you may depend on the type and severity of the infection.

Acyclovir (Zovirax)

Acyclovir is a prescription antiviral drug taken orally or applied topically that treats the symptoms of genital herpes. It can decrease the pain of outbreaks and help them heal faster. In people with weakened immune systems, acyclovir can also help prevent the risk of the virus spreading to other parts of your body, causing further infections. In severe cases, the intravenous (IV) form of acyclovir can be administered by a healthcare professional.

Famciclovir (Famvir)

Famciclovir, taken orally in the form of a tablet, is a prescription drug for oral and genital herpes. It is recommended for people with strong immune systems, though it should not be the first course of treatment for people experiencing their first episode of genital herpes. It is also not recommended for people with weakened immune systems. Famciclovir works by decreasing the severity and length of herpes outbreaks.

Valacyclovir (Valtrex)

Valacyclovir comes in tablet form taken by mouth. It is a prescription antiviral drug that can treat the symptoms of and prevent flare-ups of oral and genital herpes. People with frequent outbreaks can take valacyclovir daily as part of their suppressive therapy to prevent future infections and reduce the risk of transmission to sexual partners.

Docosanol (Abreva)

Docosanol is the active ingredient in the OTC topical medication Abreva, which is FDA-approved for the treatment of recurrent herpes simplex labialis (HSL), the most recognized recurring infection of your lips and perioral tissue caused by HSV-1. A 2001 study concluded that docosanol is safe and effective for treating recurrent HSL.

Home remedies

Like prescription and OTC medications for herpes, home remedies do not cure the virus. However, they may provide relief for symptoms like pain, cold sores, and blisters.

Some home remedies for herpes include:

  • applying a warm or cold compress
  • applying cornstarch or baking soda paste
  • making dietary changes
  • applying garlic or apple cider vinegar
  • incorporating supplements like lysine and zinc
  • applying herbs and essential oils

The three main treatments for herpes — acyclovir, famciclovir, and valacyclovir — are all FDA-approved drugs, though there are side effects and interactions to be aware of.

Common side effects of these antiviral drugs include headaches and nausea. Famciclovir can cause dizziness, confusion, or sleepiness.

Acyclovir and valacyclovir, which are very similar to each other, can cause your kidneys to stop working. If you have kidney problems, your doctor may prescribe a lower dose. These medications may interact with other drugs such as nonsteroidal anti-inflammatory drugs like ibuprofen, which may weaken kidney function.

What happens if herpes is left untreated?

Without treatment, sores and outbreaks usually heal on their own. Oral herpes is usually considered a mild infection, but complications may appear in people with weakened immune systems.

The risk of complications with genital herpes is also low, though these include inflammation, swelling, and pain. Passing HSV-2 to a newborn can be dangerous, however. Doctors may recommend a cesarean delivery to mothers with genital herpes, according to the Centers for Disease Control and Prevention.

Can herpes go away permanently?

Symptoms may go away, but the herpes virus does not. It stays in your body even after all the symptoms of infection are gone. Since herpes remains dormant until reactivated, symptoms may not show at all, show rarely, or show frequently in recurrent outbreaks.

Can you test for herpes at home?

Yes, there are at-home sexually transmitted infection (STI) tests for herpes. LetsGetChecked is a health and diagnostic company that offers home laboratory testing services. The home Herpes Test checks for HSV-1 and HSV-2 by taking a blood sample from your finger.

Herpes is a virus that, while not curable yet, is considered mild to manage. The symptoms, mainly cold sores on your mouth and blisters on your genitals, are usually temporary and can go away with treatment.

There are home remedies, OTC medications, and prescription medication for herpes. If you think you might have herpes, talk with your doctor about getting tested and treatment options right away.

Lacey Bourassa is a health, wellness, and beauty writer based in Southern California. She holds a BA in English. Her work has appeared in digital publications like Livestrong, Verywell, Business Insider, Eat This Not That, and others. When she’s not writing, Lacey is likely pursuing her other interests: skin care, plant-based cooking, pilates, and traveling. You can keep up with her by visiting her website or her blog.

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