Treatment For Genital Herpes
There are three antiviral medications that are FDA-approved for the treatment of genital herpes:
- Acyclovir: The oldest antiviral medication for herpes is acyclovir. It has been available since 1982 in a topical form and sold since 1985 in pill form. Acyclovir has been shown to be safe in persons who have used it continuously for as long as 10 years.
- Valacyclovir: A newer drug, valacyclovir, actually uses acyclovir as its active ingredient. This medication delivers acyclovir more efficiently so that the body absorbs much of the drug, which has the advantage of taking the medication fewer times during the day.
- Famciclovir: Famciclovir uses penciclovir as its active ingredient to stop HSV from replicating. Like valacyclovir, it is well absorbed, persists for a longer time in the body, and can be taken less frequently than acyclovir.
Antiviral medication is commonly prescribed for patients having a first episode of genital herpes, but they can be used for recurrent episodes as well. There are two kinds of treatment regimens: episodic therapy and suppressive therapy.
How Effective Are Medications For Herpes
Prescription antiviral medications have proven effectiveness in managing HSV symptoms.
A 2017 study comparing the antiviral medications acyclovir, famciclovir, penciclovir and valacyclovir to treat herpes simplex labialis found all antiviral medications were effective to shorten healing time for lesions and reducing pain. The comparison study found valacyclovir had the fastest healing time and pain reduction.
Which Antiviral Agents Are Used In The Treatment Of Herpes Simplex Virus Infections
Antiviral agents used to treat herpes simplex virus infections are nucleoside analogs. Acyclovir is the antiviral most commonly used to treat herpes simplex virus infections. Other oral medications include famciclovir, which is a prodrug that is converted to penciclovir, and valacyclovir, which is a prodrug that is converted to acyclovir. Oral therapy is effective for nonlife-threatening herpes simplex virus infections , and can be useful in the suppression of recurrent genital herpes simplex virus infections to diminish viral shedding and decrease rates of clinical recurrences. Intravenous acyclovir is indicated for the treatment of encephalitis, any form of neonatal disease, severe infection in patients who are immunocompromised, and occasionally for cases of severe orolabial or genital disease.
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How Is Herpes Diagnosed
The herpes virus is almost always spread through sexual intercourse, oral sex, or kissing. Although sometimes HSV-1 can spread via shared lip balm, utensils, or other items that come in contact with saliva.
In most cases, healthcare providers can diagnose herpes with a visual examination and by discussing various symptoms. If there’s any doubt, they can take a viral culture to confirm, which involves lab analysis of a swab or scraping.
“If the patient has no history of herpes simplex and is a new patient, I always do a viral culture,” says , MD, a board-certified dermatologist and founder of 5th Avenue Aesthetics. “Also, if I am suspicious of HSV-2 or if it is an immunocompromised patient, I will order a viral culture. I start treatment right away before results come back. These results can take one week and it is best to start treatment early.”
But again, symptoms aren’t always present. Fortunately, it’s also possible to diagnose HSV with a blood test. Your body produces antibodies to combat viruses, and doctors can use a blood sample to detect the specific antibodies that fight the herpes simplex virus.
A primary care physician can perform the examinations and tests necessary for an accurate diagnosis. However, sexual health clinics offer similar, reliable services.
A Pregnant Woman Can Give Herpes To Their Unborn Baby
The estimated number of pregnant women infected with HSV-2 is 880,000. Most transmission to newborns occurs during vaginal delivery. If a woman had genital herpes before getting pregnant, their baby may be infected but the chance is very low — less than 1%. However, the risk of infecting the baby is much higher when a woman is newly infected late in pregnancy.
If you are pregnant and think you may be infected, tell your doctor right away. Women with genital herpes are examined carefully for any symptoms before giving birth. If sores or signs that an outbreak is coming are present at the time of delivery, the baby may be delivered by cesarean section .
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How Should I Take Valacyclovir
Follow all directions on your prescription label and read all medication guides or instruction sheets. Your doctor may occasionally change your dose. Use the medicine exactly as directed.
Start taking valacyclovir as soon as possible after the first appearance of symptoms . This medicine may not be effective if taken after you already have symptoms.
You may take valacyclovir with or without food.
Tell your doctor if a child taking this medicine cannot swallow the valacyclovir tablet.
Your pharmacist may prepare an oral suspension form of valacyclovir. Shake this suspension before you measure a dose. Use the dosing syringe provided, or use a medicine dose-measuring device .
Lesions caused by herpes viruses should be kept as clean and dry as possible. Wearing loose clothing may help to prevent irritation of the lesions.
Some herpes infections need to be treated for longer than others. You may need to take the medicine for only 1 day or for just a few days. To prevent recurrent genital herpes, you may need to take valacyclovir for up to 1 year. Use this medicine for the full prescribed length of time, even if your symptoms quickly improve.
Follow your doctor’s dosing instructions very carefully. Taking more valacyclovir than prescribed will not make this medicine more effective.
Drink plenty of water while you are taking valacyclovir to keep your kidneys working properly.
Store at room temperature away from moisture and heat. Keep the bottle tightly closed when not in use.
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 pregnant people with genital herpes, according to the .
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How Effective Are Topical Herpes Treatments
Studies have found that topical creams and ointments like and arent so great at preventing lesions from oral herpes . Theyre also really expensive and usually have to be applied several times a day.
Two new topical medications for oral herpes may hold more promise, but they come at a cost.
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includes acyclovir 5% cream and 1% hydrocortisone and works better than either ingredient alone. Interestingly, Xerese cream has been shown not only to shorten healing time but also to make it less likely that the lesions will return. Unfortunately, Xerese is expensive and rarely covered by insurance. But it is a combination of 2 cheaper generic creams, so talk to your doctor about making your own combination.
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is a different form of acyclovir that can also be used to treat an oral herpes outbreak. It is an adhesive tablet that you place on your gums. Sitavig delivers a high concentration of acyclovir directly to your lip, the site of the cold sore. But again, itll cost you.
What Are The Treatment Options For Genital Herpes
Treatment with antiviral medication is a good idea the very first time people have an outbreak of genital herpes. Later outbreaks are often milder, and then medication isn’t always needed. Preventive treatment may be considered if the outbreaks are frequent.
Genital herpes may clear up on its own. But the symptoms are often more severe the first time you have an outbreak. Most people then use antiviral medication to relieve the symptoms and prevent complications. These medications include aciclovir, famciclovir and valaciclovir.
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What If I Forget A Dose Of Aciclovir
If you forget a dose of aciclovir, take it as soon as you remember, unless it’s nearly time for your next dose. In this case, just skip the missed dose and continue with your next one as normal.
Never have 2 doses at the same time. Never have an extra dose to make up for a forgotten one.
If you forget doses often, it may help to set an alarm to remind you.
You could also ask your pharmacist for advice on other ways to remember your medicines.
Binding And Entry Inhibition
Other antiviral drugs act on the host cell to inhibit the virus . The advantage to this approach is that resistance to the drug is less likely to appear, especially because these drugs are not subject to TK activation and ACV resistance mutations in that locus while random mutations occur in both viruses and hosts, the mutation rate in viruses is much higher than it is in host cells . On the other hand, targeting a host cell function may lead to higher toxicity, potentially limiting therapeutic use to only viral strains that are resistant to safer therapies.
n-Docosanol.
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Treating A First Outbreak Of Herpes
A first outbreak of genital herpes can cause a long illness with severe genital sores and can also affect the nervous system. Even if your first episode of herpes is mild, you may have severe or prolonged symptoms later. For this reason, the Centers for Disease Control and Prevention recommends that everyone who has a first episode of genital herpes take antiviral drugs.
Almost everyone who has one episode of genital herpes caused by HSV-2 also has later breakouts of sores. Later episodes are less common if your case of genital herpes is due to an HSV-1 infection.
The frequency of genital herpes outbreaks slows down over time in many people.
Acyclovir May Cause Side Effects Tell Your Doctor If Any Of These Symptoms Are Severe Or Do Not Go Away:
- upset stomach
- numbness, burning, or tingling in the arms or legs
- temporary inability to move parts of your body
- shaking of a part of your body that you cannot control
- seizures
- loss of consciousness
Acyclovir may cause other side effects. Call your doctor if you have any unusual problems while you are taking or using this medication.
If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration’s MedWatch Adverse Event Reporting program online or by phone .
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Protecting Your Partner And Preventing Herpes Transmission
Research shows that the single greatest fear is the fear of transmission to partners, says Dr. Handsfield.
The main ways to avoid transmitting herpes are:
- Learn to recognize how you feel when an outbreak is on the way, and stop having sex immediately.
- Dont have sex during active outbreaks.
- Always use condoms but dont rely on them during outbreaks. They dont completely cover infectious areas.
- Only after all sores have scabbed over and healed should you have sex again.
- Avoid touching your herpes sores, because you can spread them to other places on your body that way. Whenever you touch a sore, wash your hands immediately.
- Dont kiss people or have sex if you have a cold sore.
- Tell potential partners about having herpes before having sex with them, even though it may be hard.
- Ask your doctor about taking antiviral drugs regularly.
Side Effects And Follow
Side effects with these herpes drugs are considered mild, and health experts believe these drugs are safe in the long term. Acyclovir is the oldest of the three, and its safety has been documented in people taking suppressive therapy for several years.
People taking suppressive therapy should see their doctor at least once a year to decide if they should continue. You may find taking the pills every day to be inconvenient, the drugs may not work for you, or you may naturally have fewer outbreaks as time goes on. Your doctor can help you make treatment choices to suit your needs.
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New Drug May Be A Cure For Both Covid
ATLANTA, Ga. Scientists have developed a drug that could be an antiviral cure for both sexually transmitted infections and the COVID-19 pandemic.
In animal experiments, researchers discovered that a medication that mimics immune system proteins successfully treats herpes. The small synthetic molecule may also defeat the coronavirus and many other kinds of infections. The stable peptoid is harder to break down that the real thing.
The team suggests that doctors could give such a treatment to airline passengers before a flight to protect them from COVID. Scientists expect clinical trials to begin within months. Vaccines alone wont overcome the pandemic, making anti-viral therapies are just as vital.
In the body, antimicrobial peptides such as LL-37 help keep viruses, bacteria, fungi, cancer cells and even parasites under control, says principal investigator Dr. Annelise Barron of Stanford University in a media release.
These substances are not usually ideal drug candidates as they are quickly cleared by enzymes in the body. With that in mind, study authors emulated the key biophysical attributes of LL-37.
Peptoids are easy to make, Barron says. And unlike peptides, theyre not rapidly degraded by enzymes, so they could be used at a much lower dose.
So How Should I Treat Oral Herpes
Antiviral pills are your best choice for treating oral herpes. They are more reasonably priced and are effective. Antiviral therapy can quickly heal lesions if the medications are used in the first 72 hours after a lesion appears.
If you have persistent oral herpes infections, taking 1 of these 3 antiviral medications at the very start of a herpes outbreak is your best chance to relieve pain and shorten the outbreak:
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2000 mg twice in 24 hours shortens healing time and duration of pain.
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1500 mg , taken at once, also shortens healing time and pain duration.
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400 mg 5 times a day for 5 days reduces pain duration but doesnt shorten healing time.
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What Happens If You Dont Get Herpes Treatment
The good news about herpes is that its not deadly or even very dangerous. It might be annoying, but herpes doesnt get worse over time or cause serious health problems like other STDs can.
If you dont get treated for herpes, you might keep having regular outbreaks, or they could only happen rarely. Some people naturally stop getting outbreaks after a while.
There are a few reasons people may decide not to get treatment. They might not have that many outbreaks, or their outbreaks dont really bother them. Or maybe theyre not having sex, so theyre not that worried about having herpes right now. Whatever your situation is, getting treatment for herpes is your choice.
Having herpes can make it easier to get HIV, because the sores give HIV an open pathway into your body. So always use condoms to help prevent the spread of both herpes and HIV.
What You Need To Know
- Fifty percent to 80 percent of U.S. adults have oral herpes.
- Oral herpes can be spread through intimate contact with someone who is infected.
- Oral herpes can be difficult to diagnose. Often confused with many other infections, it can only be confirmed with a virus culture called PCR, blood test or biopsy. PCR is the preferred test for diagnosing herpes infections.
- The best treatment for oral herpes is antiviral oral medication. Symptomatic treatment may include antiviral ointment, over-the-counter topical anesthetics or over-the-counter anti-inflammatory agents.
Whether you call it a cold sore or a fever blister, oral herpes is a common infection of the mouth area that is caused by herpes simplex virus type 1 . Fifty percent to 80 percent of U.S. adults have oral herpes. According to the National Institutes of Health, about 90 percent of adults have been exposed to the virus by age 50.
Once infected, a person will have herpes simplex virus for the rest of his or her life. When inactive, the virus lies dormant in a group of nerve cells. While some people never develop any symptoms from the virus, others will have periodic outbreaks of infections.
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To Use Buccal Acyclovir Follow These Steps:
If the delayed-release buccal tablet comes off within the first 6 hours of application, reapply the same tablet. If it still will not stick, then apply a new tablet. If you accidentally swallow the tablet within the first 6 hours of application, drink a glass of water and place a new tablet on your gum. If the tablet falls off or is swallowed 6 or more hours after application, do not apply a new tablet until your next regular time.