How Effective Are Topical Herpes Treatments
Two new topical medications for oral herpes may hold more promise, but they come at a cost.
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.
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.
Valacyclovir Penciclovir And Famciclovir
Besides ACV, there are other alternatives to treat skin lesions caused by herpes simplex viruses, such as valacyclovir, penciclovir, and famciclovir, which are also considered first-line drugs to treat HSV-1 and HSV-2 and thus, are frequently used .
These drugs are nucleic acid analogs, similar to ACV with a shared mechanism of action that interferes with the function of the viral DNA polymerase . These compounds differ from each other mainly in their bioavailability, half-life in the body and dosing , yet similar to ACV they reduce herpetic lesions and associated pain in approximately 13 days, as compared to untreated groups when used topically .
To increase the bioavailability of acyclovir, an L-valine ester of acyclovir was developed. Valacyclovir is a prodrug of ACV with enhanced absorption at the intestinal level . Later, penciclovir was developed with the aim of being phosphorylated more rapidly than ACV, and consequently has a higher half-life than acyclovir . While acyclovir has a half-life of 0.7 h for HSV-1 and 1 h for HSV-2, penciclovir has a half-life of 10 h for HSV-1 and 20 h for HSV-2 . Famciclovir is a prodrug that derives into penciclovir and has increased oral bioavailability . Clinical benefits granted by these drugs have also generated discussions on the recommendation of their use to treat skin lesions caused by herpes simplex virus infections .
Other Types Of Antivirals
There are several different kinds of antiviral agents that are prescribed to fight viral skin infections. These medications can be divided into systemic antivirals and topical antivirals. Systemic antivirals are usually given orally in pill form. However, they sometimes may be administered intravenously .This is most likely in situations where the patient is suffering from a suppressed immune system , is unable to swallow oral medication, has impaired memory or mental capacity or does not have quick access to a hospital should complications arise during drug therapy.
Topical antivirals are usually available in various forms, including creams, ointments, gels, patches and sprays. In addition, most topical antivirals can be further subdivided into one of three major classes:
- Cytodestructive drugs
- Viricidal drugs
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Understanding Herpes With H Hunter Handsfield Md
Herpes expert H. Hunter Handsfield, MD, explains the basics about genital herpes, including the difference between genital HSV-1 and HSV-2 infection, testing options and the importance of knowing virus type, and the three-prong strategy for prevention. See more herpes videos at sexualhealthTV.com.
Have a question about herpes youd like Dr. Handsfield or our other experts to answer? Visit our Ask the Experts page to learn how.
Where Do Cold Sores Most Commonly Occur
Cold sores often occur at the corner of the mouth, which can make it painful to talk or eat. A cold sore on the lip is vulnerable to getting swiped by a napkin, stuck to a face mask, or knocked with the rim of a coffee cup. Cold sores that occur on the lip may spread to spots inside the mouth. A cold sore on the tongue or inside the lip makes eating painful, and a cold sore on the gums can make it difficult to brush your teeth. A cold sore on the nose is particularly painful if it occurs with sinus congestion.
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What Are Antiviral Medications For 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.
What Is Genital Herpes
Genital herpes is a common viral infection caused by a virus known as the herpes simplex virus .
There are two types of the virus, types 1 and 2 . As well as genital herpes, HSV can infect your mouth and cause cold sores. HSV-1 and HSV-2 infections look the same and you can only tell them apart by lab testing.
Because genital herpes can be passed to others through sexual contact, it is often referred to as a sexually transmitted infection .
As many as 1 in 3 adults has the virus that causes genital herpes. Once you have HSV it remains in your body and becomes active again from time to time.
On average, symptoms of genital herpes are likely to recur 45 times in the first 2 years after being infected with HSV. However, over time the virus tends to become active less often and each time you get symptoms they are less severe.
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Cautions With Other Medicines
Some medicines can affect the way aciclovir tablets or liquid work. They can also make you more likely to get side effects.
If youâre using aciclovir cream on your skin, this is less likely to react with other medicines.
Itâs important to tell your doctor if you take any of the following medicines before taking aciclovir:
- cimetidine, a medicine for stomach ulcers
- mycophenolate mofetil, a medicine given after organ transplants
- probenecid, a medicine for gout
- aminophylline or theophylline, medicines for asthma
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Is There Anything I Can Do To Relieve The Symptoms Myself
In some women, genital herpes blisters cause pain when urinating . Many of them find it soothing to pee while sitting in warm, shallow water . You can do this using special tubs that fit into toilet bowls. They are available at a reasonable price, for instance from pharmacies or on the internet. It’s best not to use soaps or bath additives because they can irritate the affected area even more. Other things you can do to avoid irritating it further include wearing loose-fitting clothes and underwear made out of fabrics that have a smooth surface.
Painkillers such as ibuprofen are an option if the blisters become very painful.
Topical antiviral treatments such as creams or ointments don’t provide any relief, but they can increase the risk of viral resistance. Experts advise against using topical treatments for genital herpes.
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When Should I Get Tested
The best time to get tested for herpes if you havent had an initial outbreak is 12 days after exposure. This is because your body will have had time to produce antibodies that can be detected on a test.
A blood test can determine whether you have these antibodies.
Swabs, on the other hand, can detect the virus directly from an active herpes lesion.
Before Taking This Medicine
You should not take this medicine if you are allergic to acyclovir or valacyclovir . You should not take acyclovir buccal tablets if you are allergic to milk proteins.
To make sure this medicine is safe for you, tell your doctor if you have:
kidney disease or
a weak immune system .
Tell your doctor if you are pregnant or breastfeeding.
Herpes can be passed to your baby during childbirth if you have a genital lesion when your baby is born. If you have genital herpes, it is very important to prevent herpes lesions during pregnancy. Take your medicine as directed to best control your infection.
It may not be safe to breastfeed while using this medicine. Ask your doctor about any risk.
Acyclovir should not be given to a child younger than 2 years old.
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How Do I Choose The Best Over
Herpes is a medical condition caused by a virus and can lead to the development of painful blisters. Some forms of herpes may be transmitted through sexual contact with an infected partner. An over-the-counter treatment is any type of medical treatment that does not require a prescription by a doctor. Over-the-counter herpes treatment options may include medications, lifestyle modifications, or herbal treatments. There is no actual cure for herpes, so any over-the-counter herpes treatment methods are aimed at reducing symptoms of the disease.
Over-the-counter herpes treatment options may include the use of pain relievers or topical preparations. Pain relievers such as aspirin or ibuprofen may help to ease the pain and discomfort when an outbreak occurs. Topical preparations such as creams, ointments, or gels may be useful in treating painful outbreaks as well. It is important to note that many of these products have not been FDA approved and may not be safe for all patients. It is important to discuss the benefits and risks of such treatment options with a doctor.
How Can I Best Learn To Cope With Herpes Simplex
Some people feel distressed or embarrassed about their herpes simplex infection. Its important to understand that the herpes virus is common. For most people, herpes doesnt significantly interfere with daily life.
To cope with negative feelings, you may consider:
- Connecting with others through support groups or online forums.
- Sharing your feelings with a trusted friend or loved one.
- Speaking with a therapist.
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Can You Prevent Herpes Outbreaks
Taking good care of yourself can help prevent future herpes outbreaks. Eating healthy foods, getting plenty of sleep, and avoiding stress can all help outbreaks from occurring.
If you have frequent outbreaks, your doctor may recommend that you take medicine daily, which is called suppressive therapy. It can help prevent future breakouts, and lower your chances of sharing herpes with your partner.
Research has not concluded what causes genital herpes outbreaks whether its sex, your period, stress, skin irritation, or surgery. Oral herpes outbreaks can be caused by sunburn, other infections, or injuries to your lips.
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Complementary And Alternative Medicine
Some people use natural therapies to treat herpes, either on their own or to support standard medical care. The research supporting their use is generally weak, with little evidence that they can reduce either the severity or duration of an outbreak. Even so, many people swear by their effectiveness and consider them a vital part of managing herpes outbreaks.
Complementary and alternative therapies sometimes used to treat herpes include:
- Propolis: This is a sticky substance produced by bees that may help speed the healing of genital herpes. A 2017 study found that people who used propolis ointment experienced better healing by the 10th day of treatment compared to those who used a sham ointment.
- Algae extract: Lab studies suggest that algae extract can inhibit the growth of HSV-2 in test tubes. Whether it can do so in humans has yet to be proven.
- Acupuncture: A 2011 study concluded that acupuncture was mildly effective in reducing pain caused by the herpes zoster virus , the type of herpes virus that causes shingles. While this suggests that acupuncture may be useful in easing genital herpes pain, this has yet to be proven.
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How To Avoid Passing On Genital Herpes
There are several steps you can take to reduce the chances of passing genital herpes on to your sexual partner, including:
- always using condoms when you have sex
- taking suppressive antiviral medicines and
- avoiding sex whenever you have symptoms.
However, while these steps will help reduce the chance of spreading the infection, there is still a chance that you could pass on the genital herpes virus through sexual contact.
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It has taken hundreds of years and billions of people being infected for there to finally be a ray of light in the herpes simplex virus field. A recent study at the Virology, Emerging Diseases & vaccines conference in Canada benchmarked a discovery in the battle to overcome herpes.
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When You Must Not Take Them
- Do not take Valtrex tablets if you have ever had an allergic reaction to valaciclovir, aciclovir or any of the ingredients listed at the end of this leaflet.
- Symptoms of an allergic reaction may be mild or severe. They usually include some or all of the following: wheezing, swelling of the lips/mouth, difficulty in breathing, hay fever, lumpy rash or fainting.
- Do not take Valtrex tablets if you are pregnant, trying to become pregnant or breast-feeding, unless your doctor says you should.
- Your doctor will discuss the risks and benefits of using Valtrex tablets when pregnant and during breast-feeding.
- Do not take Valtrex tablets after the expiry date printed on the pack.
- If you take it after the expiry date has passed, it may not work as well.
- Do not take Valtrex tablets if the packaging is torn or shows signs of tampering.
- If you are not sure whether you should be taking Valtrex, talk to your doctor.
Specifics About Herpes Medication
- Scientifically speaking, Valacyclovir & Acyclovir are both equally effective. Valacyclovir stays in your body longer so you only have to take it once a day, whereas Acyclovir must be taken twice a day
- Valacyclovir & Acyclovir are the most effective prescription antiviral drugs approved by the FDA for herpes treatment both to treat and prevent outbreaks that occur on the mouth and/or genitals
- There are two ways to take these antiviral medications:
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Types Of Antiviral Drugs
There are three oral antivirals recommended for the treatment of oral or genital herpes:
|Famvir, 250 mg||Twice daily|
Preventing genital herpes recurrence is important as it reduces the risk of HIV. According to the CDC, having an active genital herpes infection increases the risk of HIV by 200% to 300%.
How Long Do You Need To Take Antiviral Drugs
Treatment length varies depending on the antiviral drug and viral infection. You may need one dose of an IV drug or a week of oral medicine.
People who have chronic ailments like HIV may take daily antivirals for life. This drug regimen keeps the virus from becoming active. It can prevent the virus from infecting others.
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When And How Are Later Outbreaks Treated
Later outbreaks with only mild symptoms dont necessarily need to be treated. The blisters can then simply heal on their own.
But antiviral medication can also shorten the duration of later outbreaks by an average of about two days. If you decide to have treatment, its important to start it within the first 24 hours of the outbreak ideally, as soon as you notice the first symptoms. So its a good idea to always have a few tablets at home or to take them with you when you travel so they are ready to use. You can get a prescription from your doctor.
In later outbreaks you can take them for a shorter time. The WHO recommends the following:
- aciclovir: 400 mg three times per day or 800 mg two times per day for five days, or 800 mg three times per day for two days,
- famciclovir: 250 mg two times per day for five days, or
- valaciclovir: 500 mg two times per day for three days.
A different dose and treatment duration may be a good idea for people who have immune system disorders, such as an HIV infection.
Suppressive Therapy For Herpes
If you have frequent recurrences of genital herpes
Taking medication every day for many months will stop recurrences completely, or their frequency and severity are greatly reduced. This is called suppressive or prophylactic treatment. Generally, after a year, it is recommended you stop the medication for a few months to see if recurrences have become less frequent. This type of continuous treatment can be repeated if necessary. This type of daily treatment tends to be prescribed if you have frequent or severe recurrences of genital herpes more than six times per year.
Suppressive treatment is valaciclovir 500mg taken daily. This may be increased to 500mg taken twice daily on individual basis of clinical presentation and/or if you are having breakthrough recurrences on 500mg daily. The alternative is oral aciclovir 400mg taken twice daily .
A Doctor can give you a prescription every 3 months for up to 12 months and ongoing if your recurrences are still frequent.
Effectiveness is optimised if taken regularly as prescribed.
For special events
A course of medication may help to prevent a recurrence during special times. This may be an option even if you do not have frequent recurrences, but want to have the least risk of a recurrence â for example, during a honeymoon, holiday or during exams.
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