Treatment Of Common Cutaneous Herpes Simplex Virus Infections
DAVID H. EMMERT, M.D., Lancaster General Hospital, Lancaster, Pennsylvania
Am Fam Physician. 2000 Mar 15 61:1697-1704.
Herpes simplex virus infection is increasingly common in the United States. New antiviral medications have expanded treatment options for the two most common cutaneous manifestations, orolabial and genital herpes. Acyclovir therapy remains an effective and often less expensive option. Famciclovir and valacyclovir offer improved oral bioavailability and convenient oral dosing schedules but are more expensive than acyclovir. Patients who have six or more recurrences of genital herpes per year can be treated with one of the following regimens: acyclovir, 400 mg twice daily valacyclovir, 1 g daily or famciclovir, 250 mg twice daily. These regimens are effective in suppressing 70 to 80 percent of symptomatic recurrences. Episodic treatment of recurrent genital herpes is of questionable benefit, but it may be helpful in appropriately selected patients. There is little evidence indicating benefit from treatment of recurrent orolabial herpes, which tends to be mild and infrequent.
You May Like: How To Know If You Have Herpes
Why Trust Verywell Health
As a seasoned health writer, Jennifer Nied understands how vital quality product recommendations are for treating symptoms safely and effectively at home. For over 10 years, she has reviewed products, interviewed experts, scrutinized ingredients, and pored over research studies and claims, to help readers like you understand what works for your specific conditions. Every product in this piece was selected taking into account recommendations from doctors, published research, and real customer reviews.
Additional reporting to this story by Simone Scully
Simone Scully is a New York-based writer and editor with years of experience writing about health, wellness, science, and lifestyle. Her byline has appeared at Healthline, Well+Good, Narratively, Romper, Motherifigures magazine, Nautilus, Narratively, AskMen, among other places.
Also Check: How Can I Cure Herpes Forever
Find A Doctor You Feel Comfortable With
While some doctors have a special interest in sexual health, others may not be familiar with, or comfortable discussing, these issues. Finding a doctor with whom you can openly and comfortably discuss these issues is important. There are doctors who specialise in this area: some are in private clinics, while others belong to sexual health services. There are also sexual health services in country areas. All sexual health services are strictly confidential.
Talk to your doctor if you are feeling worried about the impact of genital herpes on your sex life, relationship or future relationships. Your doctor can give you advice on how to discuss sexually transmitted infections with your partner, and can recommend support groups.
References
1. Genital ulcer disease . In: eTG complete. Melbourne: Therapeutic Guidelines Limited 2016 Jul.http://online.tg.org.au/complete/ .2. BMJ Group. Patient information from the BMJ Group: Genital herpes . http://bestpractice.bmj.com/best-practice/pdf/patient-summaries/532420.pdf 3. Centers for Disease Control and Prevention . Genital herpes CDC fact sheet . http://www.cdc.gov/std/herpes/stdfact-herpes.htm .4. Australian STI Management Guidelines for use in primary care. Herpes . http://www.sti.guidelines.org.au/sexually-transmissible-infections/herpes .
Don’t Miss: How Quickly Does Herpes Show Up
About Herpes Suppression Treatment
-
Taking herpes suppression treatment
Take 1 tablet 2 times a day for 3 months. We usually recommend that you continue Aciclovir herpes suppression treatment for 1 year.
If you forget to take a tablet, take it as soon as you remember. However, if it’s nearly time for your next one, skip the missed dose. Do not take 2 tablets to make up for a forgotten dose.
-
Side effects of herpes suppression therapy
A small number of people will experience some side effects when taking Aciclovir, however these are generally mild and should pass quickly. These may include headache, dizziness, nausea, diarrhoea or tiredness.
For full information on side effects and correct use, see the patient information leaflet. If any side effects concern you, contact us via your Patient Record.
-
Effectiveness of herpes suppression therapy
If you have 6 or more outbreaks of genital herpes per year, this treatment should result in fewer, less severe or even no outbreaks.
Aciclovir suppression treatment is only effective if taken regularly and correctly, as prescribed.
-
How herpes suppression tablets work
Aciclovir is an antiviral that works to prevent the herpes virus from multiplying. Taking it regularly reduces the frequency of genital herpes outbreaks.
Herpes Treatment With Aciclovir
Aciclovir is an antiviral medication which is used to treat genital herpes. It is sometimes referred to as acyclovir. It works by stopping the herpes virus from replicating, reducing the severity of the infection. This helps to prevent the virus from spreading, reducing the seriousness of symptoms. It also helps to speed up the healing process. It usually takes around 2-3 days for aciclovir to start working. To treat an outbreak, you should takeone 400mg tablet three times a day. Alternatively, you can take one 200mg tablet five times a day.
You can also take aciclovir daily to help reduce the chances of getting a flare up. This is known as suppression therapy. The dose for suppression therapy is to take one 400mg tablet two times a day.
Side effects do not affect everyone, but may include stomach pain, dizziness, fatigue, headache, and skin reactions. It may be possible to take aciclovir if you are pregnant or breastfeeding, but you should check this with your doctor. They will determine whether the benefits of treatment outweigh the risks.
You May Like: Does Genital Herpes Go Away On Their Own
What Is The Best Genital Herpes Treatment
Content by
See our range of genital herpes treatments
Delivered discreetly from our UK registered pharmacy
The best genital herpes treatments are aciclovir and valaciclovir. Studies show that they help to reduce viral transmission by 75 – 90%. They can both be taken during an outbreak to help reduce the severity of a flare up. Alternatively, they can be taken daily to reduce the chances of getting an outbreak.
Are Intravenous Ozone Treatments Always More Effective Than Non
If a doctorwants to maximize the effect of a given therapy, he will often go for the intravenous route. Whether with antibiotics, Vitamin C, or anaesthetics the drug goes directly into the blood stream and the result is often strong and immediate.
Same applies for ozone: intravenous deliveries are a great and often very powerful systemic treatment. But not always.
Here some examples:
Infections tend to focus on just one part of the body: be it a strep throat, the herpes virus which sits in the lower spine, or dental cavitations.
Yes, in those cases intravenous applications can work in a supportive way but the most effective ozone treatments will focus on fighting the pathogen directly where it sits.
Big joints contain cavities filled with sinovial fluid without any blood vessels. An intravenous administration is not the best approach to address joint problems. It may not even have any effect, depending on what causes the pain.
Case in point: when working at a doctors office, I met a man who had to have 3 different shoulder surgeries during which doctors tried to debride a bacterial infection which did not respond to i.v. antibiotics.
Another area where intravenous ozone applications wont reach: intestines. Intravenous ozone will do nothing for SIBO, IBS, or colitis, except for a minor or transient improvement.
Me performing one of my favorite go-to treatments: DIV, direct ozone injection. The needle could have been definitely inserted a bit deeper.
Don’t Miss: Are There Dating Sites For People With Herpes
What Is The Best Medication For Herpes
The effectiveness of a particular medication varies depending on the person, so thereâs no single âbestâ herpes treatment. Doctors prescribe the most suitable drug for each patientâs condition, medical history, and current medications. That said, here are a few of the drugs most commonly used to treat HSV:
| Best medication for herpes |
|---|
- Redness
- Swelling
This doesnât encompass the full scope of potential side effects, just the most common ones. Anyone considering treatment with one of these medications should speak with a healthcare professional for a more comprehensive list.
Recommended Reading: How Do You Keep Herpes From Spreading
So What Is The Best Herpes Treatment
Valaciclovir and aciclovir have both been proven to reduce the length and severity of herpes outbreaks. Studies show that both treatments are as effective as each other. Aciclovir is a more cost-effective option, however, valaciclovir offers a more convenient dosing regime. Ultimately, this comes down to personal preference, and what works best for you. Before seeking treatment, you should speak to your doctor or pharmacist for medical advice.
Whilst all of our content is written and reviewed by healthcare professionals, it is not intended to be substituted for or used as medical advice. If you have any questions or concerns about your health, please speak to your doctor.
You May Like: How Not To Transmit Herpes
Aetiology And Natural History
Aetiology
. HSV-1
. HSV-2
Natural history
. Only one-third of individuals appear to develop symptoms at the time of acquisition of infection with HSV-2. Incubation of infection from acquisition to first clinical signs and symptoms in this minority of individuals ranges from 2 days to 2 weeks.
. Infection may be primary or non-primary. Disease episodes may be initial or recurrent and symptomatic or asymptomatic. It is likely that the majority of infections are acquired subclinically.
. Prior infection with HSV-1 modifies the clinical manifestations of first infection by HSV-2, usually making symptoms less severe.
. After childhood, symptomatic primary infection with HSV-1 is equally likely to be acquired in the genital area or oral areas.
. Although primary and initial genital herpes in the UK may be caused by HSV-1 or HSV-2, the majority of infections in adults are due to HSV-1 with the probability of this over HSV-2 being greater at younger age .
. Following primary infection, the virus becomes latent in local sensory ganglia, periodically reactivating to cause symptomatic lesions or asymptomatic, but infectious, viral shedding.
. The median recurrence rate for genital herpes after a symptomatic first episode is 0.34 recurrences/month for HSV-2 and is four times more frequent than the recurrence rate for HSV-1. Recurrence rates decline over time in most individuals, although this pattern is variable.
Valacyclovir Tablets Are Used In Adults:
- to treat cold sores
- to treat shingles
- to treat or control genital herpes outbreaks in adults with normal immune systems
- to control genital herpes outbreaks in adults infected with the human immunodeficiency virus with CD4 + cell count greater than 100 cells/mm3
- with safer sex practices to lower the chances of spreading genital herpes to uninfected partners. Even with safer sex practices, it is still possible to spread genital herpes. Valacyclovir tablets used daily with the following safer sex practices can lower the chances of passing genital herpes to your partner.
- Do not have sexual contact with your partner when you have any symptom or outbreak of genital herpes.
- Use a condom made of latex or polyurethane whenever you have sexual contact.
Also Check: How Is The Herpes Simplex Virus Transmitted
Do I Have To Tell Someone I Have Herpes
Is it Illegal to not tell someone you have Herpes? No, it is not illegal to not tell someone you have herpes. However, if you are in an intimate relationship with someone, it is best to let your partner know that you have an STD. This will allow you both to take precautions to minimize the spread of the STD.
Education Is An Integral Part Of Herpes Treatment
If you have genital herpes, its important for you to get educated about herpes and have the opportunity to ask questions in a supportive environment.
Becoming informed will help you learn to cope with the illness. It will also help you prevent sexual transmission of the illness, or transmission to an infant during a pregnancy.
Herpes has a tremendous psychosocial overlay. But knowledge about it and understanding about how well it can be managed can reduce that, says Handsfield.
Your doctor may be able to provide you with all the information you need, or you may choose to seek counseling from a mental health professional or at a clinic that specializes in sexual health, such as Planned Parenthood.
If you have a regular sexual partner, that person should also have the chance to learn about herpes and ask any questions they may have about it.
Recommended Reading: Can You Date With Herpes
How Do Dermatologists Treat Herpes Simplex
There is no cure for herpes simplex. The good news is that sores often clear without treatment. Many people choose to treat herpes simplex because treatment can relieve symptoms and shorten an outbreak.
Most people are treated with an antiviral medicine. An antiviral cream or ointment can relieve the burning, itching, or tingling. An antiviral medicine that is oral or intravenous can shorten an outbreak of herpes.
Prescription antiviral medicines approved for the treatment of both types of herpes simplex include:
-
Acyclovir
-
Famciclovir
-
Valacyclovir
Taken daily, these medicines can lessen the severity and frequency of outbreaks. They also can help prevent infected people from spreading the virus.
How Are Genital Herpes Diagnosed
Other STIs, like syphilis, cause similar symptoms. In addition to a physical exam, your healthcare provider will take a fluid sample from the blisters to test for the herpes virus. If your blisters are healed or you dont have blisters, a blood test can check for HSV-2 antibody, a marker that shows you have been exposed to the virus.
Donât Miss: How To Get Rid Of Herpes Simplex On Lips
Recommended Reading: How To Get Tested For Mouth Herpes
Which Herpes Medication Is Best
In the war between valacyclovir vs. acyclovir vs. famciclovir, the truth is, there is no best herpes medication. All three of the drugs are safe and proven to be effective as treatments for HSV-1, HSV-2, shingles and other forms of the herpes virus.
If you think you might have herpes, the best approach is to speak to your doctor about treatment options. Your doctor will be able to provide advice on the most effective drug for treating herpes based on your symptoms, immune system, lifestyle and overall health.
This article is for informational purposes only and does not constitute medical advice. The information contained herein is not a substitute for and should never be relied upon for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment. Learn more about our editorial standardshere.
Get the latest from Hims
Herpes Treatment With Valaciclovir
Valaciclovir is an antiviral medication, commonly referred to as valacyclovir. It is also available as a branded version called Valtrex. Valaciclovir works by stopping the herpes virus from multiplying and spreading, helping the bodyâs immune system to fight the infection. This reduces the severity of symptoms and helps to speed up the healing process. It takes around 2-3 days for valaciclovir to start working. To treat an outbreak, you should take one 500mg tablet two times a day.
You can also take valaciclovir to lower the chances of having an outbreak. This is useful for those who get more than 6 outbreaks a year and is referred to as suppression therapy. The dose for suppression therapy is one tablet daily. Although it is safe to take valaciclovir daily, you should review treatment with your doctor at regular intervals.
Side effects include stomach upset, dizziness and skin reactions, although not everyone gets them. Valaciclovir may be taken if you are pregnant or breastfeeding under advice of a doctor. You may need monitoring and valaciclovir will usually only be prescribed if the benefits are thought to outweigh the risks.
Don’t Miss: How Many People In The World Have Herpes
Is There A Cure Or Treatment For Genital Herpes
There is no cure for genital herpes. However, daily use of antiviral medicines can prevent or shorten outbreaks. Antiviral medicines also can reduce the chance of spreading it to others.
Though several clinical trials have tested vaccines against genital herpes, there is no vaccine currently available to prevent infection. One vaccine trial showed efficacy among women whose partners had HSV-2, but only among women not infected with HSV-1. Efficacy was not observed among men whose partners had HSV-2. Another trial testing the same vaccine showed some protection from genital HSV-1 infection, but none from HSV-2.
What Are The Possible Side Effects Of Valacyclovir Tablets
Kidney failure and nervous system problems are not common, but can be serious in some patients taking valacyclovir tablets. Nervous system problems include aggressive behavior, unsteady movement, shaky movements, confusion, speech problems, hallucinations , seizures and coma.
Kidney failure and nervous system problems have happened in patients who already have kidney disease and in elderly patients whose kidneys do not work well due to age. Always tell your healthcare provider if you have kidney problems before taking valacyclovir tablets.
Common side effects of valacyclovir tablets in adults include headache, nausea, stomach pain, vomiting and dizziness. Side effects in HIV-infected adults include headache, tiredness and rash. These side effects usually are mild and do not cause patients to stop taking valacyclovir tablets.
Other less common side effects in adults include painful periods in women, joint pain, depression, low blood cell counts and changes in tests that measure how well the liver and kidneys work. The most common side effect seen in children < 18 years of age was headache.
Talk to your healthcare provider if you develop any side effects that concern you. These are not all the side effects of valacyclovir tablets. For more information ask your healthcare provider or pharmacist.
Don’t Miss: What Do Doctors Prescribe For Herpes
Home Remedies And Lifestyle
At-home treatments for herpes are used to relieve pain. They do nothing to alter the course of the infection but can make you more comfortable as the herpes sores begin to heal.
There are several things you can do if have an outbreak of oral or genital herpes:
- Use a cold compress. Place a cloth-covered ice pack on the sores for 15 minutes several times daily to reduce pain. Keep the ice pack moving to prevent frostbite.
- Do not touch or scratch. Avoid touching and rubbing the sores. Doing so can spread the infection to other areas of the skin.
- Keep the sores clean. Herpes sores can become infected with bacteria if touched with soiled hands. Wash your hands thoroughly with soap and water after going to the bathroom or before applying medications.
- Reduce stress. Stress can increase your sensitivity to pain during a herpes outbreak. You can reduce stress by performing gentle exercises or practicing mind-body therapies like meditation, yoga, and guided imagery.
To reduce the risk of spreading herpes, avoid kissing and sharing objects that come into contact with saliva, like drinking straws and eating utensils.
It’s important to note that oral herpes can be spread to the genitals, and that genital herpes can be spread to the mouth. To reduce the risk of infection, use condoms and dental dams during oral sex. Better yet, avoid sex altogether if you are having an active herpes outbreak .