Effective Treatments for Herpes

Oral herpes, normally caused by HSV type 1, and genital herpes, normally caused by HSV type 2, are both treatable infections, but they are not curable. Home remedies, over-the-counter medications, and other options can help relieve pain and discomfort. Prescription medications and one over-the-counter antiviral medication can reduce the severity and duration of outbreaks.

Home Remedies and Lifestyle

There are some things that you can do at home to reduce the pain of a cold sore or genital herpes. Additionally, you can also take a few steps to prevent the lesions from getting worse and spreading or an infection from recurring. 

• Apply cold compresses: Place a well-insulated ice pack on your lesions for as long as it makes you feel better. The cold will not worsen or improve the lesion, but it can lessen the pain. 
• Don't scratch: It is important to avoid touching and scratching lesions caused by herpes, because you can spread the infection to other areas of your own skin. 
• Keep the sores clean: Cold sores and genital herpes infections can become infected with bacteria from your hands or, in the latter case, from urine or feces. It is important to keep the area of sores and blisters clean and dry to avoid an additional infection. 
• Reduce stress: Stress can interfere with optimal immune system function. Reducing your stress may help prevent excessive herpes recurrences.

Over-the-Counter Therapies

Over-the-counter antiviral therapy creams may help speed recovery from oral or genital herpes infections, and other options can help ease discomfort.

Some to consider include:

• Abreva (docosanol): This is the only FDA-approved antiviral medication for herpes infection that you can get without a prescription. Antiviral medications inhibit the ability of a virus to multiply in the body, but they do not completely destroy or eliminate the virus. This medication comes as a cream that you apply directly to the affected area about every three to four hours. Take care to only apply it to the skin, not inside your mouth, eyes, or vagina. Wash your hands before and after use.
• Pain-relieving lotions and creams: Medicated pain creams or lotions can ease discomfort associated with sores. There are a number of over-the-counter options available. Be sure to confirm with your doctor or pharmacist that the product you select is safe to use on herpes lesions, and wash your hands before and after you apply any product.
• Oral pain relievers: Oral medications such as Tylenol (acetaminophen), Advil (ibuprofen), and Aleve (naproxen) can help relieve herpes-related pain for several hours. 

Prescriptions

There are several situations when prescription antiviral medication is recommended, and almost all apply to cases of genital herpes infection. The prescriptions used for herpes infection are all antiviral medications, and, like the over-the-counter antiviral cream Abreva, they inhibit the proliferation of the virus, but they do not rid the body of it.

If you have a first episode or a recurrence, a short course of one of the three options available is recommended. Those with frequent episodes may need to take one of these drugs daily on an ongoing basis, which is known as suppressive therapy.

Taking herpes medication when you do not have symptoms has been shown to reduce the risk of sexual transmission to a partner.

The following recommendations for adults with genital herpes are from the Centers for Disease Control (CDC) herpes treatment guidelines, but your doctor will decide which of these options is best for you. 

*If symptoms remain after 10 days, your doctor might choose to continue treatment.

In general, prescription antivirals are not recommended for pregnant women or for infants under the age of one. They may be used for children under the age of 12 and the recommended dose is calculated by a physician based on weight.

Complementary Medicine (CAM)

Alternative therapies for herpes with some supporting research include:

• Propolis: A sticky substance that bees produce from tree saps, propolis shows promise in the treatment of herpes.

• Algae extract: In a laboratory setting, algae extract has been shown to inhibit HSV-2 growth, so this may be considered a useful component in alternative treatments in the future. 
• Acupuncture: Acupuncture has been used for the treatment of pain caused by herpes lesions with some beneficial results. This treatment method, while mildly helpful, has also rarely been associated with the transmission of HSV, so it is best to consider it with caution. 

Several other alternative options have been investigated for the treatment or suppression of genital herpes, including lysine, zinc, Echinacea, eleuthero, and bee products. There is no evidence to show that any of these options are beneficial for these purposes.

A recently marketed alternative therapy for herpes, Resolve Herpes is said to contain minerals and is marketed as a detox therapy. So far, there does not appear to be evidence that this product can cure or treat herpes infections.

There have been some promising trials of herpes vaccines. However, to date, no human trials have shown high enough efficacy to bring a herpes vaccine to market.

Frequently Asked Questions

What over-the-counter drugs are used to treat herpes?

Abreva (docosanol) 10% cream is the first over-the-counter antiviral drug approved for the treatment of herpes simplex type 1 (the type commonly associated with cold sores). If applied at the first sign of a cold sore (before a blister develops), it may reduce the duration of an outbreak to as few as 2.5 days.

What prescription drugs are used to treat herpes?

Herpes viruses are treated with antivirals. There are three commonly used to treat oral or genital herpes:

• Zovirax (acyclovir)
• Valtrex (valacyclovir)
• Famvir (famciclovir)

Do all antivirals work equally well in treating oral or genital herpes?

All three antivirals are effective in reducing the severity and duration of a herpes outbreak. However, some authorities recommend Valtrex over Zovirax for the treatment of genital herpes.

How long does herpes last if treated with antivirals?

Studies have shown that, if started within 48 hours of the first appearance of lesions, antivirals can reduce the duration of oral herpes by one to two days and the duration of the first genital herpes outbreak by up to 50%.

Are there natural remedies that can help treat herpes?

Although evidence on the benefits of complementary and alternative medicines for treating herpes is scant, several natural compounds have shown promise, including:

• African rue (Peganum harmala) extract
• Green algae (Stypopodium zonale) extract
• Red seaweed (Hypnea musciformis) extract
• Verbena (Verbenaceae) essential oil
• Yu Xing Cao (a traditional Chinese medicine)

Can herpes be cured?

There is no cure for herpes and there are no vaccines that can prevent either HSV-1 or HSV-2. Once you are infected, the virus remains in your body forever.

A Word From Verywell

The key to successfully treating any herpes outbreak is a timely response. The sooner you recognize the signs and access treatment, the shorter and less severe the outbreak is likely to be. Treatment should be started within 48 hours of the first appearance of symptoms.

If your primary care provider is unable to see you, do not hesitate to access treatment through a telehealth provider, the visit of which may be partially or fully covered by your health insurance.