Effective Treatments for Herpes

Herpes simplex virus (HSV) type 1, which causes oral herpes (cold sores), and HSV type 2, which causes genital herpes, are treatable—but they are not curable

The goals of herpes treatment are to relieve symptoms, reduce the risk of spread, shorten outbreaks, and prevent recurrence. This may involve home remedies, pain relievers, and other options that can help ease discomfort. It may also include antiviral medications that can reduce the severity and duration of herpes flare-ups.

herpes treatment
Illustration by Emily Roberts, Verywell

Home Remedies and Lifestyle

There are some things that you can do at home to lessen the pain of a cold sore or genital herpes, prevent worsening of your condition, and reduce the risk of spreading the infection to others.

  • 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: Avoid touching and scratching lesions caused by herpes, as this 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. Keep the sores and blisters, and the areas around them, clean and dry to avoid an additional infection. 
  • Reduce stress: Stress can affect how well your immune system can keep your herpes infection in check. 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 reduce pain.

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 healthcare provider 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.

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 healthcare provider will decide which of these options is best for you.

 Drug  First Outbreak Treatment Recurrent Outbreak Prevention  Recurrent Outbreak Treatment
Zovirax, Sitavig (acyclovir) 400 mg three times a day for seven to 10 days  400 mg twice a day  800 mg twice a day for five days
—OR—
800 mg three times a day for two days
Famvir (famciclovir) 250 mg three times a day for seven to 10 days 250 mg twice a day  125 mg twice a day for five days
—OR—
1 g twice a day for one day
—OR—
500 mg once, followed by 250 mg twice a day for two days 
Valtrex (valacyclovir) 1 g twice a day for seven to 10 days 500 mg or 1 g daily* 500 mg twice a day for three days
—OR—
1 g once a day for five days 
*500 mg/day of valacyclovir might be less effective than other valacyclovir or acyclovir dosing regimens for people who have 10 or more recurrences a year.

Usually, treatment of cold sores is not needed unless the symptoms are severe and persistent, in which case acyclovir is generally used.

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. Studies have found that people who are treated with propolis experience faster healing of herpes lesions and a higher likelihood of fully healed lesions by day 10 of treatment when compared to people who receive a sham treatment (placebo).
  • 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. More research is needed.
  • 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.

Resolve Herpes, an alternative therapy said to be a "detox therapy," is marketed for herpes. So far, there does not appear to be evidence that this product can cure or treat herpes infections.

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. If you have health insurance, the visit may be partially or fully covered.

Frequently Asked Questions

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

    Abreva (docosanol) 10% cream is the first and only over-the-counter antiviral drug approved for the treatment of the type of herpes that caues cold sores. If applied before a blister develops, it may reduce the duration of an outbreak to as few as two and a half days.

  • What prescription drugs are used to treat herpes?

    Herpes viruses are treated with antivirals. There are three commonly used to treat oral and 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 a 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. Once you are infected, the virus remains in your body forever.

  • Is there a herpes vaccine?

    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.

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Article Sources
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