Effective Treatments for Herpes

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Herpes simplex virus (HSV) types 1 and 2 are not curable, but they are treatable. Herpes treatments offer the following support:

  • Relieve symptoms
  • Shorten the duration of outbreaks
  • Prevent recurrences
  • Reduce the risk of spreading herpes to others

Treatments for herpes include:

  • At-home remedies
  • Pain relievers
  • Antiviral medications

This article discusses treatment options for HSV-1, which causes oral herpes (cold sores), and HSV-2, which causes genital herpes.

herpes treatment
Illustration by Emily Roberts, Verywell

Home Remedies and Lifestyle

At-home treatments for a cold sore or genital herpes can relieve symptoms. However, it can not cure the infection. To ease the pain and prevent sores from getting worse, try the following:

  • 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 rubbing lesions caused by herpes. Doing so can spread the infection to other areas of your 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. Therefore, 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. Therefore, reducing your stress may help prevent excessive herpes recurrences.

Over-the-Counter Therapies

Over-the-counter (OTC) antiviral therapy creams may help speed recovery from oral or genital herpes infections. In addition, 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 drugs inhibit the ability of a virus to multiply in the body, but they do not destroy or eliminate the virus. This medication comes as a cream that you apply directly to the affected area 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 several OTC 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 applying 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

Healthcare providers often prescribe antiviral medication to treat genital herpes infections. Like the OTC antiviral cream, Abreva, they inhibit the virus from multiplying in the body, but they do not rid the body of it.

If you have a first episode or a recurrence, experts recommend a short course of one of the three options available. However, those with frequent attacks may need to take one of these drugs daily on an ongoing basis. This kind of daily treatment 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 Centers for Disease Control (CDC) herpes treatment guidelines are for adults with herpes. However, your healthcare provider will help you determine which options are 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, cold sore treatment is not needed unless the symptoms are severe and persistent. If that is the case, your doctor may prescribe acyclovir.

Complementary Medicine (CAM)

Alternative therapies for herpes with some supporting research include:

  • PropolisA sticky substance that bees produce from tree saps, propolis shows promise in the treatment of herpes. Studies have found that when people were treated with propolis, they experienced faster healing of herpes lesions and a higher likelihood of fully healed lesions by the 10th day of treatment when compared to people who received a placebo.
  • Algae extract: In a laboratory setting, algae extract has inhibited HSV-2 growth. Therefore, this may be considered a valuable component in alternative treatments in the future. Even so, more research is needed.
  • Acupuncture: In a randomized trial, people with herpes-related pain received either treatment with acupuncture or standard pharmacological drugs. The study concluded that both treatments were effective with no significant difference, indicating acupuncture may be beneficial for treating herpes pain. However, while mildly helpful, this treatment method has also rarely been associated with the transmission of HSV, so it is best to consider it with caution. 

While there is not currently evidence to support the claims that other alternative options are beneficial for treating herpes, some people also use the following:

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

Recap

Some people use complementary and alternative methods (CAM) to treat herpes infection. For example, studies have found promising results for propolis, algae, and acupuncture. However, there is not currently evidence to support other CAM health claims.

Summary

There is no cure for herpes, but you can manage outbreaks with at-home treatment, OTC remedies, prescription medications, and CAM therapies. Treatment works to manage pain, shorten the duration of an outbreak, and reduce the likelihood that you will spread the virus to others.

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 episode is likely to be. For best results, try to start treatment within 48 hours of the first appearance of symptoms.

If your primary care provider cannot see you, do not hesitate to access treatment through a telehealth provider. The visit may be partially or fully covered if you have health insurance.

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 to treat the type of herpes that causes 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 effectively reduce the severity and duration of a herpes outbreak. However, some authorities recommend Valtrex over Zovirax to treat 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. Antivirals can also shorten the course of a first genital herpes outbreak by up to 50%.

  • Are there natural remedies that can help treat herpes?

    Evidence on the benefits of complementary and alternative medicines for treating herpes is scant. However, 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, no human trials have shown high enough efficacy to bring a herpes vaccine to market.

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