How Herpes Is Treated

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 the 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. 

    And remember: If you already know that you have HSV-1 or HSV-2, take precautions to avoid infecting others by avoiding skin-to-skin contact and 

    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 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. 

    DrugFirst Outbreak TreatmentRecurrent Outbreak PreventionRecurrent Outbreak Treatment
    Zovirax, Sitavig (acyclovir)400mg three times a day for seven to 10 days —OR— 200mg five times a day for the same duration*400mg twice a day400mg three times a day for five day —OR— 800mg twice a day for five days —OR— 800mg three times a day for two days
    Famvir (famciclovir) 250mg three times a day for seven to 10 days*250mg twice a day125mg twice a day for five days —OR— 1g twice a day for one day —OR— 500mg once, followed by 250mg twice a day for two days
    Valtrex (valacyclovir) 1g twice a day for seven to 10 days*500mg or 1g daily500mg twice a day for three days —OR— 1g once a day for five days

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

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

    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. 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 placebo.
    • Algae extract: In a laboratory setting, algae extract has been shown to inhibit HSV-2 growth, so this may be a 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 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.

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