How STDs Are Treated

The only person who can determine the appropriate treatment for a sexually transmitted disease (STD) is a healthcare provider. A prescription medication is typically in order, and what you need depends on the type of infection you have. For example, chlamydia can be cured with antibiotics, while herpes can be managed (though not eliminated) with antiviral medication.

In some cases, lifestyle changes, home remedies, and over-the-counter options may also be recommended to help ease symptoms, promote healing, or prevent recurrence.

Treatment is individual and may be adjusted for any other issues that affect your overall physical health. Given the potential consequences of untreated STDs, as well as the risk of passing them on to others, early and accurate treatment is imperative.

STDs caused by bacterial infections include syphilis, chlamydia, and gonorrhea. These diseases are curable when treated with the right antibiotics. The doctor will determine the course of treatment based on local and current rates of antibiotic resistance.

Resistance can be a consequence of people failing to take their antibiotics correctly and, in particular, is a growing problem for gonorrhea infections across the globe. That's why it may sometimes be necessary to be retested for gonorrhea after treatment is complete.

Antibiotics used to treat bacterial STDs may be administered as a single injection, a course of pills taken over several days, or as a cream applied directly to the infected area.

The antibiotic prescribed typically depends on the bacteria behind the infection. Here are common antibiotics prescribed for different infections:

• Chlamydia: Zithromax (azithromycin), Vibramycin/Doryx (doxycycline)
• Gonorrhea: Rocephin (ceftriaxone) or, if allergic to it, Factive (gemifloxacin) plus Zithromax (azithromycin) 
• Syphilis: Penicillin G or, if allergic to penicillin, other antibiotics such as Vibramycin/Doryx (doxycycline), Achromycin V/Sumycin (tetracycline), Zithromax (azithromycin), and Rocephin (ceftriaxone)
• Chancroid: Zithromax (azithromycin), Rocephin (ceftriaxone), Cipro/Cetraxa (ciprofloxacin)
• Bacterial vaginosis: MetroCream/Nuvessa/Flagyl (metronidazole), Clindagel/Clindacin/Cleocin (clindamycin)*

*Bacterial vaginosis is not an STD, but a common bacterial infection that often co-occurs with bacterial STDs. As such, it is helpful to consider its treatment alongside them.

STDs caused by viruses include herpes, human papillomavirus (HPV), and HIV. These are usually treated with oral antiviral or antiretroviral medications. Most viral STDs can be managed but do not have cures.

Both herpes and HIV are currently life-long infections, but that may change with new research. Hepatitis C was considered incurable until recently. Now, most cases of hepatitis C are finally able to be cured due to new medication developments.

Some viral STDs, such as HPV, aren't treated at all unless they cause symptoms. With HPV, most infections go away on their own within two years. However, symptoms such as genital warts or cervical dysplasia may need treatment. 

There are several medications available by prescription for treatment of viral STDs.

• Herpes: Zovirax/Sitavig (acyclovir), Famvir (famciclovir), Valtrex (valacyclovir)
• Hepatitis B: Interferon (interferon alpha-2b or pegylated interferon), Hepsera (adefovir), Baraclude (entecavir), Viread (tenofovir), Epivir-HBV (lamivudine)
• HPV: Condylox (podofilox), Zyclara/Aldara (imiquimod), Veregen (sinecatechins)
• HIV/AIDS: Antiretroviral medications are used to treat HIV and AIDS. The right medication for you will depend on the stage of your disease. Prescriptions used to treat HIV and AIDS include Fuzeon (enfuvirtide, T20), Emtriva (emtricitabine), Viread (tenofovir), Ziagen (abacavir), Edurant (rilpivirine), Intelence (etravirine), Sustiva (efavirenz), Tivicay (dolutegravir), Vitekta (elvitegravir), Aptivus (tipranavir), Kaletra (Lopinavir/ritonavir), Prezista (darunavir), Selzentry/Celsentri (maraviroc), and Trogarzo (ibalizumab).

While most viral STD treatments are available by prescription only, some over-the-counter remedies are sometimes recommended:

• Herpes: The OTC antiviral cream Abreva (docosanol) can help to shorten the duration of an outbreak. In addition, oral pain relievers, like Tylenol (acetaminophen) and Advil (ibuprofen) and topical pain relievers can make you more comfortable during a herpes flare-up. 
• HIV/AIDS: Over-the-counter medications like acetaminophen and ibuprofen can relieve headaches and body aches, while topical creams containing capsaicin may ease peripheral neuropathy pain.

Following a healthy diet, reducing stress, getting moderate exercise, and avoiding alcohol and tobacco can help keep you feeling your best and reduce outbreaks of symptoms from viral STDs.

Home remedies for STDs depend on symptoms and include:

• Herpes: Apply a cold compress to the area during an outbreak, do not touch or scratch sores, keep sores clean, and reduce stress to prevent reoccurrences.
• Hepatitis B: Take care of your liver by avoiding alcohol and being careful about the use of medications that can harm the liver, such as acetaminophen. 
• HIV/AIDS: Because HIV can impact your immune system, it is important to stay up-to-date with vaccinations.

Medical and surgical procedures are sometimes recommended for the treatment of viral STDs. This includes:

• HPV: Procedures to remove HPV genital warts include cryotherapy (freezing), electrocautery (burning), injection of interferon into warts, laser treatment, and surgery.
• Hepatitis: In some cases, major liver damage can occur from hepatitis infections and a liver transplant may be needed.

If you have a viral STD, talk to your doctor or pharmacist before taking any herbal medicines or nutritional supplements to ensure doing so is safe given any other medications you may be taking.

There are a few complementary treatments that are being explored for the treatment of certain viral STDs:

• Herpes: Propolis, a sticky substance bees produce from tree sap, is found to speed the healing of herpes lesions. Algae extract is being studied as a possible herpes treatment. Some people also find relief of herpes pain from acupuncture. 
• HIV/AIDS: Medical marijuana may help with pain, reduce nausea, and stimulate your appetite. (Check your state laws regarding medical marijuana.) Yoga and meditation can help ease pain, as well as alleviate feelings of stress and depression that often come with an HIV diagnosis.

STDs that are not viral or bacterial can be caused by fungi, parasites, and infestations, such as scabies. These diseases can be treated either using drugs you take by mouth or through the use of topical agents.

Some of these diseases will also require you to treat your household items. For example, sheets may need to be washed in particular ways or furniture vacuumed to remove parasites. 

Your doctor will likely prescribe medications to treat parasitic infections. These include.

• Trichomoniasis: Flagyl (metronidazole) and Tindamax (tinidazole)
• Pubic lice: Lindane shampoo or lotion 
• Scabies: Elimite (permethrin), Soolantra/Sklice/Stromectol (ivermectin), or Eurax (crotamiton), sulfur ointment and lindane lotion

Over-the-counter anti-itch creams designed for genital use can ease symptoms of trichomoniasis and scabies, while over-the-counter shampoo containing permethrin can treat pubic lice.

Over-the-counter pain relievers such as ibuprofen or acetaminophen can reduce pain and inflammation associated with scabies.

Getting treated and practicing safe sex as you do is important to protecting your partner(s) from contracting an infection, but also to protecting yourself from possible consequences of STDs.

Do not try to treat yourself for an STD using medication you have purchased over the internet or otherwise obtained without a prescription, or with a medication you were given for a previous diagnosis without your doctor's OK. Take all medications as directed, finishing the course of treatment even after symptoms resolve. Failure to do so could lead to a resistant infection.