Herpes treatments
What treatments are available to control my episodes of genital herpes?
The symptoms of herpes may cause some people significant discomfort. Although there is currently no cure for herpes, treatments are available that can reduce the severity, frequency and duration of episodes.
What are antiviral medications?
One type of effective and specific treatment for genital herpes is antiviral medication, which is usually in tablet form. Antiviral medications help to stop the virus from multiplying on the surface of the skin, effectively reducing the length of time that the virus is on the skin during a herpes episode. The treatment only works while you are taking it and cannot prevent future outbreaks once you stop taking it.
There are currently 3 herpes antiviral medications available in Australia — aciclovir, famciclovir and valaciclovir.
What is episodic treatment?
Episodic treatment of genital herpes involves treating the disease when it occurs, that is, managing individual episodes of recurrent genital herpes on an ad hoc basis. Taking medication at the first signs of an episode will help to reduce the length and severity of symptoms. This type of treatment may be of benefit to some people, particularly those whose outbreaks are relatively infrequent.
What is suppressive treatment?
Suppressive (preventative) treatment involves taking medication on a daily basis to reduce the chance of a herpes outbreak. Continuous suppressive treatment is particularly useful for those who are experiencing frequent or troublesome episodes, because it significantly reduces both symptomatic and asymptomatic viral shedding and healing time.
Suppressive treatment does not guarantee that you will not get a herpes outbreak, but should reduce the severity and frequency of herpes outbreaks. Over time, your immune system tends to exert better control over the herpes virus so your doctor may suggest stopping treatment every 6 months to see whether you have any further outbreaks. Treatment can be re-started if you do have a recurrence.
If you have a high level of herpes-related anxiety, you may find that suppressive treatment allows you to be less focused on the herpes virus. This emotional break can provide you with time to adjust to living with this infection. You may also find professional support helpful.
If you know that stress triggers a recurrence and you are experiencing significant stress, or your outbreaks tend to occur during specific situations such as holidays, then a course of suppressive therapy may be appropriate on such occasions.
Herpes antiviral treatment and HIV
Many doctors use suppressive treatment for herpes in HIV-infected people because episodes of herpes can be more severe and frequent than in those with no HIV infection. The same is true for other situations where the immune system is suppressed, for example, following transplant surgery.
Lifestyle changes
Some people with herpes find that reducing stress can help minimise the number of herpes episodes.
Relieving minor episodes
The following measures may prove helpful in relieving minor herpes episodes.
- If urination is painful, try passing urine in the bath.
- Pour lukewarm water over the painful area when you are trying to urinate.
- Try lying in a bath containing 2 to 3 tablespoons of salt.
- Use a hairdryer set on low to dry the sores carefully after bathing.
- Wear cotton underwear (or none at all) with loose clothing on top.
- Try mild pain killers such as aspirin or paracetamol.
Find a doctor with whom you feel comfortable
While some doctors have a special interest in sexual health, others may not be familiar with, or comfortable discussing, these issues. Finding a doctor with whom you can openly and comfortably discuss these issues is important. There are doctors who specialise in this area: some are in private clinics, while others belong to sexual health services. There are also sexual health services in country areas.
All sexual health services are strictly confidential and practitioners understand the hardship you may be experiencing in getting access to treatment for herpes.
Last Reviewed: 25 March 2009
- 1. Therapeutic Guidelines (eTG). Genital herpes simplex virus infection. In: Antibiotic guidelines [updated 2009, Feb; accessed 2009, May 11]. Available from: http://www.tg.org.au/
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