How is Herpes Treated?

Young woman taking pill, portrait, close-up
Bruce Laurance/Photodisc/Getty Images

Question: How is Herpes Treated?

Answer:

Herpes can be treated, but not cured, with anti-viral medication. As such, herpes treatment is predominately used to reduce symptoms. To accomplish this, medication can either be given at the time of a symptomatic episode, or patients can take medication prophylactically to try and reduce the frequency of episodes. Taking herpes medication this way has been shown to reduce the risk of sexual transmission to a partner, and herpes prophylaxis is also referred to as suppressive therapy.

It is important to remember that herpes can be transmitted even in the absence of symptoms. That's why, although suppressive therapy can reduce the frequency of outbreaks, it is important to always practice safe sex - even for oral sex, since herpes can be transmitted from the mouth to the genitals and vice versa. You should use condoms for all sexual encounters, and your sexual partners should be counseled by a professional about their risk of infection.

The drug regimens below are taken from the Centers for Disease Control 2006 STD treatment guidelines. Remember that only your doctor can say which treatment is right for you.

Recommended Herpes Treatment Regimens for Adults Experiencing Their First Genital Herpes Outbreak

Acyclovir 400 mg orally three times a day for 7–10 days
OR
Acyclovir 200 mg orally five times a day for 7–10 days
OR
Famciclovir 250 mg orally three times a day for 7–10 days
OR
Valacyclovir 1 g orally twice a day for 7–10 days

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

Recommended Prophylactic Herpes Treatment Regimens for Adults With Recurrent Genital Herpes

Acyclovir400 mg orally twice a day
OR
Famciclovir 250 mg orally twice a day
OR
Valacyclovir 500 mg orally once a day
OR
Valacyclovir 1.0 g orally once a day

Recommended Herpes Treatment Regimens for Treating Episodes of Recurrent Genital Herpes in Adults

Acyclovir 400 mg orally three times a day for 5 days
OR
Acyclovir 800 mg orally twice a day for 5 days
OR
Acyclovir> 800 mg orally three times a day for 2 days
OR
Famciclovir 125 mg orally twice daily for 5 days
OR
Famciclovir 1000 mg orally twice daily for 1 day
OR
Valacyclovir 500 mg orally twice a day for 3 days
OR
Valacyclovir 1.0 g orally once a day for 5 days

There is no good data about treatment of herpes during pregnancy. However, since active outbreaks are associated with neonatal herpes infection, you should talk to your doctor if you are pregnant and have been exposed to the virus. In general, doctors are not particularly concerned about the effect of a chronic herpes infection on pregnancy.

The risk  of fetal and/or infant complications is mostly for women who become infected for the first time during a pregnancy.

Sources:

The Centers for Disease Control 2006 STD treatment guidelines

Delaney S, Gardella C, Saracino M, Magaret A, Wald A. Seroprevalence of herpes simplex virus type 1 and 2 among pregnant women, 1989-2010. JAMA. 2014 Aug 20;312(7):746-8. doi: 10.1001/jama.2014.4359.

James SH, Kimberlin DW. Neonatal herpes simplex virus infection: epidemiology and treatment. Clin Perinatol. 2015 Mar;42(1):47-59, viii. doi: 10.1016/j.clp.2014.10.005.

Continue Reading