Can You Cure Herpes?

Unfortunately, herpes has no cure as the virus invades your immune system – once you are infected with the virus, you have it for life. This is the same for whether you have oral or genital herpes.

An infection doesn't mean symptoms are guaranteed – most oral or genital infections don’t cause any symptoms. It’s very common for people to have come into contact with the virus at some point in their lives and carry the virus without ever having any symptoms. The virus lays dormant in your body after your initial infection and can reactivate several times a year or even months or years later. The time in which the virus reactivates varies from person to person. People do not spontaneously cure themselves of herpes.

Not everyone who has been infected with herpes goes on to show symptoms, or have outbreaks. The severity of outbreaks also varies from person to person and is hard to predict.

No, herpes isn't always 'active' – a herpes infection always lies between a dormant phase, where it hibernates silently in your nerve cells and an ‘activating’ phase. When the virus is active it is called an outbreak, which causes noticeable symptoms. An outbreak will depend on how the virus is activated in your body.

How often will I get symptoms? – This varies from person to person. Some people get several outbreaks in a year and some have no outbreaks until many years after they are first infected. It is important to see your doctor if you have any herpes symptoms.

When would you be infectious to others? – oral or genital herpes is most contagious during an outbreak. In between an outbreak, the virus is mostly dormant. During this phase ‘viral shedding’ can happen. This stage is when the virus becomes active on your skin and is contagious. It may or may not cause you any symptoms. If viral shedding causes no symptoms, you can pass it to unknowing partners. You are not always infectious if you have herpes, but the virus is occasionally shed from your skin when there are no symptoms present. There is a risk of passing the infection on at any time you have it, but most of the time when you do not have an outbreak, you are not infectious.

If herpes medication doesn’t cure you, what does it do? – antivirals are important in helping you to manage your herpes outbreaks. Although they don’t cure herpes, they can reduce the time that an outbreak lasts for, and make it less severe. Antivirals work to stop the virus from multiplying by blocking the enzyme that it uses to copy itself and spread to other cells.

What does herpes medication involve? – antivirals can be used to treat an acute herpes infection and also as a suppression treatment to prevent future outbreaks. They are taken as tablets swallowed with water.

Can medication stop you from developing symptoms? – yes. If you suffer six or more outbreaks a year, then you may wish to consider suppression therapy to prevent future herpes outbreaks. There are also some possible triggers, which you can avoid to help control your herpes.

What medications are used for symptom-suppression treatment? – The most common antivirals used are called aciclovir, valaciclovir, and famciclovir.

Yes, there is ongoing research that aims to find a cure for herpes – a cure may be available in the future, but this remains uncertain. Current research includes:

• Genetic engineering
• Vaccines

Genetic engineering – research into a genetic technique called gene-editing has shown some promise. It aims to deactivate the virus by affecting its DNA, which is essential for its survival. Results are currently inconclusive.

There is also ongoing research into some vaccines – these teach the body to reject the virus. Examples are TheraVaxHSV-2 and GEN-003, which aim to treat genital herpes. Both have shown promising initial results for both strains of the virus, with GEN-003 being further along in its stage of clinical trial testing. Results are currently inconclusive, but the vaccines are still undergoing further clinical trials.

Management with treatment:

• You may need to consider suppression treatment if you experience many outbreaks in a year
• You can buy antiviral creams for cold sores from a pharmacy, but should see your doctor if the sore lasts more than 5-7 days
• For genital herpes treatment, your doctor may refer you to a sexual health clinic
• Treatment of an acute short-term infection is simple and involves taking a course of antiviral tablets. There are different types of antiviral tablets which can be used. Some courses are higher strength and only need to be taken for 1 to 2 days, and some are taken for 5 days. You may need longer treatment if new symptoms develop during treatment or of your treatment doesn’t completely heal your symptoms. You should speak to your doctor if this happens

Managing oral herpes (cold sores):

• avoid direct physical contact with people
• avoid sharing items that can pass the virus on such as cups, cutlery, make up or lip balm. You can still use communal facilities such as showers, toilets or swimming pools.
• don’t participate in oral sex or kissing
• wash your hands with soap and water thoroughly after applying antiviral cream or after touching the sore – avoid touching the sore unless you need to apply treatment

Managing genital herpes – don't have sex during an outbreak of genital herpes or during the initial signs of an outbreak (when you start getting symptoms of genital herpes). The following preventative steps will reduce the risk of passing it to partners:

• Use a condom if you have been diagnosed with herpes but have no symptoms – the virus can still be passed on from direct skin contact to your partner despite the use of a condom
• Do not allow anyone to come into direct contact with your sores or blisters
• If you use sex toys, wash them thoroughly and put a condom on them

Telling a partner about herpes:

• Many people do not understand what herpes is and how common it is. Honesty between partners is very important so you can discuss these issues openly. Many people will support and appreciate honesty
• What you say will depend on your personal style. There are good or bad times to bring up the topic. Talking about it just before sex is not a good idea
• If it appears you will have sex on the first date then it would good to bring it up during your date. Otherwise you may consider it best to allow some time for trust and comfort to develop between the both of you before deciding to talk about it
• Try to pick a comfortable time when you are feeling good about yourself and have a positive attitude. This will allow time for you both to discuss it openly

Lifestyle changes – you can adopt some lifestyle changes to help reduce the chance of outbreaks, but certain triggers in daily life are unavoidable. Some of the possible triggers are as follows:

• Stress – this is a common trigger and can be in the form of both emotional stress or physical (such as surgery). Excess stress weakens your immune system and can trigger both oral or genital herpes
• Weak immune system – you are more at risk of outbreaks if you have a weakened immune system. People with HIV infection, cancer or diabetes are at more risk
• Sex – genital friction during sex can trigger an outbreak. Ensure you use adequate lubrication during sex if this affects you
• Fever – this puts your body under physical stress. Oral herpes is more likely with fever and it can cause ‘fever blisters’ around your mouth
• Tight clothing – avoid tight clothing as this can cause genital irritation that may trigger an outbreak
• Hormones – some women report may have more frequent outbreaks before or after their periods due to fluctuations in hormone levels
• Sunlight or the use of sunbeds – it is not known how sunlight triggers an outbreak but if you are susceptible then use adequate sunscreen when exposed to sunlight. This mainly affects oral herpes
• Avoiding triggers – if you notice a pattern of trigger factors, then try to adjust your lifestyle or reduce your exposure to them

Diet – an excess intake of the amino acid arginine can trigger an outbreak. Avoid foods high in arginine, such as almonds or chocolate. Also, a diet rich in the amino acid lysine has been shown to help stop the herpes virus from multiplying and prevent outbreaks. Examples of lysine rich foods that can be effective include:

• Dairy – particularly yogurt and cheese
• Meats and fish – particularly high protein meats such as chicken and beef
• Fruits – particularly apples, apricots or pears
• Vegetables – particularly beans and cruciferous vegetables such as broccoli

Emotional impact:

• Oral herpes (cold sores) can be uncomfortable and cause social embarrassment and genital herpes can also have an important impact on your quality of life and relationships
• With some time, most people adjust well to living with herpes. You may initially feel embarrassment, anger or fear, but it is important to give yourself time to adjust
• Speak to your doctor if you feel you very worried, anxious or depressed about your diagnosis. They may recommend you counselling or further support