Treatment For Genital Herpes
Genital herpes is a sexually transmitted infection (STI) and can be passed on through anal, vaginal, and oral sex with an infected person. You can get antiviral medication, such as aciclovir, to reduce the length of your outbreak and relieve symptoms. This can come in the form of a tablet you take by mouth or cream applied to your genitals. You can also do things at home to treat symptoms and prevent the spread of genital herpes.
The first time you get symptoms of genital herpes is known as your first outbreak. You can have more than one outbreak but this is different for every person. The length of your outbreak can be shortened with the help of genital herpes treatment called antiviral medications. These cannot cure herpes but can make symptoms go away sooner and relieve pain and itching.
Aciclovir is the recommended treatment if you have genital herpes. As it is an antiviral medication, it stops the virus from multiplying which means it cannot spread further. This gives your immune system time to fight the virus.
The usual dose is 1 aciclovir 400mg tablet, 3 times daily, for 5 days. You should try to wait 8 hours between your doses and take it whole, with a glass of water. You can take the tablet with or without food. You can use aciclovir as a suppressive treatment by taking one 400mg tablet, twice a day, for up to a year.
Valaciclovir is a prodrug, which means it turns into another medication once inside your body. Valaciclovir becomes aciclovir once your body breaks it down, which means it works in the same way. For your first outbreak, the usual dose is one 500mg tablet, twice daily, for 5 to 10 days depending on your symptoms.
If you have another outbreak, you will still take 2 tablets a day, but this will be prescribed for 3 to 5 days depending on your symptoms. Your doctor may recommend this treatment to suppress the virus if you have frequent outbreaks. This involves taking one tablet every day for 6 to 12 months.
Famciclovir is an alternative antiviral medication if aciclovir or valaciclovir is not suitable for you or does not work. Famciclovir is also a prodrug, which means it changes into penciclovir once inside your body. This medication works to stop the virus from reproducing in your body, allowing your immune system to fight the virus.
The usual dose for genital herpes is one 250mg tablet, 3 times a day, for 5 days. If you get a further outbreak, this is usually treated by taking 1,000mg of famciclovir, twice a day, for 1 day. This should be taken within 6 hours of noticing your first genital herpes symptom. You can also take famciclovir as a suppressive treatment to prevent outbreaks by taking 250mg twice a day, for up to a year.
Genital herpes symptoms can be relieved with lidocaine 5% ointment, which is a local anaesthetic. This can numb the affected area which can relieve symptoms such as pain and itching. The cream can also soothe sore skin.
It can be applied directly to the affected area of your genitals and lasts for several hours. It works by stopping the nervous system from sending signals to your brain.
Over the counter medication
Antiviral medications including tablets and creams require a prescription. This is because a doctor needs to make sure that the treatment is suitable for you, that you get the right dose for your symptoms, and that you have been diagnosed with genital herpes. This means you cannot get medication to treat genital herpes over the counter.
You can get lidocaine 5% ointment over the counter, which can help numb the affected area. You can use over the counter painkillers like paracetamol and ibuprofen to help with genital herpes symptoms.
Home remedies for treating genital herpes
There are some things you can do at home to relieve symptoms and reduce the discomfort of genital herpes sores and blisters. This includes:
- keeping the affected area clean using salt or plain water, as this can stop your genital herpes blisters from becoming infected
- applying an ice pack to the affected area wrapped in a flannel to soothe burning and itching
- applying lidocaine 5% cream to numb the area
- applying petroleum jelly such as Vaseline to reduce pain when peeing
- washing your hands before and after touching your genitals when applying creams or cleaning
- peeing while pouring water over your genitals to reduce pain
- avoiding tight clothing as this can irritate your skin further
- avoiding sex until the sores have gone away
- taking over the counter painkillers regularly, such as paracetamol and ibuprofen
Herpes treatment in pregnancy
Many women with genital herpes before pregnancy can expect to have a normal vaginal delivery and a healthy baby. If you get genital herpes and are pregnant, there is a risk your baby could get a rare illness called neonatal herpes. Your baby can be given antiviral treatment if this happens.
The risk of your baby getting neonatal herpes is low if you have already had a genital herpes outbreak before. This risk is increased if this is your first outbreak. You should speak to your doctor or midwife straight away if you have or get genital herpes and are pregnant. You can take antiviral medications such as aciclovir or valaciclovir which can:
- treat a genital herpes outbreak during pregnancy
- be taken from the diagnosis of genital herpes until the birth of your baby, if you get herpes after 28 weeks into your pregnancy
- be taken from 36 weeks of pregnancy as a suppressive treatment, to reduce the chance of a genital herpes outbreak during birth
You can still have a vaginal delivery but you may be offered a caesarean depending on your circumstances.
Genital herpes symptoms
The most common genital herpes symptom is a genital herpes rash. This can cause small blisters on your genitals or anus that burst and leave open, red sores. These will eventually scab over and go away. You may also get tingling, burning, pain, or itching around your genitals. This can be worse when peeing.
Your first outbreak can last around 7 to 14 days, but further outbreaks should not last longer than a week. Antiviral medications can be used to treat the genital herpes rash, relieving symptoms and reducing the time of your outbreak. Other treatments that can help with symptoms include numbing creams, like lidocaine 5% ointment, and over the counter painkillers.
Is there a cure for herpes?
There is currently no cure for herpes, as the virus can stay within your body and cause outbreaks. Treatment is still important, as it can reduce the time of your outbreaks and reduce the number of outbreaks you have. Even though you cannot cure herpes, you will not always have symptoms. You may only get a few outbreaks after your initial outbreak and some people never get another outbreak.
There is ongoing research being carried out into a cure for herpes. This includes a herpes vaccine which is going through clinical trials, but this process can take many years and does not mean it will be successful.
Why does herpes come back?
Once you get the herpes virus, it can stay in your body and cause outbreaks. Some people can have herpes for years before they know they have it, as an outbreak does not always happen straight away. The herpes simplex virus (HSV) lays dormant in your body and can hide from your immune system, so it cannot fight it.
When you get herpes, it will only cause blisters in the same place. This means if you have genital herpes you will not get a cold sore. You can have recurrent outbreaks which means you get symptoms again. This might happen once every few years or more often. You can get suppressive treatment if you keep getting outbreaks, which can stop the number of outbreaks you get and the length of your outbreaks.
Genital herpes triggers
Herpes often comes back because of a trigger. This is something that causes an outbreak and can be different for every person. Some common genital herpes triggers include:
- friction in your genitals, such as from sex or tight clothing
- ultraviolet light from sunbeds or sunbathing
- drinking alcohol
- being unwell
- having a weakened immune system, such as during chemotherapy
- being on your period
- having surgery on your genitals
If possible you should avoid your triggers to prevent genital herpes outbreaks.
Is herpes dangerous?
Herpes is not usually dangerous and does not cause other serious health problems. It can be more serious if you also have HIV, so you may need special treatment from a genitourinary medicine (GUM) specialist. It can also be more serious during pregnancy, but you can take antiviral medications to reduce the risk for your baby.
Do I have to treat herpes?
Herpes can go away on its own but this can take longer. The best way to relieve symptoms and shorten the length of your outbreak is by using antiviral medications.
Oral herpes treatment
Oral herpes, commonly referred to as a cold sore, is not classed as an STI. Oral herpes is also caused by the herpes simplex virus (HSV). There are 2 strains of this virus, which are HSV-1 and HSV-2. HSV-1 is the main cause of oral herpes, but it can sometimes cause genital herpes. HSV-2 is the main cause of genital herpes.
Treatment for oral herpes is similar to genital herpes, such as antiviral tablets and creams. There are more creams available for oral herpes, such as aciclovir and penciclovir. You can also use topical anaesthetics on cold sores to reduce pain and inflammation.
What causes genital herpes?
Genital herpes is caused by the herpes simplex virus. It is commonly caused by the HSV-2 strain of the virus and can be passed on through vaginal, oral, and anal sex. It can be passed on through other forms of sexual contact with an infected person, such as through unwashed sex toys or on your hands if you touch the infected area and your own genitals. Outbreaks can be triggered by several things, such as being unwell or stressed.
Protecting against genital herpes
You can reduce the chances of catching genital herpes or passing it to someone else by:
- using a condom every time you have sex anally, vaginally, or orally and making sure the condom covers the infected area
- not sharing sex toys
- avoiding sex if you or a sexual partner has genital herpes symptoms
- taking regular STI tests
Dr Babak Ashrafi Clinical Lead for Service Expansion
Babak studied medicine at King’s College London and graduated in 2003, having also gained a bachelor’s degree in Physiology during his time there. He completed his general practice (GP) training in East London, where he worked for a number of years as a partner at a large inner-city GP practice. He completed the Royal College of GPs membership exam in 2007.Meet our doctors
Last reviewed: 26 Jul 2022