Herpes treatment: practical options and what really helps

Getting a herpes diagnosis can feel overwhelming, but treatment is straightforward for most people. The main goal is to shorten outbreaks, ease pain, and lower the chance of passing the virus to others. Below I cover the common medicines, simple self-care steps, and when you should contact a clinician.

Antiviral medicines you’ll hear about

The backbone of treatment is antiviral drugs. The ones doctors prescribe most are acyclovir, valacyclovir, and famciclovir. They work best when started early—ideally within 24–48 hours of symptoms appearing.

Common approaches: for a first genital outbreak, many clinicians use valacyclovir 1 g twice daily for 7–10 days. For repeat episodes, short courses like valacyclovir 500 mg twice daily for 3 days or 1 g once daily for 5 days are widely used. Acyclovir can be given as 400 mg three times daily for 5–10 days or 200 mg five times daily for 5 days, depending on the situation. For people with frequent recurrences, daily suppressive therapy (for example, valacyclovir 500 mg once daily or acyclovir 400 mg twice daily) cuts outbreaks and transmission risk significantly.

Side effects are usually mild—headache, nausea, or stomach upset. People with kidney problems need dose adjustments, so tell your provider about other health issues and medicines.

Self-care, pain relief, and prevention

Topical creams can comfort, but they don’t replace oral antivirals. For pain, simple steps help: over-the-counter painkillers, cool wet compresses, and loose clothing. Keep lesions clean and dry to avoid bacterial infection.

Avoid sex from first symptoms until lesions are fully healed. Condoms lower transmission but don’t eliminate risk, because herpes can shed from areas not covered. For couples where one partner is infected, daily suppressive antivirals plus condoms makes transmission much less likely.

Pregnancy needs special attention. If you’re pregnant or planning pregnancy, tell your provider—management changes to protect the baby. Many pregnant people are given suppression in late pregnancy to reduce the chance of needing a C-section for active lesions at delivery.

People with weakened immune systems can have severe or prolonged outbreaks. If antivirals don’t work or symptoms worsen, a specialist may use alternative treatments—this sometimes includes IV antivirals like foscarnet for resistant virus strains.

Testing, honest partner talks, and regular care matter. If you’re unsure about symptoms, start treatment quickly or call your clinic—early action makes the biggest difference. Want help finding reliable info on a specific drug or dose? Ask your clinician or pharmacist, and keep a list of your meds handy.