At the time of this writing, no medical treatment has been proven effective in curing either oral or genital herpes. However, medical researchers are pursuing an effective treatment on many fronts, with mounting optimism. Recent research suggests that efforts to develop a herpes vaccine may yield positive results sometime in the future (Belshe et al., 2012). Current treatment strategies are designed to prevent outbreaks or to reduce discomfort and to speed healing during an outbreak.
Three separate antiviral drugs are often highly effective in the management of herpes. Oral acyclovir taken several times daily is a common drug treatment for genital herpes. Two other antiviral agents, valacyclovir (Valtrex) and famciclovir (Famvir), taken orally, have also proven effective for management of genital herpes (Workowski et al., 2010).
Two antiviral treatment strategies are used to manage recurrent genital herpes infections. In suppressive therapy medication is taken daily to prevent recurrent outbreaks. Suppressive therapy often prevents HSV reactivation and development of herpes lesions (Workowski et al., 2010). Suppressive therapy also reduces asymptomatic viral shedding between outbreaks and decreases the risk of sexual transmission of HSV infections (Workowski et al., 2010). Episodic treatment involves treating herpes outbreaks when they occur with an antiviral agent. Episodic treatment has been shown to reduce the duration and severity of lesion pain and the time needed for total healing (Worcester, 2010). However, episodic treatment does not reduce the risk for transmitting HSV to a sexual partner (Workowski et al., 2010).
A number of other measures can provide relief from the discomfort associated with herpes. The following suggestions can be helpful. Because the effectiveness of these measures varies from person to person, we encourage people to experiment to find an approach that best meets their needs.
1. Keeping herpes blisters clean and dry will lessen the possibility of secondary infections, significantly shorten the period of viral shedding, and reduce the total time of lesion healing. Washing the area with warm water and soap two to three times daily is adequate for cleaning. After bathing, dry the area thoroughly by patting it gently with a soft cotton towel or by blowing it with a hair dryer set on cool. Because the moisture that occurs naturally in the genital area can slow the healing process, sprinkling the dried area liberally with cornstarch or baby powder can help. It is desirable to wear loose cotton clothing that does not trap moisture (cotton underwear absorbs moisture, but nylon traps it).
2. Two aspirin every 3 to 4 hours might help to reduce the pain and itching. Application of a local anesthetic, such as lidocaine jelly, can also help to reduce soreness. Ice packs applied directly to the lesions can also provide temporary relief (but avoid wetting the lesions as the ice melts). Keeping the area liberally powdered can also alleviate itching.
3. Some people have an intense burning sensation when they urinate if the urine comes into contact with herpes lesions. This discomfort can be reduced by pouring water over the genitals while voiding or by urinating in a bathtub filled with water.
It might help to dilute the acid in the urine by drinking lots of fluids (but avoid liquids that make the urine more acidic, such as cranberry juice).
4. Because stress has been implicated as a triggering event in recurrent herpes, it is a good idea to try to reduce this negative influence. A variety of approaches may help reduce stress. These include relaxation techniques, yoga or meditation, and counseling about ways to cope with daily pressures.
5. If you are prone to repeated relapses of herpes, try recording events that occur immediately before an outbreak (either after the fact or as part of an ongoing journal). You may be able to recognize common precipitating events, such as fatigue, stress, or excessive sunlight, which you can then avoid in the future.