Australian Herpes Management Forum
Genital herpes treatments
There are effective treatments for genital herpes. They can be used to:
- Reduce the length and severity of herpes outbreaks
- Prevent outbreaks of herpes from occurring
- Minimise the risk of transmitting herpes to partners.
In Australia, these treatments are readily available from pharmacies either over the counter or on prescription from a GP. Most of these medications are listed on the Pharmaceutical Benefits Scheme and are affordable for most people.
There are many methods of treating herpes, and herpes affects everyone in a different way—which changes as time passes. This means it can be confusing to make decisions about which is the best treatment for a person at any given time. If you are considering starting or changing treatment for genital herpes, you should discuss it with your GP or sexual health professional. This will help you decide which treatment—if any—is right for you.
Topical treatments: paints and creams
You can treat mild or infrequent outbreaks of herpes with lotions or ointments applied directly to the sores or rash. These treatments are inexpensive, help the sores clear up quicker, and may prevent them becoming infected by bacteria.
Povidone-iodine
Available as a paint, ointment or “swab-sticks”, povidone-iodine is a disinfectant which can help herpes sores dry out and form crusts. It also has a role in preventing the sores from becoming infected by bacteria. In Australia, it’s available from pharmacies as Betadine. Apply a small amount directly to blisters or sores.
Aciclovir cream
Aciclovir cream is advertised in Australia for treating cold sores, but
it’s also an effective treatment for genital herpes. It’s available “over
the counter” (without a prescription from a doctor) from pharmacies in
Australia under many names including Zovirax, Acihexal,
Acivir and Lovir. If it’s applied in the first day or two
after signs of herpes appear, it can reduce the number of days before the
pain disappears and the sores heal.
Aciclovir cream works best if applied five times per day. It should not be
applied to the sensitive membrane inside the vagina or anus as it can cause
irritation.
Antiviral medications: valaciclovir, famciclovir and aciclovir
The antiviral drugs famciclovir (Famvir), valaciclovir (Valtrex) and aciclovir act directly against the herpes simplex virus to prevent it from multiplying. These antiviral drugs can’t completely remove the virus from the body, but they control the herpes virus by stopping it from multiplying. They work extremely well to relieve outbreaks or even prevent them altogether. There is conclusive scientific evidence that antiviral medications are the most effective treatments for genital herpes.
All three medications are taken as tablets, which must be prescribed by a doctor. The Australian Pharmaceutical Benefits Scheme limits the cost of these medications to Australians with genital herpes, so that anyone who needs them for treating genital herpes can afford to take them as required.
The antiviral medications are very safe. The main side effects are headache and nausea. These are more common with very high doses or in people with medical problems such as reduced kidney function or a weak immune system.
Episodic and suppressive treatments
The medications can be taken in different ways, according to how frequent and severe the herpes symptoms are, and the preference of the person taking the medication. The main ways of taking antiviral medications are:
- Episodic: Treating the symptoms of herpes after an outbreak of herpes has commenced
- Suppressive: Taking antiviral medication every day—even when there are no symptoms—to prevent outbreaks of herpes from occurring
- Preventing transmission: Taking antiviral medication every day to prevent passing the herpes virus to sexual partners.
The following table explains some of the differences between the various ways of taking antiviral drugs. Please be aware that this is general background information only. It will help you and your doctor make the best decision about how to manage your unique situation.
| What does it do? | Who is it best for? | How to take the medication | Disadvantages | |
|---|---|---|---|---|
| Symptomatic |
Reduces the pain and duration of herpes outbreaks |
People who experience occasional, troublesome outbreaks of herpes and do not want to take medication in between outbreaks when they are feeling well. |
Should be started within 72 hours of the start of the outbreak.
|
Must be taken within 72 hours of the earliest symptoms, or it may not work so well. Outbreaks of herpes may still occur. It is still possible to transmit herpes to partners even when no symptoms are present. |
| Suppressive |
Can eliminate all outbreaks of herpes for some people. |
People with frequent and/or severe outbreaks of herpes, especially when interfering with lifestyle/work/sexual relationships. People with immune system disorders (for example HIV) |
Usually taken for several months.
|
Doesn’t affect the course of the illness. When stopping the medication, outbreaks may re-occur. Side effects such as headache and nausea (uncommon). |
| Preventing Transmission |
Significantly reduces the amount of herpes virus being shed from the skin—leading to a much lower risk of transmitting herpes to partners |
Couples where one partner has herpes and the other does not. This should be confirmed with a blood test, as sometimes people are not aware that they already have herpes. Recommended where one of the partners is a pregnant woman who has never been infected by the herpes virus. If her partner has herpes and takes antiviral medication, this risk of the woman contracting herpes and passing it on to the unborn baby is much lower. |
Valaciclovir once daily |
The person with herpes must continue taking medication daily even if there have been no outbreaks of genital herpes. As soon as medication is discontinued, the risk of passing on herpes returns. Potentially this means that the person with herpes must continue taking medication for a very long time. As the Pharmaceutical Benefits Scheme only subsidises antiviral treatment for people with “moderate to severe” genital herpes, the cost of treatment may be expensive. |
Complementary therapies
Some people have noticed that their herpes symptoms seem to improve when they take complementary or “alternative” therapies such as vitamins, herbs and dietary supplements. These treatments are not as effective as antiviral medications, and in most cases their benefits have not been conclusively proven in controlled scientific trials. However, they are popular forms of treatment.
If you are considering alternative treatments, please remember these important points:
- Some herbal and “natural” treatments contain chemicals that—like prescription drugs—can have side effects or cause dangerous interactions with other treatments or drugs. Please discuss with your doctor any alternative medications you are taking.
- Alternative medicines may be marketed in Australia without scientific evidence to support claims about how well they work. Just because an alternative medicine is available to buy, it doesn’t mean it will be effective for you.
Some of the more common alternative medicines and their reported benefits are listed below.
| Possible benefits | Scientific evidence | |
|---|---|---|
| Echinacea |
Antiseptic action against the herpes virus has been observed in laboratory tests. |
There is no firm scientific evidence that shows this medicine improves herpes outbreaks in patients. |
| L-lysine |
May reduce the frequency of herpes outbreaks or the time it takes them to heal |
Not all of the controlled studies have confirmed the benefit of l‑lysine. In studies where l-lysine has worked well, the most effective dose and frequency have not been established. |
| Zinc |
If directly applied to herpes sores, zinc may help lesions to heal faster. However, when applied to inflamed tissue, zinc may cause stinging or burning. |
There is no firm scientific evidence that oral zinc supplements have a beneficial effect. |
| Bee products and honey |
When applied directly to the sores, bee products such as honey or propolis may reduce the healing time. |
Controlled studies have shown promising results. |
| Tea tree oil |
May work as an antiseptic if applied directly to herpes sores. Must be used with care as it can cause inflammation. |
No firm scientific evidence for or against |
More information
For more information about complementary and alternative therapies, we
recommend the following article:
Perfect M et al. Use of complementary and alternative medicine for
the treatment of genital herpes. Herpes, 2005. vol
12, no 2. 38-41. Available at
www.ihmf.org/journal/download/122Perfect(38)vol1238.pdf (accessed
September 2007)
Non-medical treatments
Many people with genital herpes choose not to use any medications and manage their symptoms with diet and lifestyle modifications. This strategy works best for people with fairly mild outbreaks, but people who are taking medications may find that they get extra benefit from using these techniques.
Treating painful outbreaks
Painful, raw herpes outbreaks can be very sensitive. Soaking in a lukewarm, salty bath can provide some relief while helping keep the affected area clean. Half a cup of household salt in a regular-sized bathtub makes the right concentration to provide relief.
Sometimes passing urine can be painful when you have herpes. Many women find that passing urine in a bath of warm water is helpful.
Dietary changes
The herpes virus needs the amino acid arginine to function, and the amino acid lysine seems to inhibit the activity of the virus. Some people have reported that a diet high in lysine and low in arginine helps them reduce the number of herpes outbreaks. These people eat more of the meats and dairy products high in lysine, and avoid the nuts which are high in arginine.
|
High lysine/low arginine foods |
High arginine/low lysine foods |
|
|---|---|---|
| Tuna | Cheese (Ricotta) | Almonds |
| Turkey | Cheese (Cheddar) | Cashews |
| Chicken | Sardines | Avocado |
| Salmon | Yoghurt | Peanuts |
| Pork | Whole milk | Egg |
The Australian Herpes Management Forum
The Australian Herpes Management Forum is a group of medical experts that provides resources and information about the herpes group of viruses and the conditions they cause. These include genital herpes, shingles, chickenpox, glandular fever and cold sores. If you are concerned about herpes or think that you may have come into contact with someone that has herpes, please see a doctor.
|
á Top of page |
http://www.ahmf.com.au/herpes/treatments.htm |
| Document Information |
Date: September 2007 |
| Where can I go for help? |
| To find a public sexual health clinic near you, see the Register of Public Sexual Health Clinics (published by the Australasian Chapter of Sexual Health Medicine) |
Australian Herpes Management Forum
c/- STIRC
Marian Villa, Westmead Hospital,
Westmead NSW 2145
Australia
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