Like many other sexually transmitted diseases, herpes doesn't have a cure. However, researchers and physicians have come up with effective treatment regimens that keep the virus at bay and provide the infected individual with an improved quality of life.
The best treatment option for herpes is an antiviral medication. Acyclovir, Famcyclovir, and Valacyclovir are the three antiviral drugs approved by the FDA to be used in the USA. While all three drugs are extremely effective in treating herpes outbreaks and preventing the future onset of symptoms, Acyclovir is the most commonly used out of all three options. Other than antiviral medications, symptomatic treatment is also available for infected individuals.
While antiviral medications are certainly the best treatment option for herpes, not everyone with herpes needs these medications. Some people never experience any symptoms of herpes in their life, while others don't get outbreaks as frequently as some people.
BEST TREATMENT OPTIONS FOR HERPES
Since a virus causes herpes, it makes sense that antiviral medication is the best treatment option for herpes. Antiviral drugs work by eliminating the virus from the body as much as possible and, consequently, lowering the viral load.
Acyclovir and the other two antiviral drugs function by dismantling the virus. They do so by recognizing the surface proteins of the herpes simplex virus (HSV), the virus that causes herpes. While they are very effective in lowering the frequency and severity of the symptoms, they are, unfortunately, not a cure since they cannot eliminate the virus from the body.
Antiviral medications work equally well for both genital and oral herpes. Studies have shown that antiviral drugs reduce the symptomatic period of herpes by at least 3 to 4 days. They also prevent future outbreaks when taken regularly and reduce the risk of transferring the virus to an infected individual's sexual partners; granted that they take necessary precautions such as wearing a condom during sex and abstaining from sex when symptomatic.
Generally, all three antiviral medications are given orally in pill form. Their individual dosage and frequency (see more below) depend on a number of factors, such as the choice of drug, a person's immune health, other medications they may be taking, and any comorbid conditions they may have.
Rarely, oral medications may not provide relief during the symptomatic period. In that case, IV Acyclovir is employed to provide effective relief.
Other than the antiviral drugs, there is also effective symptomatic treatment available which is often employed in conjunction with the antiviral drugs. The supportive treatment consists of a combination of ibuprofen, paracetamol, cold sponging, and other instant-relief methods which provide relief from the provocative symptoms of herpes.
IS HERPES TREATMENT LIFELONG?
Since herpes cannot be cured, the general consensus is that the treatment for herpes is lifelong. However, with modern therapies available, two types of medical regimens are available to treat an infected individual. The choice between these two regimens depends on the disease pattern a person exhibits.
The intermittent treatment regimen for herpes involves a person taking antiviral drugs only when needed, i.e., only when they experience any symptoms of herpes. An infected individual is given certain doses of antiviral drugs to keep on hand. When they experience any flare-up or an outbreak, they are advised to take these drugs for 3 to 5 days.
Taking antiviral drugs during the blister outbreak of herpes can reduce the severity and the longevity of the symptomatic period. It also helps in decreasing future outbreaks for patients. Generally, this treatment regimen is reserved for people who do not exhibit symptoms frequently or those who don't want to or cannot take antiviral medications every day.
The suppressive treatment regimen is much more aggressive and involves an infected individual taking the antiviral drug every day for the rest of their life. This type of therapy is reserved for people who experience frequent herpes outbreaks, for example, up to five or six times per year.
The suppressive therapy is extremely effective in reducing the severity of the ongoing outbreak and all future outbreaks. In fact, taking daily antiviral medication can reduce the probability of future outbreaks happening by many folds. According to a study, taking daily antiviral medication can reduce the number of symptomatic outbursts by approximately 80%!
SHOULD I START PREVENTATIVE TREATMENT FOR HERPES?
The suppressive, daily treatment regimen is also called preventative treatment for herpes since it prevents the likelihood of future outbreaks while treating an ongoing symptomatic period.
The decision to start preventative therapy for herpes depends on several factors. These factors primarily include the severity and the frequency of symptomatic periods in an affected individual. Having comorbid conditions is also a major factor that affects whether or not to start preventative therapy.
The WHO recommends the following dosage for preventative medication:
- Acyclovir – 400 mg oral pill taken twice a day
- Famcyclovir – 250 mg oral pill also taken twice a day
- Valacyclovir – 500 mg oral pill taken once per day
While prevention is a major benefit of daily preventative treatment, there is also another benefit that intermittent therapy lacks: reduced risk of transmission of the virus through sexual contact. Since intermittent therapy only starts when symptoms appear, it does not allow a person to enjoy their sexual freedom throughout the symptomatic period.
However, on the other hand, the daily preventative medication reduces the risk of transmission through sexual contact by minimizing the possibility of future outbreaks ever happening. Therefore, patients who take daily antiviral medication for herpes enjoy a much better sex life with their partners than those who take intermittent therapy.
Your doctor may stop the treatment once a year to see if you still require the preventative regimen. If you are currently on intermittent therapy but your symptoms have gotten worse in both severity and frequency, talk to your doctor about the possibility of starting daily preventative medication.
WHEN IS THE BEST TIME TO START TREATMENT FOR HERPES?
The best time to start treatment for herpes depends, again, on the symptomatic pattern. Generally, an initial treatment starts when a person first gets the infection. Ideally, this treatment should be started within the first three days of getting the infection or with the onset of symptoms. The treatment for the initial outbreak lasts for 7 to 10 days.
The recommended dosage for the initial outbreak, as recommended by WHO, is as follows:
- Acyclovir – 200 mg oral tablets given five times per day / 400mg oral tablets given a day thrice
- Famcyclovir – 250 mg oral tablets given three times a day
- Valacyclovir – 500 mg oral tablets given twice a day
Later outbreaks are also treated with the same medications, but their dosage differs. Here is what the WHO recommends:
- Acyclovir – 400 mg thrice a day / 800 mg twice a day for five days OR 800 mg thrice a day for two days
- Famcyclovir – 250 mg twice a day for five days
- Valacyclovir – 500 mg twice a day for three days
However, it is important to remember that starting antiviral medication on your own is never recommended. Whether you are on intermittent therapy or the daily preventative regimen, it is best to consult your doctor before starting your treatment.
IS HERPES TREATMENT SAFE?
Since these medications only affect the cells that the virus has infected, they are generally considered very safe for the patient. They seldom exhibit any unwanted symptoms and are typically tolerated well by people of all ages. However, people with kidney conditions may need to take a lower dose since these drugs are primarily eliminated from the kidney.