How to Treat Herpes

Medically reviewed by Luba Lee, FNP-BC, MS

Last Updated: August 16, 2022 References Approved

Herpes is an outbreak of painful, itchy blisters caused by a viral infection. While there is no cure for herpes, antiviral medications can relieve symptoms and shorten an outbreak's duration. There are also steps you can take on your own to ease your discomfort. To reduce the risk of subsequent outbreaks, maintain a healthy diet, get 7 to 9 hours of sleep nightly, and try to keep your stress levels in check.

Part 1

Part 1 of 3:

Using Antiviral Medications

1
Get an accurate diagnosis from your doctor. Herpes blisters are small, red, and filled with a yellowish fluid. Small blisters can cluster together and grow into a larger blister. To rule out other causes, have your doctor examine the blisters and, if necessary, take a viral culture.^{[1]
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- Herpes virus type 1 usually causes blisters around the mouth, and herpes virus type 2 usually causes genital outbreaks. Blisters are often painful, burn, or itch. You may also experience moderately enlarged lymph nodes. You might feel tingling or pain in the affected area just before an outbreak.
- Fever, swollen glands, flu-like symptoms, and decreased appetite often occur, especially during the first outbreak.
- It's important that you doctor does a thorough examination, as there are other conditions that can cause similar bumps around your genitals, anus, or perianal area. These include syphilis, chancroid, carcinoma, trauma, or psoriasis.
2
Manage your first outbreak with a prescription antiviral. The first outbreak is usually more severe and lasts longer than subsequent outbreaks. Because of this, doctors typically prescribe an oral antiviral medication to manage an initial infection.^{[2]
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- Medications for oral and genital herpes include acyclovir (better known by the brand name Zovirax), valacyclovir (better known as Valtrex), and famciclovir (better known as Famvir).
- These don't cure herpes, but they help relieve symptoms and shorten the outbreak's duration. The treatment is most effective when it's begun within 1 day of the outbreak onset.
- If the doctor prescribes an episodic treatment, the patient should be given the medication or a valid prescription for it so that they can administer it at the first sign of a new outbreak.
- Within 12 months of their first outbreak, about 90% of patients report at least one recurrence.
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3
Take your medication according to your doctor's instructions. Take your medication as prescribed, and don't stop taking it prematurely, even if your symptoms improve. Depending on which medication you're prescribed, you'll take 1 to 5 tablets per day with a glass of water for 7 to 10 days.^{[3]
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- Side effects don't usually occur, but can include fatigue, headache, nausea, and vomiting. Taking a tablet with food can help prevent an upset stomach.^{[4]
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4
Apply an antiviral cream if your doctor prescribes one. Your doctor might prescribe an antiviral ointment instead of or in addition to oral medication. Apply a prescription ointment as directed. To prevent spreading the outbreak, apply the ointment with a cotton swab, and wash your hands after tending to the affected area.^{[5]
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- Don't let the swab touch anything after it's come into contact with your skin. If you need to apply more ointment, get a new swab instead of adding more medicine to the used swab. Throw the swab away promptly after applying the ointment.
- Ointments are usually only recommended for oral herpes. If you experience oral and genital herpes, don't apply medication intended for oral herpes on your genitals.^{[6]
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5
Ask your doctor if they recommend medication for recurrent outbreaks. Most people experience multiple herpes outbreaks, which can occur weeks or months after the first outbreak. Subsequent outbreaks are usually mild, and many people don't seek medical treatment. However, you should ask your doctor about taking antiviral medication if painful, itchy blisters affect larger patches of skin or if you have a fever or flu-like symptoms.^{[7]
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- If your doctor prescribes an antiviral medication, take it as directed.
6
Take a daily medication if you experience frequent outbreaks. People who experience 6 or more outbreaks per year should take acyclovir, valacyclovir, or famciclovir every day. Depending on the type of medication prescribed, you'll take 1 to 2 tablets with a glass of water daily.^{[8]
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- Daily suppressive therapy can reduce the number of outbreaks by 70 to 80%.
- If you have a partner who doesn't have herpes, taking a daily medication can also reduce the risk of spreading it to them.
7
Try episodic therapy if you don't want to take medication daily. Episodic therapy involves taking an antiviral medication as soon as you feel tingling and burning, which are the first signs of an outbreak. For best results, you'll need to take the first dose within 24 hours of experiencing the warning signs of an outbreak. You'll then continue taking medication for 5 to 7 days.^{[9]
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- Episodic therapy might be your best option if you don't like taking pills, or if taking a daily suppressive medication isn't affordable.

Part 2

Part 2 of 3:

Easing Your Symptoms

1
Relieve itching and pain with an over-the-counter ointment. Look for a medicated ointment that contains lidocaine, benzocaine, or L-lysine at your local pharmacy. These products can relieve pain, itching, and burning, and might reduce an outbreak's duration. Read your product's instructions carefully, and use it as directed.^{[10]
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- To ease symptoms on/in mouth: gargle (do not swallow) hydrogen peroxide (caution it can stain clothes), make sure to allow it to spread over the bumps on lips as well for roughly 30 seconds. Rinse with water, dry off, and add Neosporin to lips (like chapstick).
- Don't apply ointment to genital herpes sores without consulting your doctor. Herpes outbreaks can affect sensitive mucous membranes in and around the genitals. Applying medicated ointments to these areas without your doctor's approval can be harmful.^{[11]
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2
Take an over-the-counter pain reliever. Ibuprofen or acetaminophen can help relieve pain, swelling, and discomfort caused by a herpes outbreak. Take any over-the-counter medication according to the label's instructions.^{[12]
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- Avoid drinking alcohol while taking acetaminophen. In combination, alcohol and acetaminophen can cause liver damage.
3
Apply a cold or warm compress to ease pain. Try applying warm and cold compresses to the affected area, and see which is better at relieving your symptoms. Wrap ice or an ice pack in a cloth, and hold it to the area for 20 minutes. To apply heat for 20 minutes, microwave a damp cloth for 30 seconds or purchase a warm compress at your local pharmacy.^{[13]
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- Use a hot or cold compress every 3 hours to relieve pain, itching, and swelling. If you experience burning, go for ice instead of heat.
- Promptly machine wash the cloth you used on a hot water cycle to prevent spreading the infection.
4
Wear loose cotton clothing during genital herpes outbreaks. Avoid wearing tight undergarments, pantyhose, and tight pants. Instead, wear loose-fitting garments to provide air exposure to the affected area and reduce irritation.^{[14]
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- Air can help speed healing. For this reason, you should also avoid bandaging the area.
- Cotton is more breathable than synthetic fibers, such as nylon or polyester.
5
Take an Epsom salt bath or soak the area in a salt solution. Soak the affected area for 10 to 20 minutes in a mixture of 2 teaspoons Epsom salt and 2 cups (470 mL) of warm water. If you prefer to take a bath, add 1 cup (240 mL) of Epsom salt to the tub.^{[15]
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- Epsom salt soaks can cleanse the area and soothe pain and itchiness.

Part 3

Part 3 of 3:

Preventing Future Outbreaks

1
Wash your hands after tending to the affected area. Apply prescription and over-the-counter ointments with cotton swabs, and avoid touching the area unless you're cleaning or caring for it. After tending to it, wash your hands thoroughly with antiseptic soap and hot water for at least 20 seconds.^{[16]
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- Never pick at or try to pop sores. You'll worsen itching and pain and risk spreading the infection.
- Practicing healthy hand hygiene is absolutely essential. It's easy to spread herpes to other people or other parts of your body during an outbreak.
2
Maintain a balanced, nutritious diet. Eat your daily recommended servings of vegetables, fruits, grains, proteins, and dairy products. To maximize your nutrient intake, include a variety of veggies in your diet, such as leafy greens, root veggies, and legumes. Fruits and lean sources of protein, such as poultry and fish, are also vital for your immune health.^{[17]
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- A healthy diet can help keep your immune system strong and reduce the risk of future outbreaks.
- Learn more about your specific daily recommended values at https://www.choosemyplate.gov.
3
Get 7 to 9 hours of sleep each night. Try to go to bed and wake up at the same times every day. Go to bed early enough that you can get enough sleep, and avoid drinking caffeine or eating heavy meals within 4 to 6 hours of bedtime.^{[18]
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- Proper rest will help keep your immune system strong.
4
Try to keep your stress levels in check. Stress can weaken the immune system and trigger outbreaks, so work on managing your stress levels. Take deep breaths and try to relax when responsibilities begin piling up or when you feel overwhelmed.^{[19]
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- Breathe in and out slowly when you're stressed, close your eyes, and imagine that you're in a relaxing, comfortable place. Control your breathing and visualize calming scenery for 1 to 2 minutes, or until you feel more relaxed.
- When you feel overwhelmed, break large problems up into smaller, actionable steps. Don't be afraid to turn down extra commitments if you have a lot of your plate.
- Talk to friends, relatives, or coworkers if you need help getting things done. For example, ask someone to help you with a project at work, or see if a friend can watch your kids while you run errands.
5
Wear sunblock to help prevent oral herpes outbreaks. Sunburns can trigger and aggravate oral herpes outbreaks. Whenever you go outside, wear an SPF 30 moisturizing lip balm and apply sunscreen around your mouth (or wherever you typically experience outbreaks).^{[20]
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- Keeping yours skin moisturized can also minimize irritation and reduce the risk of future outbreaks.

Warnings

Tell your doctor if you're pregnant or planning on becoming pregnant. Herpes must be managed aggressively in order to prevent spreading the infection to a newborn.^{[23]
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Herpes outbreaks in or around the eye are serious, so seek prompt medical attention if you have unusual blisters near your eyes.^{[24]
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