Reflections

Treatments for Herpes Simplex

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This page covers several basic topics regarding treatments for HSV: (a) the antiviral brands, (b) how the antivirals work, (c) the types of antiviral therapies and dosages, and (d) alternative remedies. Most of this information can be found in more detailed form on ASHA’s Herpes Treatments page.

As always, please consult with your healthcare giver regarding any medication for the treatment of any medical condition. The information on this page is not intended to substitute for your medical provider’s advice.


What are the antiviral medicines approved for the treatment of HSV? There are three antiviral brands approved by the FDA for the treatment of herpes simplex. It’s worth noting that our individual responses to each of the antivirals will likely vary, as our systems differ.

Acyclovir was the first of the three antivirals to be developed. It has been shown to be highly effective in the treatment of HSV symptoms. For those without insurance, it can be purchased with a doctor’s prescription from a discount pharmacy, such as Walmart or Walgreens, for under $10.

Valacyclovir/Valtrex features acyclovir as its active ingredient. It is a more bioavailable form than acyclovir, in that it delivers the drug to the system more efficiently, and therefore does not need to be taken as often as acyclovir.

Famciclovir/Famvir features penciclovir as its active ingredient. Like valacyclovir, it does not need to be taken as often as acyclovir

How do the antivirals work?
After HSV enters the body, it establishes latency (sets up house) in one of the ganglia (nerve bundles) either at the base of the neck (oral herpes) or below the neck (genital herpes), where it generally goes into dormancy (sleep) for a period of time. When it activates (wakes up), it travels up one of several nerve pathways (cells) from the ganglion to the surface of the skin, where it can replicate, which causes an outbreak in the form of a herpes blister or lesion. The antivirals work by trying to prevent the virus’ replication, and prevent a herpes outbreak. On interesting thing to note is that taking the antivirals right after the virus is first contracted by the patient  can affect IgG test results. Terri Warren, the community’s best clinician and a top investigator of the virus, suggests waiting to take antivirals until after the IgG test has been administered following the primary episode.

How much and how often do I take the antivirals?
There are two types of antiviral therapy:

Episodic Therapy treats the virus only when it causes symptoms, which can be (a) as mild as prodrome (signals that the virus is active, including itching, burning, tingling, redness, rash, flu- or cold-like symptoms, nerve pain, etc.) or as severe as a full outbreak. The dosage can vary from 400-500 mg a day to up to 2400 mg a day, and is often prescribed for 5 days or more. It’s usually best to take the antiviral at the first sign of symptoms and to continue until the symptoms have completely gone.

Suppressive Therapy is a daily dose of an antiviral, prescribed to prevent the virus from shedding (emerging onto the surface of the skin) and transmitting to others. Suppressive therapy has been found in clinical trials to reduce the rate of both shedding and transmission by about 50% overall. It has also been found to reduce full outbreaks by up to 75%.

What can I do if I don’t want to take the antivirals?

Over the counter (OTC) and herbal supplements including L-lysine, are numerous and readily available, at both online and actual stores, but it’s important to note that none of them are medically approved, nor proven by scientific research, to have a guaranteed effect on HSV. However, many HSV folks have had success with various remedies to treat their symptoms. The most important cautionary note to remember is that none of these remedies have been proven to reduce either shedding or transmission of the virus.One final thing to note is that there are many, many internet merchants out there who are looking to separate us from our hard earned money. Please exercise caution regarding any remedy other than the three medically-approved HSV antivirals.

Triggers of symptoms and outbreaks vary from person to person. Unfortunately, the only trigger that has been scientifically identified as causing the virus to activate is ultraviolet light, usually from sunlight, which can cause oral herpes outbreaks. Other triggers have only been anecdotally identified by individuals in the HSV community. It’s certainly worth it to monitor one’s diet and activities to see whether a pattern develops regarding triggers.

Healthy lifestyle management is probably the best thing for all HSV+ folks to engage in. This includes reducing stress levels, getting enough rest and exercise and adopting a healthy nutrition regimen.


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