Genital herpes - Treating genital herpes

Treatment for genital herpes will depend on whether you have the infection for the first time (a primary infection) or your symptoms keep coming back (a recurrent outbreak).

Primary infection

If you have genital herpes for the first time, see your GP or visit your local GUM clinic (also called sexual health clinics). They may prescribe antiviral tablets, such as aciclovir, which you will need to take five times a day.

Aciclovir works by preventing HSV from multiplying. However, it does not clear the virus from your body completely and does not have any effect once you stop taking it.

You will need to take a course of aciclovir for at least five days, or longer if you still have new blisters and open sores forming on your genital area when your treatment begins.

Aciclovir can cause some side effects, including being sick and headaches.

Other antiviral medications that may be used to treat genital herpes include famciclovir and valaciclovir.

For more information, see the patient information leaflet that comes with your medicine or read our medicines information page.

Recurrent outbreaks

You should visit your GP if you have been diagnosed with genital herpes before and are experiencing a recurrent outbreak.

If the symptoms are mild, your GP may suggest things you can do at home to help ease your symptoms without the need for treatment.

• Keep the affected area clean using either plain or salt water. This will help prevent blisters or ulcers from becoming infected and may encourage them to heal quicker. It will also stop affected areas from sticking together.
• Apply an ice pack wrapped in a flannel, or cold, wet, tea bags on the sores to help soothe pain and speed up the healing process. Do not apply ice directly to the skin.
• Apply petroleum jelly, such as Vaseline, or an anaesthetic (painkilling) cream, such as 5% lidocaine, to any blisters or ulcers to reduce the pain when you pass urine. 
• Drink plenty of fluids to dilute your urine. This will make passing urine less painful. Passing urine while sitting in a bath or while pouring water over your genitals may also help.
• Avoid wearing tight clothing because it may irritate the blisters and ulcers.

If your symptoms are more severe, you may be prescribed antiviral tablets (aciclovir), which you will need to take five times a day for five days.

Episodic treatment

If you have fewer than six recurrent outbreaks of genital herpes in a year, your GP may prescribe a five-day course of aciclovir each time you experience tingling or numbness before symptoms begin. This is known as episodic treatment.

Suppressive treatment

If you have more than six recurrent outbreaks of genital herpes in a year, or if your symptoms are particularly severe and causing you distress, you may need to take aciclovir every day as part of a long-term treatment plan.

This is known as suppressive treatment and aims to prevent further outbreaks developing. In this instance, it is likely you will need to take aciclovir twice a day for six to 12 months.

It is important to note that while suppressive treatment can reduce the risk of passing HSV on to your partner, it cannot prevent it altogether. Your GP may refer you for specialist advice if you are concerned about transmitting the virus to your partner.

Suppressive treatment will usually be stopped after 12 months. As long as recurrent outbreaks of genital herpes are infrequent and mild, you will only need to take a five-day course of aciclovir as and when it is needed. Episodes of recurrent genital herpes usually become less frequent and less severe after around two years.

Suppressive treatment may be restarted if you have further severe outbreaks. Your GP may refer you for specialist treatment if you continue to have outbreaks of genital herpes while you are having suppressive treatment.

HIV and genital herpes

If you are experiencing recurrent outbreaks of genital herpes you should also consider being tested for HIV. This may be a sign of a weakened immune system (the body’s natural defence against infection and illness), which may indicate you have HIV. 

Read about diagnosing HIV for more information about getting tested for this condition. 

If you have HIV and genital herpes you will be referred to a GUM specialist. This is because genital herpes can be a more serious condition in people with HIV.