Herpes Simplex Treatment

By Dr Ananya Mandal, MD

The treatment of individuals infected with the herpes simplex virus depends on several factors. Some of the factors that determine the intensity of herpes simplex infection and therefore the type of treatment include:

Age of the patient
For example, neonatal herpes is treated in a different way to adult herpes.

Site of infection
Different types of herpes infect different areas of the body and include genital herpes, oral herpes, ocular or eye herpes and herpes encephalitis (affecting the brain). The type of infection determines the priority and setting of treatment. For example, oral herpes may be treated at home while herpes encephalitis may require hospitalization and emergency treatment.

Pregnancy status A woman who is pregnant needs to be screened for the infection before risking transmission to the newborn during childbirth. The mother is at particular risk of transmitting the virus if she has been exposed to it since becoming pregnant. Recurrence status Primary or first-time infection is treated differently to recurrent infection. In the case of primary infection, antiviral tablets containing aciclovir, for example, may be prescribed for five days. In recurrent infection, longer-term treatment lasting 6 to 12 months may be required.

Medications

Aciclovir interrupts the DNA multiplication of the herpes viruses. It can be taken five times a day for at least five days or longer if blisters persist or more develop.

Genital herpes can also be treated with other antiviral medications such as valaciclovir or famciclovir. These drugs depend on the viral enzyme thymidine kinase, which converts the drug from its prodrug or inactive form to its monophosphate, diphosphate and finally triphosphate form. The triphosphate form binds to the viral DNA and inhibits replication.

In recurrent cases, treatment depends on the severity of symptoms. In the case of mild symptoms, the area is kept clean using ice packs and petroleum jelly to prevent secondary infections and ease pain. In people with less than six symptom outbreaks per year, a five-day course of aciclovir is prescribed. This is called episodic treatment. In people with more than six recurrent outbreaks per year, aciclovir is given twice daily over a long-term period of 6 to 12 months and this is called suppressive treatment.

Apart from oral treatment, antivirals are also available as topical or locally applied creams or lotions. For example, penciclovir cream can be used to interrupt the multiplication of the virus and although it may not improve existing blisters, it can prevent them from getting worse or lasting as long as they would have done.

An emollient called docosanol can also be used to soothe the skin in patients with oral herpes and is available over-the-counter. Tromantadine is a gel that can inhibit the entry and spread of the virus into the skin cells, through changing the glycoproteins on host cells. Zilactin acts as a protective barrier that "shields" the sore, helping to prevent transmission of the virus.

Reviewed by , BSc

Further Reading

Last Updated: Mar 28, 2014

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Comments
  1. Adam Aswani Adam Aswani India says:

    With the Herpes Virus, the main cause of reccuring outbreaks is a drop in immunity. As long as you keep your immunity boosted, you are lowering your chances of repeated outbreaks. A Healthy lifestyle, right nutrition and regular sleep; foods such as tomatoes, garlic, fish and herbs such as ecinecea, Phyllanthus emblica, Hyperisince Mysorense are known to boost immunity. Most plants of the Hypericum family have also been ssudied to have anti-viral effects. Win-Win situation!!

  2. Dr. Ritu Sandhu Dr. Ritu Sandhu India says:

    The most important thing to remember is that with natural remedies there is a lot of hope. Many people who once suffered tremendously from continual outbreaks can enjoy their life by preventing recurrent outbreaks after using natural therapies such as Hypericum Mysorense for a short period of time.

  3. german fernandez german fernandez United States says:

    There is a medicine that was created over 50 yrs. ago that was not meant to prevent the outbreaks of hsv-1 (fever blisters/cold sores) that I take when I feel the symptoms of the tingling aorund the mouth and when my immune system is down.  I take this once before the virus attacks and I son't have to go through those days of having cold sores on my mouth.  I have been free of cold sores now for over 10 yrs.  I have been trying to get in touch with some of the pharmaceutical companies with no avail.  This medicine costs less than $5.00 and will carry you for one year or more with no incidents of outbreaks.  The good part of it is that when you feel the virus about to attack your system you attack it a different way other than what pharmaceutical companies do.  I need someone to contact me for more information.  I have been living with hsv-1 for over 25 yrs. but now I can say I can live with.  NO outbreaks and I feel good after I take my medicine...simple as that.

  4. Neeraj Singh Neeraj Singh India says:

    Hemoform serum is great stuff and used by our family when we have cold sores. If we apply this at the first twinge of hurt, the sore never develops.

The opinions expressed here are the views of the writer and do not necessarily reflect the views and opinions of News-Medical.Net.
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