How is genital herpes treated?

Updated: Mar 17, 2020
  • Author: Sean P McGregor, DO, PharmD; Chief Editor: William D James, MD  more...
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Genital herpes is a chronic disease characterized by intermittent recurrences. The majority of cases are caused by HSV-2, and, like HSV-1, the primary infection is typically more severe. On average, patients experience four recurrences per year and 38% of patients have six or more recurrences during the first year. [54] Approximately 90% of patients experience a recurrence in the first year and some have a prodrome of tingling, pain, or paresthesias. [54, 55] The duration of lesions and viral shedding is shorter in recurrent episodes of genital herpes. Lesions may be asymptomatic, and many patients may be unaware when transmission occurs. [48] Primary genital herpes infections are typically more severe and may last 3 weeks if untreated. Treatment with systemic antivirals helps to decrease the duration and severity of both primary and recurrent genital herpes, but it does not eliminate the virus. Thus, the chronicity of the disease and preventive strategies are important aspects of management. [48]

Treatment for primary infection of genital herpes is as follows:

  • Acyclovir 200-400 mg PO 3 times per day for 7-10 days

  • Valacyclovir 1000 mg PO twice daily for 7-10 days

  • Famciclovir 250 mg PO 3 times per day for 7-10 days

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