Genital herpes cannot be cured, but it can be treated. Antiviral medications are available to help reduce the symptoms of genital herpes and decrease the number of recurrences. These antiviral medications include acyclovir, famciclovir, and valacyclovir. Valacyclovir can also be used to reduce the risk of transmitting herpes to your sex partner(s). It should be used in combination with safer sex. You should discuss the value of using antiviral medications with your physician.

Here are some suggestions if you have, or think you may have, a first episode of genital herpes:

  • Go to your doctor or clinic as soon as possible. Early diagnosis and treatment will help you to feel substantially better more quickly.
  • Have a trained professional diagnose the problem and confirm the presence of herpes by a virus test taken from the affected area (a culture test is the most common method, but a blood test for antibodies may also be used). A blood test for syphilis, HIV, and possibly hepatitis B may also be performed.
  • If the pain is severe, you may wish to take a prescription pain reliever.
  • If it is helpful, take very warm showers to run warm water over the area 3 or 4 times a day.
  • When you get out of the shower or bath, blow dry the genital area with a hair dryer. Set the temperature on low or cool.
  • Make sure you are passing urine without difficulty. Try urinating in the shower or tub to decrease the sting. Pouring a glass of warm water over the area may also be helpful. Some people have found that drinking a lot of water (8 glasses a day) dilutes the urine enough that it hurts less.
  • If you cannot pass urine and you've tried several times, wait a couple of hours - even 3 or 4. If there is still no result, you must get medical attention. Not passing urine can lead to serious problems, but they can generally be prevented. Either visit your own doctor or go to the emergency room of a local hospital.
  • Avoid wearing tight underwear. If possible, do without underwear altogether. Try wearing loose clothes made of pure cotton. When you get home, take a shower or soak in the tub. Leave your clothes off if you can.
  • Talk to your physician about the value to you of using antiviral medications.
  • Avoid (because they may be worse than doing nothing):
    • cortisone cream or ointment
    • antibiotic cream or ointment
    • any cream or ointment that does not contain a useful, specific antiherpes drug
    • petrolatum (e.g., Vaseline®)
    • antibiotics (unless you have a clear-cut secondary infection)
    • alcohol (because it stings)
    • ether (because it stings and can catch fire)
    • DMSO (dimethyl sulfoxide)
  • Avoid (because they are of no proven benefit):
    • L-lysine
    • BHT

If you have your first episode of herpes during pregnancy, consult your physician as soon as possible about what you can do to reduce your baby's risk of infection. Take care of yourself by giving yourself time to heal, treating any other infections, and treating your herpes.

It is hard to learn and figure out everything all at once, but the answers will come. Your ability to cope and your methods for coping will also evolve. Speak to your doctor about how to cope with herpes and reduce the risk of passing the infection on to your sex partner(s).

What if I am having recurrent herpes?

With recurrent herpes, it is important to fully understand the active phases of infection so you can avoid contact when necessary. It is also important to use safer sex precautions, such as condoms and dental dams, for the prevention of herpes and other sexually transmitted infections. Since people can spread the herpes virus even when they have no noticeable symptoms, it's important to take these precautions at all times. It's important to know that condoms don't provide complete protection from herpes, since they don't always cover all affected skin.

If you are facing issues such as loneliness and the fear of discussing herpes with new partners, keep in mind that these are very common issues and that frustrations can be overcome through a commitment to yourself and to your ability to grow from this experience. In addition, you may wish to have treatment for recurrent herpes. People with recurrent genital herpes now have choices to make regarding antiviral treatment for control of the infection. Talk to your doctor about medications that might help treat your symptoms, reduce the number of outbreaks, or reduce your risk of passing on herpes to your sex partner(s).

Stephen L. Sacks, MD, FRCPC, with revisions by the MediResource clinical team