Treatment for genital herpes will depend on whether:
- you have the infection for the first time (a primary infection) or you have an infection that keeps coming back (a recurrent infection)
- you are being treated at a genitourinary medicine (GUM) clinic or by your GP
Primary infection
In most instances, a primary infection of genital herpes will develop some time after you have been exposed to the herpes simplex virus (HSV). This can be months or even years after the exposure, or it may be after four to seven days.
Treatment from a GUM specialist
If you have genital herpes for the first time, you will usually receive treatment from a GUM specialist at a GUM clinic (also called sexual health clinics).
GUM specialists are able to provide specialist screening for genital herpes and other sexually-transmitted infections (STIs), as well as treatment, counselling and follow-up care.
Treatment from your GP
If you have a primary genital herpes infection and it is not possible for you to see a GUM specialist your GP may treat you for the condition. They may prescribe antiviral tablets, called 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 ulcers (open sores) forming on your genital area when your treatment begins.
Aciclovir can cause some side effects, including:
- feeling sick
- being sick
- headaches
For more information, see the patient information leaflet that comes with your medicine or the Medicines information tab at the top of this page.
There are also several self-help measures that you may be able to follow to ease your genital herpes symptoms. See Genital herpes - self help for more information about these.
Recurrent infections
You should visit your GP if you have been diagnosed with genital herpes before and you are experiencing a recurrent infection. In most cases, you will not need to return to your local GUM clinic.
If the symptoms of your recurrent infection are mild, your GP may suggest some self-help measures to help ease your symptoms without the need for treatment (see Genital herpes - self help). 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 infections of genital herpes in a year, your GP may prescribe a five-day course of aciclovir each time you experience symptoms. This is known as episodic treatment.
Suppressive treatment
If you have more than six recurrent attacks 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 it aims to prevent further recurrent infections from developing. In this instance, it is likely that you will need to take aciclovir twice a day for 6 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 while you are having suppressive treatment.
After you have been taking aciclovir for 12 months, your GP will usually stop your suppressive treatment. You may continue to experience further recurrent infections of genital herpes after your treatment has been stopped.
As long as recurrent genital herpes infections 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 genital herpes infections after the treatment has been stopped, or if you have severe recurrent infections. Your GP may refer you for specialist treatment if you continue to have recurrent infections of genital herpes while you are having suppressive treatment.
If you are experiencing recurrent attacks of genital herpes you should consider being tested for HIV. Recurrent attacks may be a sign of a weakened immune system (the body’s natural defence against infection and illness), which may indicate that you have HIV. See HIV - diagnosis for more information about getting tested for this condition.
