Herpes treatment: what works and what to do when an outbreak starts

Herpes (HSV-1 or HSV-2) stays in your body, but treatment controls outbreaks and cuts symptoms fast. You don’t have to wait in pain — there are proven medicines and simple self-care steps that make a real difference.

Antiviral options

Oral antivirals are the mainstay: acyclovir, valacyclovir, and famciclovir. Doctors use two approaches: episodic treatment (take meds when you feel an outbreak coming) or suppressive therapy (daily pills to reduce outbreaks and lower transmission).

For many people, starting antivirals at the first tingle or redness shortens the episode. Typical prescriptions vary: short courses for cold sores and a few days to a week for genital outbreaks. If you have frequent recurrences, daily suppressive dosing often cuts outbreaks by 70–80% and reduces the chance of passing the virus to partners.

If you’re immunocompromised, or if lesions are severe or spreading, doctors may use higher doses or IV antivirals. Always follow the prescriber’s plan and tell them about other meds you take.

Practical tips for outbreaks and everyday life

Start care early. At the first tingling, wash the area gently and apply cold compresses to lower pain. Over-the-counter options help: docosanol cream can shorten cold-sore healing when applied early, and topical lidocaine eases pain.

Keep the sore clean and dry, avoid picking scabs, and wash hands often. For genital herpes, avoid sex until sores fully heal; condoms help but don’t remove all risk. Tell sexual partners so they can make informed choices.

Think about suppression if you have more than a few outbreaks a year or if you want to reduce transmission to a steady partner. Discuss testing and options with your clinician—some people stay on daily antivirals for years; others stop after a time with fewer outbreaks.

Special situations: pregnant people should see a clinician early. Many doctors start suppressive antivirals late in pregnancy to lower the chance of a delivery complication and may recommend cesarean delivery if sores are present at labor. Eye herpes is urgent — seek medical care fast to prevent vision loss.

When to call a doctor: fever with an outbreak, widespread lesions, severe pain, signs of infection (increased redness, pus), or if you can’t drink or eat. Also reach out if meds aren’t working or you get outbreaks more often than before.

Living with herpes is manageable. With quick treatment, sensible habits, and honest partner conversations, most people keep outbreaks rare and short. If you’re unsure about treatment choices, ask a healthcare provider — clear, practical options exist and help is available.