How is herpes treated?
A central role in the treatment of herpes is played by the so-called antivirals. Doctors use these drugs as standard against various types of herpes. In addition, antivirals are used for other viral diseases.
In addition, there are other agents that can be used for herpes, but they usually only relieve the symptoms and do not act against the cause.
A herpes infection lasts for different lengths of time. In most cases, those affected are rid of the herpes after one to two weeks. If it is the first infection with the virus, it may take longer to heal.
Medications for herpes treatment
There are various antiviral drugs that are approved for the treatment of herpes. However, they almost all have the same mechanism of action. Most of the active ingredient names end in “-ciclovir”. For example, the active ingredients used include:
- Aciclovir
- Famciclovir
- Valaciclovir
- Penciclovir
Brivudine is another preparation that can be used to treat herpes, as well as zinc sulfate.
Other drugs in herpes treatment
In addition to antiviral medications, there are several others. These do not directly combat herpes, but they act against its symptoms or reduce the external spread of the viruses.
For example, anti-inflammatory and pain-relieving preparations are available, as well as germicidal (antiseptic) preparations that kill the viruses that penetrate to the outside. Some products have a cooling effect, others cause the crusts to loosen more quickly.
What helps quickly against herpes?
“What to do about herpes?” asks everyone who has ever made acquaintance with the annoying blisters, and of course you want to get rid of herpes quickly. Unfortunately, the currently known active ingredients for herpes treatment do not work miracles. At best, they shorten the duration of the disease and alleviate the symptoms, but they do not offer reliable quick help for herpes.
Early herpes treatment works better
The best way to at least accelerate healing is to start treatment as early as possible. Those who suffer from frequent herpes reactivations often have a sense for the first symptoms of an impending outbreak of the disease. Harbingers of a herpes outbreak often announce to sufferers that it will not be long before the first fluid-filled blisters appear. These include:
- Itching or pain in the affected area
This is the best time to start herpes treatment with medication. Some patients even report that the outbreak of herpes can be prevented in this way. Antivirals only have a significant effect on the course of the disease if the virus has not yet spread to any great extent. Already “finished” viruses cannot be destroyed by antivirals.
Possible problems with herpes treatment with drugs
Most antiviral drugs for herpes simplex treatment are also used for other herpes diseases such as glandular fever or herpes zoster. In some cases, they are also used in the treatment of viral diseases outside the herpes group.
However, under certain circumstances this promotes the development of resistance. This means that herpes viruses of all groups are increasingly resistant to the active substances. In the worst case, the standard active ingredients no longer work at all in a patient, and only expensive alternatives for herpes treatment are still effective.
This may not be a bad thing for the treatment of simple herpes blisters on the lip. However, it is dangerous when therapy for complications such as herpes-related encephalitis or sepsis fails due to drug resistance.
How are the different types of herpes treated?
Herpes outbreaks occur in almost all parts of the body, with the face and genital area being among the preferred areas for herpes simplex viruses.
In the face, for example on the lip or nose, type 1 herpes simplex viruses (HSV-1) are usually responsible for infections, while type 2 viruses (HSV-2) are the majority in the genital area. The antivirals act equally on both virus types (HSV-1 and HSV-2), but there are specifics in herpes treatment depending on the manifestation.
What to do against herpes on the lip?
In most cases, cold sore progresses harmlessly without medication. However, timely therapy with antivirals reduces the duration of symptoms such as itching and pain. What helps, for example, are creams containing aciclovir or penciclovir.
Antivirals are the only thing that helps against herpes on the lip and shorten the outbreak in many cases. The creams for herpes treatment can be applied externally to the affected area. Applied locally, they also have fewer side effects.
Aciclovir and some other antivirals for treating herpes on the lip are also available in tablet form. For very pronounced symptoms or complications of cold sore, doctors also give the active ingredients as an infusion.
Finally, there are herpes patches that are free of active ingredients and merely create a moisture cushion over the herpes blisters, thus containing the external spread of the viruses via smear infection. Since an antiviral active component is missing, this does not reduce the duration of the disease.
What helps against herpes in the genital area?
Antivirals are used to treat herpes in the genital area, primarily in tablet form. Locally applied ointments or creams with antiviral agents are recommended by doctors at most for mild outbreaks of genital herpes.
As a rule, doctors base their treatment of genital herpes on the current guidelines for the treatment of this disease. Guidelines are current scientific recommendations for the treatment of certain diseases. According to these, when genital herpes first appears, tablets are used two to five times a day for at least one week, depending on the concentration of active ingredient and antiviral.
The active ingredients used are:
- Aciclovir
- Famciclovir
- Valaciclovir
The active substances can also be used for recurrent outbreaks, but usually in lower doses and for shorter periods. If the genital herpes outbreak occurs more than four times a year, permanent therapy with a virostatic agent is also possible.
What to do in case of herpes on the eye?
In some cases, the herpes virus also affects the eye. For example, the eyelid or directly the cornea of the eye is affected (herpes simplex keratitis), but in principle the infection is possible in the entire eye. If, for example, an infection of the retina of the eye occurs (herpes simplex retinitis), rapid medical treatment is important, because in the worst case, blindness of the eye is imminent.
If you suspect a herpes infection in the eye, it is important to see an ophthalmologist promptly. The ophthalmologist is able to assess whether the herpes infection is dangerous or not. As a rule, he prescribes eye drops or tablets with a virostatic agent in order to inhibit the multiplication of the virus.
How to treat herpes in the mouth?
Herpes in the mouth (stomatitis aphthosa) usually affects children. Usually, herpes in the mouth heals on its own after about two to three weeks. However, because of the severe pain throughout the mouth and throat, children often refuse food with this form of herpes. Treatment usually shortens the duration of the disease to about one week, which is why a visit to the doctor is urgently advisable here.
On the one hand, doctors give gels and creams for pain relief, which contain locally anesthetic active ingredients such as lidocaine and can be applied directly to the diseased mucous membrane in the mouth and throat area. However, they suppress the sensation of taste on contact with the tongue. On the other hand, classic painkillers such as ibuprofen or paracetamol are available. Both also have an antipyretic effect.
Before using such painkillers in children, it is important to consult the attending physician.
It is important that children with herpes in the mouth drink enough fluids despite the pain. If this is not possible, fluid intake through the vein via IV may be considered. If the child’s food intake is very severely restricted or if he or she refuses it completely, a high-calorie liquid diet may provide relief.
Suitable foods
When choosing foods for herpes in the mouth, there are a few tips to keep in mind:
- Look for foods that do not irritate the oral mucosa, if possible.
- Drinks are best consumed chilled. Fruit juices are not a good choice due to acidity, clear water, milk or chamomile tea are better.
- Solid food is also ideally pH neutral, cool and of as soft a consistency as possible. Acidic foods such as tomato sauce or foods that are too dry, such as rusks or cookies, further irritate the areas affected by herpes.
Antivirals and antibiotics for herpes in the mouth.
Herpes treatment with antivirals is not mandatory for herpes in the mouth. Since the antiviral drugs are also associated with side effects and children are generally more sensitive to them, their use should be well weighed, especially in children. Sometimes, however, their use is advisable, for example in the case of a very severe outbreak of herpes. Doctors often prescribe aciclovir as a tablet or infusion.
If a so-called superinfection occurs, i.e. a bacterial infection occurs in addition to the viral infection, antibiotics in the form of tablets or, if necessary, as an infusion, support the rapid healing of the bacterial inflammation.
Herpes treatment during pregnancy
The known antivirals are not officially approved for use during pregnancy. However, at least for the active ingredient aciclovir, no negative effects for mother or child have been shown in the observations to date.
Whether herpes treatment with medication is necessary during pregnancy depends on a number of factors:
- What is the manifestation of the herpes?
- At what point in the pregnancy did the herpes occur?
- Is it the first-time infection with herpes or reactivation?
The real danger with herpes in pregnancy is possible transmission to the child. Therefore, especially genital herpes of the mother is dangerous for the child. Other manifestations such as herpes on the face play almost no role in transmission to the child.
An initial infection with genital herpes poses a greater risk during pregnancy than reactivation. In addition, the closer the onset of herpes is to the due date, the greater the risk of transmission to the child. This is because a large part of the infection occurs during birth.
In the case of an initial infection of the mother in the first or second trimester, doctors in some cases give aciclovir three times a day as a preventive measure in the last third of pregnancy (from the 36th week of pregnancy). With such suppressive therapy, they try to prevent the occurrence of herpes lesions during birth and thus protect the child from infection.
Read more about herpes in pregnancy.
Treatment of first infections in the last trimester of pregnancy
If genital herpes symptoms occur in the last trimester of pregnancy and it is a first-time infection, a cesarean section may be an option. Especially if the herpes breaks out in the last six weeks before birth, the risk of virus transmission to the child during vaginal birth is otherwise very high.
If a cesarean section is not feasible for certain reasons, both mother and newborn will receive aciclovir for herpes treatment immediately after birth.
What else you should know about herpes treatment
False tips against herpes: Caution is advised with many tips against herpes from online forums. For example, they claim that if you prick the blisters or open them in some other way, the herpes will quickly go away. On the contrary, however, this causes an increased release of the viruses and thus an increased risk of infection.
If the usual herpes treatment is not an option for you, ask a doctor or pharmacist for advice.
