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Genital herpes treatment

What is genital herpes?

Genital herpes is a common sexually transmitted infection caused by the herpes simplex virus (HSV). There are two types: HSV-1, which more commonly causes oral herpes but can also affect the genitals, and HSV-2, which is the more frequent cause of genital herpes. Both types are transmitted through close skin-to-skin contact, including vaginal, anal and oral sex.

Genital herpes is a lifelong condition. Once the virus is present in the body, it remains there permanently, though many people experience long periods without symptoms. Outbreaks can recur, particularly in the first year following initial infection, and tend to become less frequent over time for most people.

Available treatment approaches

• Antiviral treatment for initial outbreaks
• Suppressive antiviral therapy for recurrent outbreaks
• Self-care and outbreak management
• Foundations of sexual health

How the assessment process works

• Complete a short, secure medical questionnaire.
• Select a treatment category for assessment.
• An independent UK-registered prescriber reviews your information and determines whether medical treatment may be appropriate.
• Next steps are arranged following clinical approval.

Understanding genital herpes and treatment options

Genital herpes is more common than many people realise. A significant proportion of people with HSV-2 are unaware they carry the virus, as symptoms can be mild, absent, or easily mistaken for other conditions.

When symptoms do occur, they typically include blisters or sores in the genital or anal area, itching, tingling or burning around the affected area, pain when urinating, and in some cases flu-like symptoms during a first episode. A first outbreak is often the most severe. Subsequent outbreaks are usually milder and shorter in duration.

Genital herpes cannot be cured, but antiviral medicines can reduce the severity and duration of outbreaks, lower the frequency of recurrences, and reduce (though not eliminate) the risk of passing the virus to a sexual partner.

How genital herpes is diagnosed

Genital herpes is most reliably diagnosed by a clinician during an active outbreak. Diagnosis typically involves a swab taken directly from a blister or sore, which is tested for the herpes simplex virus. Blood tests can detect HSV antibodies but are not routinely used in the UK for diagnosis, as a positive result does not confirm genital infection or predict future outbreaks.

When should genital herpes be treated?

Antiviral treatment is recommended for a first episode of genital herpes and for recurrent outbreaks that are frequent, severe, or significantly affecting quality of life. Treatment may also be considered for people who wish to reduce the risk of transmission to a partner.

There are two main approaches to antiviral treatment.

Episodic treatment: Antiviral medication taken at the start of an outbreak to reduce its severity and duration. Most effective when started within 72 hours of symptoms appearing.

Suppressive therapy: Antiviral medication taken daily on an ongoing basis to reduce the frequency of outbreaks and lower the risk of transmission. This approach is typically considered for people who experience six or more outbreaks per year, or where transmission risk to a partner is a significant concern.

Which healthcare professionals can support genital herpes treatment?

Genital herpes is managed primarily through sexual health services and primary care, though online prescribing pathways offer a more discreet route for those who prefer it. The following healthcare professionals may be involved depending on your circumstances and needs.

General practitioner (GP)
Can diagnose and treat genital herpes and provide referrals to specialist sexual health services where needed.

Sexual health clinician
Specialist sexual health and GUM clinics offer confidential testing, diagnosis and treatment without the need for a GP referral. They can also provide guidance on managing the emotional and relational aspects of a herpes diagnosis.

UK-registered online prescriber
A UK-registered prescriber can assess suitability for antiviral treatment through a secure online process, including both episodic and suppressive therapy, following a clinical questionnaire.

Psychosexual therapist or counsellor
A herpes diagnosis can have an emotional impact. Psychological support may be helpful for people experiencing anxiety, relationship concerns, or distress related to their diagnosis.

How is genital herpes managed?

Management of genital herpes typically involves a combination of antiviral treatment and self-care, alongside open communication with sexual partners.

• Antiviral treatment: Prescribed to reduce the severity and duration of outbreaks, or taken daily to suppress recurrences and reduce transmission risk
• Self-care during outbreaks: Keeping the affected area clean and dry, wearing loose-fitting clothing, avoiding sexual contact during and immediately after an outbreak, and using pain relief such as paracetamol for discomfort
• Partner notification: Informing current and recent sexual partners so they can be assessed and supported
• Ongoing monitoring: Regular review with a clinician to assess whether the current treatment approach continues to be appropriate

Medicines that may be considered

Where clinically appropriate, a UK-registered prescriber may consider antiviral treatment for genital herpes. Suitability depends on individual health profile, frequency and severity of outbreaks, any relevant allergies, and current clinical guidance from the British Association for Sexual Health and HIV (BASHH).

Aciclovir

A well-established antiviral used for both episodic and suppressive treatment of genital herpes. Available in tablet form and taken multiple times daily. Aciclovir has an extensive safety record and is the most widely used antiviral for herpes in the UK.

Valaciclovir

A prodrug of aciclovir that is converted into aciclovir in the body. It is absorbed more efficiently, meaning it can be taken less frequently than aciclovir while achieving comparable blood levels. Often preferred for suppressive therapy due to the simpler dosing schedule.

Famciclovir

Another antiviral option that may be considered in certain clinical circumstances. Used for both episodic and suppressive treatment.

How DoktorABC UK supports access to care

DoktorABC UK is a digital health platform that connects patients with independent, UK-registered healthcare professionals. Patients can access a clinical assessment through a secure online process.

A UK-registered prescriber reviews the information you provide and determines whether treatment may be appropriate for you. If treatment is considered suitable, a prescription is issued by the UK-registered prescriber in accordance with UK regulations.

DoktorABC UK does not itself provide medical care, issue prescriptions or dispense medicines. All clinical decisions are made by the independent prescribing healthcare professional following an individual assessment.

Summary

Genital herpes is a common, manageable condition. While there is no cure, antiviral treatment can significantly reduce the frequency and severity of outbreaks and lower the risk of transmission to sexual partners. Early treatment at the onset of an outbreak produces the best results. A UK-registered prescriber can assess your individual circumstances and advise on whether episodic or suppressive therapy is the most appropriate approach for you.