A genital herpes diagnosis can feel like a lot to take in. But it's far more common than most people realise, and with the right genital herpes treatment and a few practical habits, most people manage it well and get on with their lives.
This guide explains the difference between treating an outbreak and managing herpes long term, how antiviral medicines like Aciclovir and Valaciclovir help, and what you can do to ease symptoms and lower the risk of passing it on.
Herpes is extremely common and nothing to be ashamed of. Many people with it never know, and outbreaks often become milder and less frequent over time.
What is genital herpes?
Genital herpes is a common sexually transmitted infection caused by the herpes simplex virus (HSV). It can be caused by HSV-2 or by HSV-1, the virus that also causes cold sores.1
Once you have the virus, it stays in your body for life, resting in the nerves. From time to time, it can reactivate and cause an outbreak of blisters or sores.2 There's no cure, but treatment can help a lot.2
Treating vs managing genital herpes
Treating herpes means easing the symptoms of an outbreak and helping it heal faster. Managing herpes is the bigger picture: reducing how often outbreaks happen, lowering the chance of passing the virus on and keeping you comfortable day to day.
You can read more in our guide to herpes explained.
How is genital herpes treated?
Antiviral tablets are the main genital herpes treatment. They stop the virus multiplying, which can help sores heal faster and ease symptoms.3
They work best if you start them as soon as possible. For a first outbreak, the NHS advises starting antiviral tablets within 5 days of symptoms appearing.2
Aciclovir
Aciclovir is the most widely used antiviral for herpes. It's usually taken several times a day for a few days during an outbreak.3
Valaciclovir and Valtrex
Valaciclovir is a pro-drug, which means your body converts it into aciclovir after you swallow it. It's absorbed more efficiently, so you need to take it less often.4
Valtrex is the branded version of valaciclovir. It works in exactly the same way.
Suppressive treatment
If you get frequent outbreaks, usually more than 6 a year, a doctor may suggest taking an antiviral every day. This is called suppressive treatment. It can reduce how often outbreaks happen and lower the chance of passing the virus on.2
Daily treatment isn't only about comfort. Fewer outbreaks can also mean less worry about passing the virus on.
Our guide to treating and suppressing herpes goes into more detail.
How to ease the symptoms of an outbreak
Alongside antivirals, a few simple steps can make an outbreak more bearable.2
- Keep the area clean - wash gently with plain or salty water, then pat it dry with a clean towel that you use only for that area.
- Ease the pain - take painkillers such as paracetamol or ibuprofen if you need them.
- Soothe the skin - apply petroleum jelly or a numbing cream to the sores.
- Make peeing easier - if it stings, try peeing in the bath or while pouring water over the area.
- Cool it down - hold a cold compress or an ice pack wrapped in a towel against the area.
- Wear loose clothing - tight underwear and trousers can rub and irritate sores. Breathable cotton is best.
Always wash your hands after touching the sores, especially before touching your eyes.2
Do not have sex, including oral sex, from the first signs of an outbreak until the sores have fully healed.
What triggers herpes outbreaks?
Outbreaks don't always have an obvious cause, but some people notice patterns.2 Common triggers include:
- Being unwell or run down
- Stress
- Drinking alcohol
- Friction during sex
- Exposure to strong sunlight or UV
Keeping a note of when outbreaks happen can help you spot your own triggers. Many people find outbreaks become less frequent over time.
For a guide to how outbreaks progress, see the five stages of a herpes outbreak.
How to lower the risk of passing herpes on
Herpes is most likely to spread when you have symptoms. But it can also be passed on when there are no visible sores.2
- Avoid sex during an outbreak, until sores have completely healed
- Use condoms, which reduce the risk but don't remove it completely
- Talk to partners openly about your diagnosis
- Consider suppressive treatment if you're worried about passing it on
If you're pregnant or planning a pregnancy, tell your midwife or doctor that you have genital herpes. They can plan your care to protect your baby.2
Herpes can sometimes be passed on even without symptoms, so condoms and open conversations matter even when you feel fine.
Living with herpes is about more than medicine. Our guide to living with herpes covers relationships, disclosure and wellbeing.
Frequently asked questions
Can genital herpes be cured?
No, there’s currently no cure for genital herpes. Once you have the virus, it stays in your body. But antiviral treatment can ease outbreaks, help sores heal faster and reduce how often outbreaks happen. For many people, outbreaks also become less frequent over time, and some rarely get symptoms at all.
How long does a herpes outbreak last?
A first outbreak can last a few weeks, while later outbreaks are usually shorter and milder, often clearing within about a week. Starting antiviral treatment as soon as you notice symptoms can help sores heal faster. If an outbreak is very painful or not healing, speak to a GP or sexual health clinic.
What causes a herpes outbreak after years?
The herpes virus can stay dormant in your nerves for years, then reactivate. Common triggers include being unwell, stress, alcohol, friction during sex and strong sunlight. An outbreak after a long gap doesn’t necessarily mean you were recently infected, as the virus may have been present for some time without causing symptoms.
How long after a herpes outbreak are you contagious?
You’re most contagious from the first tingling or itching until the sores have completely healed. But herpes can also be passed on when there are no visible symptoms. Using condoms, avoiding sex during outbreaks and considering daily suppressive treatment can all lower the risk of passing it on.
Does aciclovir cream work for genital herpes?
Aciclovir cream is mainly used for cold sores and isn’t usually recommended for genital herpes. Antiviral tablets, such as aciclovir or valaciclovir, are the standard treatment because they work throughout the body. Soothing products like petroleum jelly or a numbing cream can help ease discomfort alongside tablets.
References
- World Health Organization. Herpes simplex virus. WHO; 2024. who.int
- NHS. Genital herpes. NHS website; 2024. nhs.uk
- NHS. Aciclovir. NHS website; 2023. nhs.uk
- NHS. Valaciclovir. NHS website; 2023. nhs.uk
This article is intended for informational purposes only and does not replace professional medical advice. Always read the patient information leaflet supplied with your medication and speak to a healthcare professional if you have specific concerns.