Genital herpes cannot be cured, but the right antiviral treatment can make outbreaks shorter, milder and less frequent. The catch is that aciclovir genital herpes treatment is not one-size-fits-all: the drug you choose, the dose, and how long you take it for all depend on how often outbreaks happen, how soon you catch the first signs, and whether you are pregnant. Here are five questions worth answering before you choose a genital herpes treatment plan.
1. How often you get outbreaks
Occasional outbreaks compared to frequent ones call for different approaches. If you only get a flare-up once or twice a year, episodic treatment, a short course of antiviral tablets taken at the first sign of symptoms, is usually enough.
If outbreaks come more often, daily suppressive therapy may suit you better. The NHS notes that people who have more than 6 outbreaks a year may benefit from taking antiviral medicine continuously for 6 to 12 months.1 Guidance from the British Association for Sexual Health and HIV also recommends considering suppressive treatment where outbreaks cause significant distress, even if they happen less often.2 Our guide to suppressive therapy covers how the daily option works in more detail.
2. Aciclovir or Valaciclovir
Both aciclovir and valaciclovir treat and suppress genital herpes, and the choice usually comes down to how often you want to take tablets.
Aciclovir is typically taken two to five times a day, depending on whether you are treating an outbreak or using it for suppression.3 Valaciclovir is converted into aciclovir in the body but is absorbed more efficiently, so it needs fewer doses, generally once or twice a day for the same purposes.4 The two are equally effective for most people, so convenience and cost are often the deciding factors. Our full aciclovir vs valaciclovir comparison breaks down their differences side by side.
3. How soon you start treatment
Antiviral tablets work best early. The NHS advises starting treatment within 5 days of symptoms appearing, and doing so may shorten an outbreak by a day or two.1 Clinical guidance from sexual health services suggests the benefit is greatest when treatment begins within the first 24 hours of noticing tingling, itching, or blisters.2
If you know you get recurrent outbreaks, it's worth having aciclovir or valaciclovir ready in advance rather than waiting to see a GP once symptoms have already set in, since a delay of even a day or two can reduce how much the tablets help.
4. Pregnancy and contraception
If you are pregnant, think you might be, or are trying to conceive, treatment for genital herpes needs specialist input rather than a standard online order.
Both aciclovir^3^ and valaciclovir^4^ may be used in pregnancy where a healthcare professional considers the benefit to outweigh the risk, though the right medicine, dose and duration can vary with individual circumstances. Speak to your GP, midwife, or a sexual health clinic before starting or continuing any antiviral treatment if you are pregnant, so your care can be planned around your stage of pregnancy.
5. How long you will need treatment
Episodic treatment is short. A typical course of aciclovir for an outbreak runs for around 5 days, taken multiple times daily.3
Suppressive therapy is different. It's designed to be taken every day, often for months at a time. The NHS recommends reviewing suppressive treatment with a doctor after 6 to 12 months to check whether you still need it, since outbreak frequency can change over time.1 It's common to pause and see whether outbreaks return before deciding whether to continue, rather than staying on suppressive treatment indefinitely without review.
Frequently Asked Questions
How quickly does aciclovir work for genital herpes?
If started within 5 days of symptoms appearing, aciclovir and valaciclovir can shorten an outbreak by around a day or two. They work best when taken within the first 24 hours of noticing tingling, itching or blisters.
Which is better for genital herpes, aciclovir or valaciclovir?
Both are equally effective for treating and suppressing genital herpes. The main difference is dosing frequency: aciclovir is typically taken two to five times a day, while valaciclovir needs fewer doses. The choice usually comes down to convenience and cost rather than effectiveness.
How many outbreaks a year mean I should consider suppressive therapy?
The NHS notes that people with more than 6 outbreaks a year may benefit from daily suppressive antiviral treatment for 6 to 12 months. Fewer but more distressing outbreaks can also be a reason to consider it.
Can I take genital herpes treatment while pregnant?
Aciclovir and valaciclovir may be used in pregnancy where a healthcare professional judges the benefit outweighs the risk, but the right dose and duration should always be guided by a GP, midwife or sexual health clinic rather than a standard online order.
Does treatment stop genital herpes from being passed on to a partner?
Daily suppressive treatment reduces viral shedding between outbreaks, which can lower the chance of passing the virus to a partner, though it does not remove the risk entirely. Condoms and avoiding contact during an outbreak also help reduce transmission.
How long does a course of genital herpes treatment last?
Episodic treatment for a single outbreak usually lasts 5 days. Suppressive therapy is taken daily and is typically reviewed with a doctor after 6 to 12 months.
References
- NHS. Genital herpes. nhs.uk
- Patel R, et al. 2024 UK national guideline for the management of anogenital herpes. British Association for Sexual Health and HIV (BASHH). bashh.org
- Aciclovir 400mg Tablets. Summary of Product Characteristics (SmPC). medicines.org.uk
- Valaciclovir 500mg Film-Coated Tablets. Summary of Product Characteristics (SmPC). medicines.org.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.