Antiviral tablets available to treat genital herpes include: aciclovir and valaciclovir. They work by stopping the
herpes virus from multiplying. They do not clear the virus from the body. If an antiviral medicine is started early
in an episode of symptoms, it tends to reduce the severity and duration of symptoms during an episode of genital
Aciclovir tablets are effective in treating a full outbreak of genital herpes.
It can also be used as a
suppressive treatment, especially if you suffer from multiple outbreaks a year.
Valaciclovir is a “prodrug” meaning it is converted into Aciclovir by the body. The effectiveness is similar but
Valaciclovir tablets are better absorbed by body. Valaciclovir is also known by the brand name Valtrex.
What is Valtrex?
Valtrex is a brand name for Valaciclovir. Valtrex is commonly sold in the USA but in the UK it usually sold under
the generic version, which is known simply as Valaciclovir. Valtrex is substantially more expensive than generic
Valaciclovir tablets but medically they are identical and there is no effective difference.
Aciclovir and Valaciclovir start working straight away to reduce the severity and duration of an outbreak by one to
If taken within five days of the start of an outbreak should shorten your outbreak by one
to two days and make the symptoms less severe. It might even prevent the outbreak if taken early enough.
What is Genital Herpes?
Genital herpes is a very common and highly contagious infection usually spread through sex. This infection is
usually caused by the herpes simplex virus-2 (HSV-2) or the herpes simplex virus-1 (HSV-1), the virus usually
responsible for cold sores.
Most cases of genital herpes are caused by infection by the herpes
simplex virus type 2 (HSV-2). Herpes simplex virus type 1 (HSV-1) is more often the cause of cold sores or fever
blisters. But it can also be a cause of genital herpes.
Most people with genital herpes don’t know
they have it. That’s because in most people it produces either no symptoms or very mild ones.
Genital herpes is caused by the herpes simplex virus (HSV).
Genital herpes is very similar to the herpes that appear on the hands and face (‘cold sores’), but is
found on or around the penis, anus or vagina.
There are two types of herpes virus, HSV-1 and HSV-2. Both types can cause genital herpes. The first
episode of infection (primary) with genital herpes is often quite severe. There are blisters and inflammation at
the site of infection and the sufferer may feel generally unwell. It is common to have symptoms of burning when
After the first episode of infection with HSV the virus enters into a dormant phase in the nerve, which
supplies feeling to the area where infection occurred.
The dormant virus reactivates from time to time to cause recurrences.
Some people get symptoms warning them that a recurrence is about to occur, such as itching, tingling or
pain in the genital area; blisters or sores may then develop. These tend to be less severe than the symptoms that
occurred at the time of the first episode of infection.
From time to time the virus may reactivate without causing any symptoms of infection at all.
Who gets Genital Herpes?
Anyone who has sex can catch genital herpes. The people at most risk are those having unprotected sexual intercourse
(i.e. not using condoms), especially those with more than one sexual partner and those who change sexual partners.
How do you get infected with Genital Herpes?
Genital herpes is spread by direct contact with the infectious virus, via unprotected vaginal or anal sex,
genital contact or through oral sex with someone who gets cold sores.
Genital herpes and cold sores are both very infectious when an infected person has blisters or sores.
It is possible for an infected person to transmit the virus when they have no symptoms of infection. The
risk of this happening is probably reduced by using condoms.
What Are the Symptoms of Genital Herpes?
Even though you can still pass the infection, you may never notice symptoms from an HSV infection. On the other
hand, you might notice symptoms within a few days to a couple of weeks after the initial contact. Or, you might not
have an initial outbreak of symptoms until months or even years after becoming infected.
When symptoms occur soon after a person is infected, they tend to be severe. They may start as small blisters that
eventually break open and produce raw, painful sores that scab and heal over within a few weeks. The blisters and
sores may be accompanied by flu-like symptoms with fever and swollen lymph nodes.
Any of the following symptoms of a genital HSV infection can occur in a man or a woman:
Cracked, raw, or red areas around your genitals without pain, itching, or tingling
Itching or tingling around your genitals or your anal region
Small blisters that break open and cause painful sores. These may be on or around your genitals (penis or
vagina) or on your buttocks, thighs, or rectal area. More rarely, blisters may occur inside the urethra — the
tube urine passes through on its way out of your body.
Pain from urine passing over the sores — this is especially a problem in women.
Flu-like symptoms, including fever, swollen lymph nodes, and fatigue
How Serious is Genital Herpes
The majority of people with genital herpes experience mild and infrequent symptoms. Some people may
experience more frequent and severe recurrent episodes.
The risk of transmission from a mother to her baby is greatest for babies born to a woman with first
episode genital herpes around the time of delivery. Neonatal herpes is potentially life threatening but occurs
very rarely in the UK.
Women with recurrent herpes prior to pregnancy are at very low risk of transmitting the infection to their
Self-care measures may be helpful for some people:
Clean the affected area with plain or salt water to help prevent secondary infection and promote healing
Apply vaseline or a topical anaesthetic (e.g. lidocaine 5%) to lesions to help with painful micturition,
Increase fluid intake to produce dilute urine (which is less painful to void). Urinate in a bath or with
water flowing over the area to reduce stinging.
Avoid wearing tight clothing (which may irritate lesions) and use adequate pain relief (e.g. oral
Avoid sharing towels and flannels with household members (although it is very unlikely that the virus
would survive on an object long enough to be passed on, it is sensible to take steps to prevent this).