Herpes: treatment
Marian Grosser studied human medicine in Munich. In addition, the doctor, who was interested in many things, dared to make some exciting detours: studying philosophy and art history, working on the radio and, finally, also for a Netdoctor.
More about the experts All content is checked by medical journalists.Only a limited number of drugs are suitable for treating herpes. In order to have a positive influence on the course of the disease, they must be used as early as possible. In addition to the antiviral agents, painkillers are sometimes used against herpes. Here you can find out everything you need to know about herpes therapy.
ICD codes for this disease: ICD codes are internationally recognized codes for medical diagnoses. They can be found, for example, in doctor's letters or on certificates of incapacity for work. B02O26P35A60B00
What helps against herpes?
The so-called antivirals play a central role in herpes therapy. These drugs are used by default against various types of herpes and are also used for other viral diseases. There are also other active ingredients that can be used for herpes, but these only affect the symptoms and not the cause.
Medicines used to treat herpes
There are several antiviral drugs that are approved for treating herpes. However, almost all of them have the same mechanism of action. Most active ingredient names end with "-ciclovir". For example, the active ingredients used include acyclovir, valaciclovir, ganciclovir, valganciclovir and penciclovir. Brivudine is another preparation that can be used to treat herpes, as is zinc sulfate.
If resistance to these agents occurs, Foscarnet can be given as an alternative. All of these active ingredients are so-called antivirals, which means that they cannot destroy the viruses, but only prevent them from multiplying. Medicines that destroy viruses would be called virucides, but there are currently no such preparations.
Other drugs used in herpes treatment
In addition to the antiviral drugs, there are a few others that do not fight herpes directly, but work against its symptoms or reduce the external spread of the virus. For example, anti-inflammatory and pain-relieving preparations are available, but also antiseptic ones that kill the viruses that penetrate the outside world. Some agents have a cooling effect, others can be used to loosen the crusts more quickly.
What helps quickly against herpes?
“What to do with herpes?” Asks everyone who has ever become acquainted with the annoying blisters and of course you want to get rid of the herpes quickly. Unfortunately, the currently known active ingredients for herpes treatment do not work miracles. At best, they shorten the duration of the illness and alleviate the symptoms, but they do not offer reliable, quick help with herpes.
Early herpes treatment works better
The best way to at least accelerate healing is to start therapy as early as possible. Those affected who suffer from herpes reactivations often have a feeling for the first symptoms of an impending outbreak of the disease. If there are unpleasant sensations, itching or pain in the affected area, you already know that it will not be long before the first fluid-filled blisters appear.
This is the best time to start herpes drug treatment. Some patients even report that they can prevent the outbreak of herpes in this way. The fact that only the early use of antivirals has a significant effect on the course of the disease is explained by the way these drugs work: They can only prevent the virus from multiplying, but cannot destroy "finished" viruses.
Possible problems with herpes treatment with medication
Most of the above-mentioned antiviral drugs are used not only for herpes simplex treatment, but also for other herpes diseases such as Pfeiffer's glandular fever or herpes zoster. Some of them are also used in the treatment of viral diseases outside the herpes group.
This can promote the development of resistance, which means that herpes viruses of all groups are increasingly resistant to the active ingredients. 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 sores on the lip, but it can be dangerous if the therapy fails for complications such as herpes-related encephalitis or blood poisoning due to drug resistance. It is therefore important to use herpes medication sparingly and responsibly. Medicinal herpes treatment is often not necessary at all, since the herpes would heal without any further action after a certain time.
Which treatment for which herpes?
Herpes outbreaks can occur in almost any part of the body, with the face and genital area being the preferred areas for herpes simplex viruses. Herpes simplex viruses of type 1 (HSV1) are usually responsible for infections in the face, for example on the lip or nose, and in the genital area mostly type 2 viruses (HSV2). The antivirals act equally on HSV1 and HSV2, but there are special features in herpes treatment depending on the manifestation.
What to do about herpes on the lip
In most cases, cold sores are harmless even without medication. However, timely antiviral therapy reduces the duration of symptoms such as itching and pain by 20 to 30 percent because it weakens the outbreak of the herpes. Creams that contain acyclovir or penciclovir can help, for example. Studies have not yet sufficiently clarified whether ointments containing zinc sulfate are also effective.
Antivirals are the only thing that helps against herpes on the lip, at least they can shorten the outbreak. The creams for herpes treatment can be applied externally to the affected area. This means that there are fewer side effects. Creams against herpes usually contain additional substances that allow the antiviral active ingredients to penetrate the tissue more quickly. Use is recommended up to five times a day for about five to seven days. The creams should not be used in the mouth, on the mucous membrane of the vagina or on the eyes.
Acyclovir and some other antivirals used to treat herpes on the lip can also be given in tablet form. In the case of very pronounced symptoms or complications of the cold sore, intravenous administration of these active ingredients can also be useful.
Finally, there are also herpes patches that are free of active ingredients and that only create a moisture cushion over the cold sore and thus curb the external spread of the virus via smear infection. Since there is no antiviral active component, this does not reduce the duration of the illness.
What helps with herpes in the genital area?
To help against herpes in the genital area, antivirals are mainly used in tablet form. Topical ointments or creams with antiviral active ingredients are only recommended for mild outbreaks of genital herpes.
When genital herpes occurs for the first time, tablets are given three to five times a day for at least one week, depending on the concentration of the active ingredient. In severe cases, such as when the patient has a pronounced immune deficiency, the herpes medication must be brought into the bloodstream via the veins. The active ingredients used for intravenous infusion are acyclovir, famciclovir, and valaciclovir.
How to treat herpes in the mouth
Herpes in the mouth (aphthous stomatitis) mostly affects children. Because of the severe pain in the entire mouth and throat, they often refuse to eat with this form of herpes. So what can be done to make the child eat again?
On the one hand, there are gels and creams that contain locally anesthetic agents such as lidocaine and which can be applied directly to the diseased mucous membrane in the oropharynx. However, when they come into contact with the tongue, they also suppress the sense of taste. On the other hand, classic pain relievers from the group of non-steroidal anti-inflammatory drugs are available, such as ibuprofen or paracetamol. Both also have an antipyretic effect. Such pain relievers should always be used in children with caution and only on medical advice.
Suitable foods
When choosing food, you should make sure that it does not irritate the oral mucosa as much as possible. Drinks are best given chilled and should not contain acids. Fruit juices are therefore not a good choice, clear water, milk or chamomile tea are better suited. Even solid food causes the least pain if it is pH-neutral, cool and of the softest possible consistency. Acidic foods such as tomato sauce or food that is too dry such as rusks or biscuits, on the other hand, would additionally irritate the areas affected by the herpes.
Herpes treatment with antivirals is not absolutely necessary for stomatitis aphtosa. Since antiviral drugs are also associated with side effects and children are generally more sensitive to them, their use should always be carefully considered. If the doctor decides, for example because the herpes outbreak is very strong, acyclovir is the drug of choice, either as a tablet or intravenously.
Herpes Treatment During Pregnancy
What can you do about herpes if the patient is pregnant? Can antivirals be used during pregnancy or do they harm the child? These questions are of course of concern to an expectant mother if she has a herpes outbreak during pregnancy.
The known antivirals are not officially approved for use during pregnancy. At least for the active ingredient acyclovir, the observations to date have not shown any negative effects for mother or child.
Whether medicinal herpes treatment is necessary during pregnancy depends on the manifestation of the herpes, at what point in pregnancy the herpes occurs and whether it is a first-time infection or a reactivation. The real danger of herpes during pregnancy is possible transmission to the child. Therefore, especially a genital herpes of the mother is dangerous for the child. Other manifestations such as herpes on the face play almost no role in the transmission to the child.
An initial infection with genital herpes poses a greater risk during pregnancy than reactivations. In addition, the closer the occurrence of the herpes is to the due date, the greater the risk of transmission to the child.Because a large part of the contagion happens during childbirth.
If a reactivated genital herpes occurs in the first or second trimester of pregnancy, medication is usually avoided, while an initial infection in this phase of pregnancy often requires herpes treatment with acyclovir in tablet form or intravenously. If the mother is infected for the first time in the first or second trimester, acyclovir can be given three times a day as a preventive measure from the 36th week of pregnancy. With such a suppression therapy one tries to prevent the occurrence of herpes lesions during the birth and thus to protect the child from infection.
Treatment of initial infections in the last trimester of pregnancy
If herpes symptoms appear in the genital area in the last trimester of pregnancy and it is an initial infection, a caesarean section must be considered. Especially if the herpes breaks out in the last six weeks before the birth, the risk of virus transmission to the child during vaginal birth is otherwise very high. If a caesarean section is actually necessary but cannot be performed for certain reasons, acyclovir is not only given to the mother for herpes treatment, but also to the newborn immediately after birth.
What else you should know about herpes treatment
Some people suffer from herpes reactivations very often, sometimes several times a year. In such cases, suppression therapy can often help. For this, the patient receives a low dose of an antiviral continuously for months or even years. Many sufferers can get rid of the typical symptoms of herpes for a long time.
Wrong tips against herpes
By the way, caution is advised with many forum tips against herpes. For example, it is said that if you puncture the vesicles, the herpes will go away quickly ”. On the contrary, this ensures an increased release of the virus and thus an increased risk of infection. If the usual herpes treatment is not an option for you, you should rather ask a doctor or pharmacist for advice.
Tags: menopause pregnancy prevention
