There are four different ways that herpes medications can be used to treat genital herpes:
- To Treat Or Abort An Outbreak When There Are Early Symptoms (Prodrome): For both genital and oral herpes, people can take medication when their specific prodrome tells them an outbreak is about to occur. The medication will stop an outbreak cold (often) and when it does not, it can shorten the outbreak and make it milder than it might have been otherwise.
- To Prevent Outbreaks When There Are No Symptoms But Outbreaks Are More Likely: Patients also learn the life circumstances or behaviors that lead to more outbreaks. For some, a lack of sleep, increased alcohol, another illness, stress, too much sunlight, irritation, or anything that can affect one’s immunity can spur an outbreak. That means that some patients can know not just when they feel an outbreak coming on but can know when they are more likely to have an outbreak due to their circumstances. They might be under stress, having more sex therefore causing more physical irritation, drinking a bit more than they should or missing sleep over an extended period. They will know that they should avoid those triggers and do their best to do so, but they also might want to take medication preventatively knowing they are more vulnerable at that time. Essentially they might take the medication for a week or two until the stress that is making them more susceptible to an outbreak has resolved.
- To Suppress Outbreaks For An Extended Period: Another way patients can take the medication is when they know they absolutely would like to do all they can to reduce their chance of having an outbreak at a pivotal time. The classic example would be during a honeymoon but taking medication to suppress outbreaks on a daily basis can be prudent when going on vacation, starting a new job, in a new relationship, or at any time a patient feels it is how they want to approach their condition. The key is to learn everything you can and do not worry about using the medication in the way that suits you best. That may change as your circumstances change, or as the condition changes, or even as your mind changes.
- To Prevent Transmission to An Uninfected Partner: One of the most important advances in herpes treatment came with the knowledge that transmission from an infected person to their uninfected partner could be reduced by the use of valacyclovir (and other herpes medications). Valacyclovir not only reduces the number of outbreaks a person experiences when using the medication every day but it reduces the number of days that someone sheds the virus asymptomatically. That results in fewer uninfected partners catching herpes. If a condom is worn and the medication used, the chances are reduced at least in half compared to using a condom alone. Fewer outbreaks and fewer episodes of shedding means fewer people become infected.
For oral herpes, medications can be used to abort an outbreak. At that earliest sign that an outbreak is about to occur, take two tablets of Valacyclovir 1000 mg, for a total of 2000 mg, by mouth as the first dose. Then, 12 hours later, take 2 tablets of 1000 mg of Valacyclovir, for a total of 2000 mg, by mouth as the second and final dose. The second dose can be taken sooner than 12 hours but never before 6 hours have passed. Adequate hydration makes sure the medicine is cleared through the kidneys as it should be.
The medication is only approved for two doses and there is no evidence in studies to advise the use of medication once lesions have appeared.
This information is not, nor is it intended to be, a substitute for professional medical advice, diagnosis, or treatment, and should never be relied upon for specific medical advice. If you have any questions or concerns, please talk to your doctor.