management

Last reviewed 01/2018

Treatment

  • in healthy patients, the infection is self limited even without treatment (1)
  • treatment in immunocompetent patients is often symptomatic.Topical acyclovir may be indicated.(1)
  • oral anti-viral medications include:
    • acyclovir, famciclovir, valacyclovir
    • indications for systemic use are:
      • if lesions are noticed within 72 hrs (1)
      • to treat an outbreak
      • to suppress herpes recurrences
        • suppressive therapy may be indicated for patients having > 6 recurrences per year (1)
      • to reduce outbreaks
      • to reduce spreading by viral shedding.(2)
      • in severe infections
      • in the immunocompromised
        • tend to have chronic disease
        • require anti-viral therapy (1)
  • oral therapy will reduce pain, viral shedding and time to healing (1)
  • if secondary infection occurs then treat with antibiotics
  • recurrent herpetic infections should not be treated with corticosteroids.(3)

Prevention

  • there is no vaccine that prevents the disease (2)
  • the area of the body where there is a herpes infection should be kept away from other people.
  • with oral herpes, kissing, sharing cups, or lip balms should be avoided
  • persons with genital herpes should avoid sexual relations, including oral/genital contact during active lesions
    • condoms should always be used
      • condoms helps prevent transmission of genital herpes

Note:

  • more detailed information regarding management is found on sections relating to specific infections e.g. cold sores, genital herpes.

Reference: