How to Control Herpes
Outbreaks with Meds

"Recently, I got a cold sore. At least I thought it was a cold sore; but now thinking about it, maybe it was something else, like a fever blister. I had a similar thing happen to me a once or twice before, but I'm pretty sure that happens to all teenagers. In fact, I don’t think it could have been a cold sore at all because my best friend gets cold sores and this was different."

Sound familiar?

Whether you were recently diagnosed with herpes or have been living with it for a while, it’s important to inform yourself about what herpes is, how it impacts your health, and what you can do to identify and prevent the symptoms.

First Things First

For starters, experiencing a "cold sore," "fever blister," "mouth ulcer," "canker" or any "oral lesion" may be a sign of HSV-1 (oral herpes). If you fit into this category, that's totally normal, which is to say, herpes is totally normal. It's also totally treatable, human, and it can’t stop you from living a healthy life. The only thing you shouldn’t do if you have herpes is stress out about it.

So, let's take a deep breath and remember that three-out-of-every-four people are living with herpes. Out of your four closest friends/coworkers/peers, it’s likely that three of them carry the virus—and many do not even know it. If they do, they might not be talking about it because, unfortunately, herpes and other STDs carry social stigmas and are sometimes considered taboo to talk about, which perpetuates the problem of misinformation.

Unless you’ve seen a licensed medical provider about an outbreak, you probably have some questions about the types of treatments available. The key to getting your herpes under control is to get on a treatment plan that controls your specific type of outbreaks and that matches your lifestyle.

Once you begin appropriate treatment, you’ll feel more empowered and can get back to feeling like your normal self.

How To Treat Herpes Outbreaks

There are two different types of antiviral regimens when it comes to treating recurrent genital herpes and oral herpes: suppressive treatment and episodic treatment. Suppressive treatment consists of taking daily antiviral medication to “suppress” the number of outbreaks and thus is often suggested for people who have multiple outbreaks per year. Episodic treatment is more of a “reactive” treatment initiated on the first signs of an outbreak, what is known as the “prodrome,” or first signs of a lesion. Antiviral medications, like acyclovir and valacyclovir, can be used for both types of treatment, although the dosages and the durations vary.

What is Suppressive Treatment?

Suppressive herpes treatment aims to “suppress” and reduce the frequency of herpes outbreaks by taking antiviral medication on a daily basis.

This preventative approach is often prescribed for individuals suffering from frequent outbreaks of six or more times per year. Medical studies report that a suppressive protocol may reduce the frequency of outbreaks by 75%, while for some individuals, a daily antiviral treatment inhibits outbreaks completely.

The quantity of antiviral medication varies, with individuals typically taking 1-2 pills on a daily basis. Additionally, suppressive treatments may prevent the transmission of genital herpes, since it suppresses viral shedding of HSV 2. Suppressive treatment is therefore helpful and effective for couples who want to mitigate the risks of transmitting the STD.

Suppressive Treatment & Medication

Identifying your herpes symptoms and frequency is the first step toward taking back control of your life. Clarity here helps determine whether you are better suited for suppressive or episodic treatment. Some factors that a suppressive treatment plan is right for you, include:

• Frequent outbreaks (typically more than six per year)
• Outbreaks that interfere with daily life and cause physical or emotional pain
• Transmission prevention between couples and sexual partners to reduce the risk of spreading the virus

If you qualify for suppressive treatment, your medical provider will prescribe you Acyclovir or Valacyclovir to take on a daily basis. The CDC suggests one of the following regimens:

• Acyclovir 400 mg orally twice a day OR
• Valacyclovir 500 mg orally once a day OR
• Valacyclovir 1 g orally once a day

Adding in supplements like L-lysine and Organic Antiviral Herbs to your suppressive treatment plan can help boost your body’s ability to fight the virus and keep any outbreaks at bay. Herbal supplements can strengthen your immune system, which is essential to fighting the virus.

What is Episodic Treatment?

While suppressive treatment focuses on lowering the frequency of outbreaks, an episodic herpes regimen aims to reduce the symptoms and duration of a recurrent outbreak. With episodic treatment, an individual takes antiviral medication at the onset of an outbreak, ideally at the first indications of prodrome. Prodrome refers to the tingling, itching, or burning sensation which occurs right before any lesions appear. Once the lesions appear, the episodic treatment becomes less effective. The antiviral medication is continued for a few days to shorten or even prevent a full-blown outbreak. Dosage and length of the antiviral medication varies, with anywhere from one to five pills daily for three to five days.

Episodic Care & Medication

If your medical provider feels that an episodic treatment plan is right for you, your symptoms may match the following:

• Infrequent outbreaks (less than six per year)
• Outbreaks cause mild pain or discomfort
• You are able to detect early signs of an outbreak, allowing you to treat it before the virus advances (ideally within the prodrome phase)

Both acyclovir and valacyclovir are effective in an episodic treatment plan. The CDC suggests one of the following episodic treatment regimens:

• Acyclovir 400 mg orally three times a day for 5 days OR
• Acyclovir 800 mg orally twice a day for 5 days OR
• Acyclovir 800 mg orally three times a day for 2 days OR
• Valacyclovir 500 mg orally twice a day for 3 days OR
• Valacyclovir 1 g orally once a day for 5 days

Creating a Personalized Treatment Plan

You may be wondering which option is best for you. While both a suppressive treatment plan and episodic treatment plan are effective, choosing the right plan can have a significant impact on the frequency and duration of your cold-sore/herpes outbreaks.

Taking the next step can be difficult, especially when it involves an awkward in-person medical provider visit. At Wisp, you can chat discreetly with a US licensed medical provider and avoid the most embarrassing step in establishing care. With your personalized treatment plan, it’s easy to speak with your medical provider whenever you need to, as well as manage current prescriptions through your HIPAA compliant Patient Dashboard.

Effectively managing your outbreaks begins with a better self-care routine established between you and your licensed medical provider—and is the first step to living a better life.