Genital Herpes

Medical information

Written and reviewed by a team of doctors. Dr Fox is regulated by the CQC & GPhC.

If you have previously been diagnosed with genital herpes, and you are confident that you recognise the symptoms of repeat outbreaks, you can request treatment from Dr Fox pharmacy.

If you are aged under 18 please contact your GP or a local sexual health clinic for testing and treatment:

• England
• Wales
• Scotland
• Northern Ireland

Diagnosis and check-up before treatment

Not every sore in the genital area is caused by herpes. It is important to see a doctor or visit a Sexual Health Clinic to have a diagnosis and to be tested for other sexually transmitted infections. Do NOT self-treat with antiviral medication without getting a medical diagnosis first. New sores in different places are unlikely to be caused by herpes. Aciclovir 400mg tablets are for the treatment of herpes sores in the vaginal area, on or around the penis, and in the region of the anus (back passage) - see photos of herpes. More photos of herpes on genitalia available from DermNet NZ.

Treatment with aciclovir

A 5-day course of aciclovir tablets will typically reduce the duration of genital herpes sores by one or two days. It also reduces severity of symptoms and infectiousness. If taken early enough, aciclovir may prevent sores from breaking open. A course of aciclovir will not prevent future outbreaks. Aciclovir cream is not recommended for treatment of genital herpes as it offers minimal benefit.

Suppression with aciclovir

If attacks are frequent (six or more attacks per year) guidelines recommend considering suppressive antiviral treatment. This involves taking aciclovir 400mg twice a day continuously for 6 months and up to a maximum of 12 months. Be aware you may get an outbreak 4-5 days after stopping long-term treatment. This is not a sign you will start to have repeated outbreaks. However if you have 2 or more reoccurrences on stopping then you can consider restarting suppressive treatment.

If breakthrough recurrences occur during suppressive treatment please notify your GP or visit a sexual health clinic.

Is herpes infectious?

When herpes sores are open and active, the virus is more infectious, however if you have the virus it can be spread to others even when you don't have sores. Using condoms provides some protection from transmission, but this protection is not 100% effective. Spread can still take place.

There is currently no genital herpes vaccine.

The following steps will help to reduce infection:

• Using condoms for all sexual contact, including oral and anal sex. Avoid all sexual contact if you or your partner have blisters or sores, or other signs that a herpes sore is developing.
• Avoid contact with blisters and sores - wash your hands if this occurs.
• Avoid sharing sex toys and use them with a condom.
• Managing stress - a common trigger for an outbreak.

Aciclovir dosage

Repeat genital herpes

Start treatment early, preferably in the first 24-48 hours of a new sore. Take one 400mg tablet three times daily 8 hours apart for 5 days. 15 tablets is enough for one course of treatment.

Suppression of genital herpes

Take one 400mg tablet twice a day 12 hours apart for a minimum of 6 months. Can be taken for up to 12 months, then a trial stopping treatment is advised.

Swallow tablets whole with plenty of fluids, or dissolve in water. Can be taken with or without food. Seek medical advice if treatment is not effective or there are new symptoms or side effects. It is important to drink plenty of water whilst taking aciclovir, and to avoid alcohol.

Can anyone take aciclovir?

People over 65 years, those diagnosed with kidney disease (impaired renal function), some neurological conditions, and women who are pregnant or breastfeeding may not be able to take aciclovir. Checks are carried out during the online consultation and advice is given. Dr Fox pharmacy supplies medicine only to adults (over 18s).

If you experience a bout of herpes during pregnancy or while breastfeeding, visit your doctor to discuss treatment options. Aciclovir should not interfere with contraception.

Aciclovir tablets and other medication

People taking the following medications should consult a doctor or pharmacist before taking aciclovir:

• Probenecid (used to treat gout).
• Cimetidine (used to treat stomach ulcers).
• Mycophenolate mofetil (used to stop your body rejecting transplanted organs).
• Ciclosporin (an immunosuppressant drug).
• Theophylline (used in asthma and other breathing problems).
• Zidovudine (used in HIV infection).

Side effects of aciclovir

Like all medicines, aciclovir can cause side effects, although not everybody gets them.

If you have an allergic reaction (may affect up to 1 in 1,000 people) stop taking aciclovir 400mg tablets and see a doctor straight away.

Common side effects include headache, feeling dizzy or sick, diarrhoea, stomach pains, rash, skin reaction after exposure to light (photosensitivity), fatigue, and fever.

See the patient information leaflet for further details.

Dr Fox supplies genital herpes medication on prescription - you are required to answer a short medical questionnaire before your order can be completed.

Authored 26 February 2020 by Dr Tony Steele
MB ChB Sheffield University 1983. Former hospital doctor and GP.

Reviewed by Dr A. Wood, Dr C. Pugh, Dr B. Babor, Dr P. Hunt
Last reviewed 07 April 2021
Last updated 15 October 2021

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