How can I treat herpes? (And. . .will effective therapy have me skipping down the beach with a companion like the TV ads show?)

Treatment is antiviral medications taken orally. There are three on the market.

• Acyclovir (Zovirax®)–the oldest and least expensive antiviral which is taken more often than the newer formulations,
• famciclovir (Famvir®),
• and valacyclovir (Valtrex).

The dose and length of treatment depends upon whether the outbreak is the first episode or is a recurrence.

How should I take the antiviral?  With six outbreaks or less a year, you may consider taking antivirals only during an outbreak. Unfortunately, episodic treatment does not reduce the frequency of outbreaks (but it can decrease the duration by hours to days and the severity). Episodic treatment is most effective when started within 72 hours of the first symptoms. So, it is best to have an antiviral prescription in your home.

In contrast, suppressive therapy is daily low dose antiviral treatment intended to prevent outbreaks. Suppressive therapy is recommended for those with

• six or more recurrences each year,
• a weakened immune system (from HIV or use of immune-suppressing drugs),
• if you are in a sexual relationship with a partner who does not have a history of genital herpes or antibodies to HSV-1 or 2 (as determined by blood testing).

Ways to reduce spreading the virus? Taking suppressive therapy (may reduce virus transmission by half), using a latex condom with EVERY sexual encounter, avoiding sex anytime genital ulcers are present. If there are ulcers or blisters around the mouth, oral sex should not be performed.

Tell your new sexual partners.  Life goes on. . . And be sure to take a walk together.