Many mild cold sores need no specific treatment; but the general rule in treating herpes simplex is that all treatments work best if they start as soon as possible. It may be hard to know what is happening during a first infection; but in future episodes it is easier to spot the first signs of the virus becoming active, and so to start treatment early.
At the start of an episode of infection - when the area of skin is uncomfortable, tingling or painful - you may need to take a painkiller. Starting treatment with a drug to counteract the virus can help to lessen the severity of the attack and/or shorten it. The anti-viral treatments (acyclovir, famcyclovir or valcyclovir) can be taken as tablets, which have few side effects. Be sure to follow the correct dose, as these treatments often need to be taken frequently. If the attacks are particularly frequent or bothersome, taking a tablet like acyclovir for several months can help to reduce their number, though it may not stop the attacks altogether. Acyclovir and famcyclovir are also available as creams, but these do not work as well as the tablets. Other soothing skin treatments are listed below.
It would be sensible to seek medical advice if you are not sure of the diagnosis or if the treatments you have tried do not seem to help. To avoid delay in treating recurrences, your doctor may give you an extra course of tablets to be kept in reserve and used at the first sign of a flare up. Once you have started this, you will need to order another course for the next episode. If the infection involves the eye it is important to seek medical advice promptly.
Genital herpes can be passed on to a baby during delivery as it passes down the birth passage. Women who have genital herpes should let their obstetrician know during the antenatal period so that measures can be taken to protect the baby.
To avoid triggering an attack
If you have recurrent attacks of herpes simplex, you may be able to avoid things that seem to trigger an attack:
- Avoid getting burnt in the sun or by a sun bed.
- Avoid getting stressed or run down.
- Avoid anything else that you have noticed seems to bring on an attack.
- Keep healthy and get enough sleep.
To avoid spreading
Try also to avoid spreading the infection to someone else. If the infection is active on your skin, do not let that area touch another person’s skin. People at particular risk of developing a severe infection if they catch the virus are:
- The very old.
- The very unwell.
- People, especially children, with eczema.
- Anyone whose immune system is not working well, either because of treatments such as steroids, or because of
- illnesses such as AIDS.
Consider using the following treatments on the skin:
- Sometimes a cool wet compress helps.
- It may be helpful to keep a moisturising cream on the skin – e.g. petroleum jelly
- Wash the area gently; a salt bath or wash can help. Dry thoroughly but gently.
- Use an anti-viral cream on the surface.