Skin Therapy Letter HOME
Written for dermatologists by dermatologists. Indexed by the US National Library of Medicine.
Skin Information
Skin Therapy Letter About STL Subscribe Today

Herpes Treatment Charts

Not everyone will need to be treated when they have genital herpes or cold sores. The decision to treat or not is up to you and your healthcare provider.

Treatment is generally needed for severe primary herpes infections and includes pain killers as well as antiviral drugs. The latter shorten the duration of the outbreak and reduce viral shedding time. Antiviral drugs also shorten the length of an outbreak of recurrent herpes infections if they are used early enough.

Valacyclovir and famciclovir are more bioavailable than acyclovir. This means that more of the drug is absorbed into the body after swallowing the tablet or capsule, allowing the drug to be taken less often for a given effect. By taking a drug less often, such as once or twice a day, you are more likely to remember to take all the doses (improved compliance).

The following tables contain the dosages to be used for each drug approved by Health Canada to treat herpes infections in people with normal immune systems.

Table 1 : Treatment of Cold Sores

Drug name

Dosage for Treatment of Recurrent Disease Outbreak

Acyclovir cream (Zovirax ®)

Apply 4-6 times daily until healed

Docanosol cream (Abreva®)

At prodrome, apply 5 times a day until healed

Valacyclovir capsules (Valtrex ®)

2 grams every 12 hours for one day; will prevent the outbreak of cold sores if taken early in the prodrome

Table 2: Treatment of Genital Herpes

Drug name

Dosage for Primary or First Episode

Dosage for Treatment of Recurrent Disease Outbreak

Dosage for the Suppression of 50%-78% of Recurrent Disease

Acyclovir (Zovirax ®)

400 mg three times a day for 7-10 days

(i). 800 mg twice a day or (ii). 400 mg three times a day, each for 5 days

400 mg twice daily; shown to be safe and effective for at least 3 years; has also been used for much longer periods

Famciclovir (Famvir ®)

250 mg three times a day for 7 – 10 days

125 mg twice a day for 5 days

250 mg twice daily

Valacyclovir (Valtrex ®)

1g twice a day for 7 – 10 days

500 mg twice a day for 5 days

i). 500 mg once daily for people with less than 10 episodes/yr;

(ii). 1 g once daily for those with more than 10 episodes/yr

Are there any vaccines?

No vaccines are currently available for the prevention of HSV infection, but medical researchers are working actively in order to produce a safe and effective vaccine.