Genital Herpes (Herpes Simplex Virus Infection)

BASHH Guidelines for the Management of Anogenital Herpes. Last Updated: Oct 2024. NICE CKS Herpes Simplex - Genital. Last Revised: May 2024.

Guidelines

1st line: viral swab for PCR

General advice:
  • Increase fluid intake 
  • Urinate in a bath or with water flowing over the area
  • Abstinence from sexual contact during lesion recurrences / prodromes 

Self-care measures
  • Saline bathing 
  • Analgesia (paracetamol / ibuprofen)
  • Topical petroleum jelly / anaesthetic agent (e.g. 5% lidocaine ointment)

Antiviral therapy is generally indicated for primary infections, exact indications:
  • <5 days of onset
  • New lesions are forming
  • Persistent systemic symptoms 

Recommended 1st line regimens (either):
  • Aciclovir 400mg TDS for 5 days
  • Valaciclovir 500mg BD for 5 days

  • Advice patients that recurrences are self-limiting and generally cause minor symptoms
  • Conservative management is mainstay of treatment 

Consider antiviral therapy if conservative management is inadequate
  • Infrequent episodes (<6/year) → episodic oral antiviral treatment (e.g. aciclovir 800mg TDS for 2 days)
  • Frequent episodes (≥6/year) → suppressive oral antiviral treatment (e.g. aciclovir 400mg BD)
Author: Adams Lau
Reviewer:
Last Edited: 24/03/25