Topical Acyclovir for recurring herpes outbreaks?

[Yana234]

I am new here, just diagnosed two months ago with GHSV-1.  For my first OB, the doctor had me use topical acyclovir cream in addition to the oral Valtrex.  I’m having my first recurrence and treating it with 500mg of Valtrex twice a day for 3 days. Does that sound right or should I do more days?

And, should I be using the topical acyclovir cream again or is it pointless for recurrences? I don’t see anyone mentioning it here.  I’m not even sure if topical is generally indicated for a first OB. I was diagnosed and treated in a developing country with rudimentary healthcare and a doctor who barely spoke English. 
I don’t yet have a doctor here in the US to ask (hence my relying on the interwebs for advice). 

[AlliKat12]

Hello,

I was also prescribed Valtrex for outbreaks.  My dosage is one 500 mg tablet once a day for suppression and two 500 mg tablets a day for 3 days during outbreaks so I believe what you are doing right now should be enough.  You can always use the topical acyclovir as a secondary antiviral if you believe the Valtrex isn't enough.   I have not had a reoccurrence yet but my initial outbreak was terrible.  I took the Valtrex and also used Hydrocortisone with Lidocaine in it for the pain. 

 

[mr_hopp]

Hi @Yana234, welcome!

As @AlliKat12 said, it's common to take 500mg of Valtrex twice a day for a few days as an episodic treatment. So, what you're doing right now sounds on track. And since we're not doctors, take this as peer-to-peer guidance that you can clarify with your doc when you find a good one. (And don't put up with anyone who gives you the least bit of shade or shame about having herpes; there are plenty of good docs out there who are totally understanding!)

As for the topical acyclovir cream, it can be used as a secondary antiviral alongside oral medication if you think it's necessary. Some find it helpful in relieving symptoms, while others may not find it as effective. It's worth a try if you believe it could provide additional relief.

A study named "Efficacy of topical acyclovir cream in first and recurrent episodes of genital herpes" says that topical acyclovir cream showed significant improvements for individuals experiencing both first episodes and recurrent episodes of genital herpes. In both cases, the duration of symptoms, time to healing of lesions, and formation of new lesions were reduced compared to the control groups.

[Yana234]

@AlliKat12 and @mr_hopp These are both super helpful replies, thank you so much. This is my first OB since the primary one two months ago. This one was not bad at all compared to the first one, and tamed down within a couple days. I wouldn’t have really needed the cream for symptoms but I did use it because I had it on hand. Good to know that probably will help, even if just a bit. 

RE doctors and shade - funny story: my primary OB happened in a developing country where the doctor did not bat an eye. In fact, she wondered what all the fuss was about when I started crying. When this recurrence started I went to urgent care here in the US where I grew up - a very conservative, religious, racially homogeneous, sexually repressed small town in the south. I was asking the Nurse Practitioner about how prevalent GH is in this area.  
 

First, he was completely unfamiliar with GHSV-1 and didn’t seem to know it was a thing. He wasn’t judgmental at all, he was just a bit flummoxed. Then I asked him “So, how often do you see GH in general in this practice?” What I was looking for was some level of comfort if he would say “Oh yes, I see it regularly (or even sometimes) here.” He kind of thought about it and wanted to say something comforting so eventually said, “Well I do work in the prisons sometimes…”.  
 

Of course my initial reaction was horror, but now it just makes me giggle. Like WTF have I gotten myself into. 🙂. Can’t keep crying, just gotta laugh at some point.