Will genital herpes go away after taking acyclovir (antiviral medication)?

Will Genital Herpes Go Away After Taking Acyclovir?

No, acyclovir does not cure genital herpes or make it "go away" permanently—it controls symptoms during active outbreaks and reduces recurrence frequency, but the virus remains dormant in your body for life. 1, 2

What Acyclovir Actually Does

Acyclovir is not a cure for genital herpes. The medication works by:

• Reducing viral replication during active outbreaks, which shortens the duration of symptoms and lesion healing 3, 4
• Controlling symptoms but not eradicating the latent virus from nerve ganglia 1
• Decreasing recurrence frequency by at least 75% when taken as daily suppressive therapy 5, 2
• Reducing (but not eliminating) asymptomatic viral shedding, meaning transmission risk persists even without visible lesions 5, 2

Treatment Outcomes Based on Episode Type

First Episode (Initial Infection)

For your first clinical episode, acyclovir 200 mg orally 5 times daily for 7-10 days will: 1

• Significantly shorten viral shedding duration (median 1.0 vs 8.0 days with placebo) 4
• Reduce pain duration (median 3.5 vs 4.5 days) 4
• Accelerate lesion healing (median 5.5 vs 11.0 days to complete healing) 4
• Prevent new lesion formation during treatment 3, 4

However, after treatment ends, the virus establishes lifelong latency in your sensory nerve ganglia and cannot be eliminated. 1

Recurrent Episodes

For recurrent outbreaks, episodic treatment (acyclovir 400 mg three times daily for 5 days) provides limited benefit unless started at the very first sign of symptoms: 1

• Most immunocompetent patients with recurrent disease do not benefit substantially from episodic treatment because early administration is rarely achieved 5
• When started early, acyclovir reduces viral shedding (median 0.5 vs 2.5 days) and healing time (median 5.0 vs 7.0 days) 4

Long-Term Management: Suppressive Therapy

If you experience frequent recurrences (≥6 episodes per year), daily suppressive therapy is the most effective strategy: 5, 2

• Valacyclovir 1 gram once daily (preferred for ≥10 recurrences/year) 2
• Acyclovir 400 mg twice daily (alternative with documented safety up to 6 years) 5, 2

What Suppressive Therapy Achieves:

• Reduces recurrence frequency by ≥75% 5, 2
• In one study, 45%, 52%, and 63% of patients remained recurrence-free in years 1,2, and 3 respectively 5
• Reduces but does not eliminate asymptomatic viral shedding 5, 2
• May reduce transmission risk when combined with condom use 2

Critical Limitation:

Once you stop suppressive therapy, viral shedding and recurrences return to pre-treatment levels—the virus is still present and reactivates. 6

Transmission Risk Persists

Even with acyclovir treatment, you must understand: 5, 1, 2

• Asymptomatic viral shedding occurs between outbreaks, allowing transmission when no lesions are visible 5
• Abstain from sexual activity when lesions or prodromal symptoms (tingling, burning) are present 5, 1, 2
• Use condoms during all sexual exposures with new or uninfected partners 5, 2
• Inform sex partners about your herpes status 2

Common Pitfalls to Avoid

• Do not use topical acyclovir cream—it is substantially less effective than oral therapy and not recommended 1, 2
• Do not expect cure—patients must be counseled that acyclovir controls but does not eradicate the infection 1, 2
• Do not assume you're non-contagious on treatment—transmission can occur during asymptomatic periods even with suppressive therapy 5, 2

Bottom Line

Acyclovir will help your current outbreak heal faster and can prevent future outbreaks if taken daily, but the herpes virus will remain in your body permanently. The infection does not "go away"—it becomes a manageable chronic condition requiring either episodic treatment for outbreaks or continuous suppressive therapy for frequent recurrences. 5, 1, 2