From the Guidelines
Corticosteroids are not recommended for HSV-2 ulcers as they can worsen the infection by suppressing the immune system. Instead, antiviral medications are the standard treatment for herpes simplex virus type 2 (HSV-2) genital ulcers. The most recent and highest quality study 1 suggests that topical corticosteroids potentiate HSV epithelial infections and should be avoided.
Treatment Options
- First-line treatments include oral acyclovir, valacyclovir, or famciclovir, which work by inhibiting viral DNA replication, reducing the severity and duration of symptoms, and decreasing viral shedding 1.
- For severe cases, intravenous acyclovir may be necessary.
- Pain management with acetaminophen or ibuprofen and keeping the affected area clean and dry are important supportive measures.
- Patients should avoid sexual contact during outbreaks to prevent transmission and should inform sexual partners about their HSV-2 status.
Key Considerations
- Genital herpes is a chronic sexually transmitted infection (STI) characterized by recurrent, self-limited genital ulcers, caused by herpes simplex virus type 1 (HSV-1) or type 2 (HSV-2) 1.
- Accurate diagnosis of genital herpes can be realized using type-specific molecular or virologic tests when genital ulcers are present, and type-specific serologic test to detect antibody when lesions are not present 1.
- Genital herpes can be managed either by episodic antiviral therapy or suppressive antiviral therapy, which can prevent recurrences and shedding 1.
From the Research
Corticosteroids for HSV2 Ulcers
- There is no mention of corticosteroids being used to treat HSV2 ulcers in the provided studies 2, 3, 4, 5, 6.
- The studies focus on antiviral medications such as valaciclovir, famciclovir, and aciclovir as treatments for herpes simplex virus infections, including HSV2 2, 3, 4, 5, 6.
- Some studies compare the efficacy of different antiviral medications, such as valacyclovir and famciclovir, in suppressing recurrent genital herpes and viral shedding 3.
- The use of antiviral medications like valacyclovir, famciclovir, and acyclovir is well-documented in the treatment of herpes simplex virus infections, including HSV2 2, 3, 4, 5, 6.