Are there topical treatments, apart from antivirals, to help heal genital Herpes Simplex Virus type 2 (HSV-2) ulcers?

From the Guidelines

Yes, there are several topical treatments besides antivirals that can help heal genital HSV-2 ulcers. These treatments work primarily by reducing pain, decreasing inflammation, keeping the area clean, or creating protective barriers. Some of the options include:

• Lidocaine 5% ointment or benzocaine to provide pain relief when applied directly to lesions
• Zinc oxide cream to promote healing by supporting skin repair and reducing inflammation
• Witch hazel to reduce inflammation and provide temporary relief
• Warm sitz baths with Epsom salt to soothe discomfort and keep the area clean
• Aloe vera gel to promote healing with its anti-inflammatory properties
• Petroleum jelly to create a protective barrier over ulcers to prevent further irritation However, they don't directly fight the virus like antiviral medications do. It's essential to maintain good hygiene by gently washing the affected area with mild soap and water, wearing loose cotton underwear to reduce friction, and keeping the area dry 1. These topical treatments should complement, not replace, prescribed antiviral therapy for HSV-2 outbreaks. In cases where lesions persist despite antiviral treatment, resistance to the medication should be suspected, and alternative therapies like foscarnet or topical cidofovir gel may be considered 1. The primary goal of managing genital herpes is to prevent symptoms, improve quality of life, and prevent transmission to sexual partners 1. Suppressive antiviral therapy can reduce the frequency of recurrences and subclinical viral shedding, but it does not eliminate the risk of transmission 1. Overall, a comprehensive approach to managing genital HSV-2 ulcers includes antiviral therapy, topical treatments, and good hygiene practices to reduce morbidity, mortality, and improve quality of life.

From the Research

Topical Treatments for Genital HSV2 Ulcers

There are several topical treatments that can be used to help heal genital HSV2 ulcers, apart from antivirals. These include:

• Topical wound care for ulcers caused by sexual trauma 2
• Consideration of subcutaneous pegylated interferon alfa-2a for ulcers caused by Behçet syndrome 2

Alternative Therapies

Some studies suggest that alternative therapies such as:

• Cidofovir and foscarnet could serve as alternative treatments in cases of acyclovir resistance 3
• Novel antiviral approaches include therapeutic vaccines, with the most advanced having successfully completed Phase 2 clinical development 4
• Small molecules approaches are being developed for the treatment of genital or labial HSV infections, including amenamevir and pritelivir 4

Treatment Options

The treatment options for genital ulcers caused by HSV2 include:

• Oral acyclovir, famciclovir, and valacyclovir 2, 5
• Episodic treatment and chronic suppressive therapy 5
• Topical treatments to promote wound healing and reduce symptoms 2, 6