Genital herpes is common and treatable, although it cannot be cured. Antiviral pills shorten outbreaks and, taken every day, prevent most of them. This guide covers the treatments that CDC's 2021 STI treatment guidelines recommend, what online services such as Wisp offer, and the points to raise with whoever prescribes for you.
This page explains treatment options and is not medical advice. If you have new genital sores, see a clinician who can test them.
How genital herpes is diagnosed
Genital herpes is caused by herpes simplex virus type 2 (HSV-2) or, increasingly, type 1 (HSV-1). CDC recommends that sores be confirmed by a test taken from the sore itself, a nucleic acid test (NAAT) or culture, and notes that "HSV NAAT assays are the most sensitive tests". The virus should be typed as HSV-1 or HSV-2, because the type predicts how often outbreaks return: "Recurrences and subclinical shedding are much more frequent for HSV-2 genital herpes infection than for HSV-1 genital herpes" (CDC STI Treatment Guidelines: Genital Herpes).
Swab tests work best on fresh sores. CDC warns that culture sensitivity "decreases rapidly as lesions begin to heal". Blood tests for HSV antibodies can help when there are no sores, but CDC says they should be type-specific, that a common HSV-2 test "often is falsely positive at low index values (1.1–3.0)", and that "HSV-2 serologic screening among the general population is not recommended". CDC also advises that "all persons with genital herpes should be tested for HIV" (CDC: Genital Herpes). Our at-home STI test guide covers the self-tests that are available for HIV and syphilis.
An online consult cannot swab a sore, and Wisp's herpes FAQ says it does not require a test. If this is your first outbreak, getting it tested at a clinic, urgent care or health department before it heals gives you a firm diagnosis and the virus type. CDC's GetTested locator lists testing sites.
Antiviral treatment for genital herpes
Three antiviral pills are used: acyclovir, valacyclovir and famciclovir. Tier: FDA-approved prescription medicines. The Valtrex (valacyclovir) label lists the initial episode, recurrent episodes, daily suppressive therapy and reduction of transmission among its indications for genital herpes in immunocompetent adults (and suppression in adults with HIV) (Valtrex (valacyclovir) — DailyMed Drug Label). None of them removes the virus. The label states that patients "should be informed that VALTREX is not a cure for genital herpes", and CDC says the antivirals "neither eradicate latent virus nor affect the risk, frequency, or severity of recurrences after the drug is discontinued" (CDC: Genital Herpes).
CDC's recommended regimens, adapted from its 2021 guidelines (CDC: Genital Herpes):
| Situation | Acyclovir | Valacyclovir | Famciclovir |
|---|---|---|---|
| First outbreak | 400 mg 3 times a day for 7–10 days | 1 g 2 times a day for 7–10 days | 250 mg 3 times a day for 7–10 days |
| Recurrent outbreak (HSV-2), episodic | 800 mg 2 times a day for 5 days, or 3 times a day for 2 days | 500 mg 2 times a day for 3 days, or 1 g once daily for 5 days | 1 g 2 times a day for 1 day, and other schedules |
| Daily suppression (HSV-2) | 400 mg 2 times a day | 500 mg or 1 g once a day* | 250 mg 2 times a day |
*CDC notes that valacyclovir 500 mg once a day "might be less effective" than other regimens for people with 10 or more outbreaks a year, and that famciclovir "appears somewhat less effective for suppression of viral shedding". These are general adult regimens. The Valtrex label gives a different suppressive dose for adults with HIV and says the dose should be reduced in kidney disease, and CDC lists separate regimens for pregnancy. Your prescriber should check which applies to you.
First outbreak
CDC says "all patients with first episodes of genital herpes should receive antiviral therapy", and that treatment "can be extended if healing is incomplete after 10 days of therapy". The Valtrex label notes that its benefit has not been established when treatment starts more than 72 hours after symptoms begin, so do not wait.
Recurrent outbreaks: treating each one
Episodic treatment means keeping pills on hand and starting them as soon as an outbreak begins. CDC says it is "most effective if therapy is initiated within 1 day of lesion onset or during the prodrome that precedes some outbreaks", the tingling or burning some people feel first. It recommends giving patients a supply or prescription in advance "with instructions to initiate treatment immediately when symptoms begin", and says the three drugs "appear equally effective for episodic treatment". The Valtrex label adds that its benefit for a repeat outbreak has not been established when treatment starts more than 24 hours after symptoms begin (CDC: Genital Herpes).
Daily suppressive therapy
Taking an antiviral every day prevents most outbreaks. CDC says "Suppressive therapy reduces frequency of genital herpes recurrences by 70%–80% among patients who have frequent recurrences", that people taking it "often report having experienced no symptomatic outbreaks", and that it "also is effective for patients with less frequent recurrences". CDC suggests reviewing each year whether to continue, and says "neither treatment discontinuation nor laboratory monitoring is necessary". For HSV-1 genital herpes, which recurs less often, CDC says suppressive therapy "should be reserved for those with frequent recurrences" (CDC: Genital Herpes).
Lowering the risk of passing herpes on
Daily valacyclovir also lowers the chance of infecting a partner. In a trial of 1,484 heterosexual, monogamous couples, partners with HSV-2 took valacyclovir 500 mg once daily or a placebo for eight months. Symptomatic genital herpes developed in 4 of 743 susceptible partners in the valacyclovir group, compared with 16 of 741 in the placebo group. Counting infections without symptoms too, 1.9% of partners caught HSV-2 in the valacyclovir group and 3.6% in the placebo group. Both partners were counseled on safer sex and offered condoms PMID: 14702423.
The benefit has limits. The Valtrex label says its effect on transmission has not been established beyond 8 months, or in people with multiple partners or in non-heterosexual couples. It also says safer sex practices should be used alongside suppressive therapy. CDC adds that condoms "can reduce, but not eliminate, the risk" and are "less effective for preventing transmission from women to men", and advises avoiding sex with an uninfected partner "when lesions or prodromal symptoms are present" (CDC: Genital Herpes). Our condom guide compares latex and latex-free condoms.
Do herpes creams work?
Not well, according to CDC: "Topical therapy with antiviral drugs offers minimal clinical benefit and is discouraged" (CDC: Genital Herpes). Antiviral pills are the recommended treatment. Wisp describes its lidocaine cream as relieving outbreak pain; a numbing cream does not act on the virus itself.
Side effects and safety
In the Valtrex trials, the most common side effects in adults were headache, nausea and abdominal pain. The label's warnings include kidney problems, especially in older people, people with kidney disease and people who are dehydrated, so it advises that "Adequate hydration should be maintained for all patients". It also warns of nervous system effects such as confusion or agitation, which are more likely in older people, and of severe skin reactions reported after the drug was marketed: stop the drug and get help if a painful rash affecting the mouth or other mucous membranes, or a spreading severe rash, develops (Valtrex (valacyclovir) — DailyMed Drug Label).
Pregnancy. Tell your prenatal provider if you or a partner have genital herpes. CDC says the risk to a newborn is high (30% to 50%) when herpes is caught near the time of delivery, and low (under 1%) for women with a history of recurrent herpes. The under-1% figure also covers women who catch herpes in the first half of pregnancy. For women with recurrent genital herpes, CDC recommends suppressive treatment starting at 36 weeks, and a cesarean delivery if herpes sores are present when labor starts (CDC: Genital Herpes). This is a decision for your obstetric care team, not an online service.
Get urgent care if you feel severely unwell during an outbreak. CDC says severe complications, such as meningitis or encephalitis, need intravenous acyclovir, and some need hospital care (CDC: Genital Herpes).
Getting herpes treatment online
Some telehealth services prescribe herpes antivirals after an online questionnaire. Tier: telehealth service (prescribes FDA-approved antiviral pills; its creams are compounded, which means not FDA-approved). Wisp LegitScript status not verified is one. On October 12, 2026, its genital herpes page listed (Wisp, genital herpes):
- A first-outbreak consult at "$65", which says "Medication costs may apply at the pharmacy" (Wisp, first outbreak consult).
- Valacyclovir and acyclovir for outbreaks and prevention, "Starting at $10 / month", with a "one-time treatment or 3, 6, or 12-month subscription". The page lists 500 mg and 1,000 mg valacyclovir and 400 mg and 800 mg acyclovir, but not the regimen or pill count. The lowest monthly price is for acyclovir on a 12-month supply paid once ($120), and for pharmacy pickup it says "Medication costs may apply at pharmacy" (Wisp, valacyclovir and acyclovir).
- Acyclovir cream (10%), "Starting at $30". Wisp says it "is compounded in our specialty pharmacy and is not available at local pharmacies" (Wisp, acyclovir cream). CDC discourages antiviral creams, as described above.
- Lidocaine-amitriptyline cream (lidocaine 5%, amitriptyline 2%) for outbreak pain, "Starting at $30". Wisp says it "is compounded in our specialty pharmacy" (Wisp, lidocaine-amitriptyline cream).
Compounded products are not FDA-approved: FDA states that it "does not verify the safety, effectiveness or quality of compounded drugs before they are marketed" (FDA: Compounding and the FDA, questions and answers).
- Supplements (L-lysine and an herbal product), from $27. They are not antiviral medicines; every regimen CDC recommends is an antiviral drug.
Wisp says "Most prescriptions are sent to your pharmacy within 3 hours of completing your medical intake form and phone call or video chat when necessary", that it uses "board-certified medical providers", and that you can pick up at a local pharmacy or have it delivered. Its site shows a LegitScript seal, which this site has not yet confirmed on LegitScript's directory (what this means).
Questions to ask any online service:
- Which drug, dose and number of pills will I get, and is it for episodic or daily treatment?
- Does the price include the consult, and what will the pharmacy charge?
- Can you arrange a swab test if this is my first outbreak?
- Will the prescriber check my kidney function, other medicines and pregnancy plans?
Generic acyclovir and valacyclovir are older, widely available medicines, so it is worth comparing a telehealth price with your insurance copay or a pharmacy discount price.
Telling partners
CDC recommends telling current partners and "informing future partners before initiating a sexual relationship", and notes that "most genital herpes infections are transmitted by persons unaware that they have the infection or who are asymptomatic when transmission occurs". Partners without symptoms can be offered a type-specific HSV-2 blood test (CDC: Genital Herpes).