Online Herpes Treatment: Complete Guide

Herpes simplex virus (HSV) affects millions of people worldwide, with HSV-2 (genital herpes) affecting about 1 in 6 Americans aged 14-49, and HSV-1 (oral herpes/cold sores) affecting 50-80% of adults. While there’s no cure for herpes, modern antiviral medications provide highly effective management of outbreaks and can significantly reduce transmission risk.

Telehealth platforms now offer convenient, discreet access to herpes treatment without the need for awkward in-person visits. This comprehensive guide covers everything you need to know about treating herpes online.

Understanding Herpes (HSV-1 and HSV-2)

HSV-1 (Oral Herpes)

• Primary site: Mouth and lips (cold sores/fever blisters)
• Prevalence: 50-80% of U.S. adults
• Transmission: Oral contact, kissing, sharing utensils
• Note: Can also cause genital herpes through oral sex

HSV-2 (Genital Herpes)

• Primary site: Genital and anal area
• Prevalence: ~12% of Americans (1 in 6 people aged 14-49)
• Transmission: Sexual contact (vaginal, anal, or oral)
• Note: Can be transmitted even without visible symptoms (asymptomatic shedding)

Outbreak Phases

1. Prodrome (Warning Phase)

• Tingling, itching, or burning sensation
• Occurs hours to days before visible sores
• Best time to start episodic treatment

2. Active Outbreak

• Small, painful blisters or sores
• Flu-like symptoms (first outbreak)
• Lasts 2-4 weeks (first outbreak) or 3-7 days (recurrent)

3. Healing Phase

• Sores crust over and heal
• Risk of transmission decreases but still present
• Avoid sexual contact until completely healed

4. Latency

• Virus dormant in nerve cells
• No symptoms but asymptomatic viral shedding possible
• Can be triggered into active outbreak by various factors

Treatment Options: Episodic vs. Suppressive

Episodic Therapy (As-Needed Treatment)

Used for treating active outbreaks

Best for:

• Infrequent outbreaks (less than 6 per year)
• First outbreak
• People who can recognize prodrome symptoms early
• Cost-conscious users with occasional symptoms

How it works:

• Take medication at first sign of outbreak (tingling, itching)
• Continue for 3-5 days depending on medication and dosage
• Shortens outbreak duration by 1-2 days
• Reduces severity of symptoms

Key: Start within 24 hours of first symptoms for best results

Suppressive Therapy (Daily Prevention)

Used to prevent recurrent outbreaks

Best for:

• Frequent outbreaks (6 or more per year)
• People in serodiscordant relationships (one partner has herpes, one doesn’t)
• Anyone wanting to minimize outbreak frequency
• Those experiencing significant psychological distress from outbreaks

How it works:

• Take medication daily, even when symptom-free
• Reduces outbreak frequency by 70-80%
• Reduces asymptomatic viral shedding
• Lowers transmission risk to partners by approximately 50%

Benefits:

• Fewer outbreaks (many people become outbreak-free)
• Peace of mind
• Reduced transmission risk
• Can improve quality of life significantly

Antiviral Medications for Herpes

1. Valacyclovir (Generic Valtrex)

MOST POPULAR HERPES MEDICATION

How It Works

• Prodrug of acyclovir (converts to acyclovir in the body)
• Blocks viral DNA replication
• Prevents virus from multiplying

Dosing Regimens

Episodic Treatment (Outbreaks):

• Initial outbreak: 1000mg twice daily for 7-10 days
• Recurrent outbreaks: 500mg twice daily for 3 days
  • OR 1000mg once daily for 5 days

Suppressive Therapy (Prevention):

• Standard dose: 500mg once daily
• Frequent outbreaks (10+ per year): 1000mg once daily
• HIV-positive patients: 500mg twice daily

Effectiveness

• Episodic: Shortens outbreak by 1-2 days when started early
• Suppressive: Reduces outbreak frequency by 70-80%
• Transmission reduction: ~50% when combined with safe sex practices

Advantages

• ✅ Once or twice daily dosing (better compliance than acyclovir)
• ✅ Better absorption than acyclovir
• ✅ Most prescribed herpes medication
• ✅ Extensive safety data
• ✅ Can be used long-term

Side Effects

Common (5-10%):

• Headache
• Nausea
• Abdominal pain

Less Common (<5%):

• Dizziness
• Fatigue

Rare:

• Kidney problems (especially at high doses or with dehydration)
• Thrombotic thrombocytopenic purpura (extremely rare)

Cost

• Generic valacyclovir: $15-60 per month
• Brand-name Valtrex: $200-400 per month

2. Acyclovir (Generic Zovirax)

ORIGINAL HERPES ANTIVIRAL

Dosing Regimens

Episodic Treatment:

• Initial outbreak: 200mg five times daily for 7-10 days
  • OR 400mg three times daily for 7-10 days
• Recurrent outbreaks: 200mg five times daily for 5 days
  • OR 800mg twice daily for 5 days
  • OR 800mg three times daily for 2 days

Suppressive Therapy:

• 400mg twice daily

Effectiveness

• Comparable to valacyclovir in effectiveness
• Reduces outbreak frequency and severity
• Proven track record (approved 1982)

Advantages

• ✅ Slightly cheaper than valacyclovir
• ✅ Longest safety track record
• ✅ Multiple dosing options

Disadvantages

• ❌ More frequent dosing required (3-5 times daily)
• ❌ Lower bioavailability than valacyclovir
• ❌ Less convenient for busy lifestyles

Cost

• Generic acyclovir: $10-40 per month

3. Famciclovir (Famvir)

ALTERNATIVE ANTIVIRAL

Dosing Regimens

Episodic Treatment:

• Recurrent outbreaks: 1000mg twice daily for 1 day
  • OR 125mg twice daily for 5 days

Suppressive Therapy:

• 250mg twice daily

Effectiveness

• Similar to valacyclovir and acyclovir
• Particularly effective for single-day treatment

Advantages

• ✅ Single-day treatment option for episodic therapy
• ✅ Effective alternative if valacyclovir not tolerated

Disadvantages

• ❌ More expensive than valacyclovir and acyclovir
• ❌ Less commonly prescribed
• ❌ Fewer telehealth platforms offer it

Telehealth Platforms for Herpes Treatment

Our Top Recommendations

Best Overall: Ro offers comprehensive valacyclovir treatment ($15 consultation + medication cost) with free 2-day shipping, discreet packaging, and both episodic and suppressive therapy options. Great for fast, reliable herpes care.

Best for Privacy: Nurx provides ultra-discreet packaging and billing with easy automatic refills. Some insurance accepted. Perfect if privacy is your top concern.

Best for Affordability: Lemonaid Health offers bundled consultation + medication pricing with free shipping. Ideal for budget-conscious treatment.

Compare all herpes treatment services to find the best option for your needs.

Ro (Roman)

Comprehensive Herpes Treatment Platform

• Medications: Valacyclovir for genital and oral herpes
• Consultations: $15 initial consultation (includes unlimited follow-ups)
• Episodic therapy: Available for as-needed treatment
• Suppressive therapy: Daily prescriptions available
• Shipping: Free 2-day shipping
• Packaging: Discreet, unmarked boxes
• Cost: Varies by prescription, competitive pricing
• Best for: Fast shipping and comprehensive service
• Website: ro.co/genital-herpes or ro.co/cold-sores

Nurx

Convenient Online Herpes Care

• Medications: Valacyclovir for genital and oral herpes
• Process: Online consultation → prescription → free delivery
• Shipping: Free to your door
• Packaging: Plain, discreet packaging
• Refills: Easy automatic refills
• Insurance: May accept insurance for some services
• Best for: Hassle-free prescriptions and refills
• Cost: Competitive cash-pay pricing

Lemonaid Health

Affordable Telehealth Option

• Medications: Acyclovir and valacyclovir
• Consultation: Asynchronous (no video required in most states)
• Shipping: Free, 2-3 business days
• Cost: Medication + consultation bundled pricing
• Packaging: Discreet
• Best for: Simple, affordable treatment
• Note: Available in most states

Everlywell

Genital and Cold Sore Treatment

• Medications: Acyclovir and valacyclovir
• Process: Online visit → prescription if appropriate → home delivery
• Services: Both episodic and suppressive therapy
• Best for: People wanting comprehensive telehealth
• Features: Ongoing provider support

Hers (For Women, Some States Serve Men)

Primarily Women’s Health Platform

• Medications: Valacyclovir for genital herpes
• Audience: Primarily women, but some states allow male patients
• Process: Online consultation → prescription → delivery
• Best for: Women, or men in states where service is available

Call-On-Doc

Budget-Friendly Option

• Consultation fee: $45 (standard), $79 (live visit if required)
• Medications: Acyclovir and valacyclovir
• Process: Online form → physician review → prescription
• Best for: Cost-conscious users
• Turnaround: Quick prescription process

RexMD (LifeMD)

Men’s Health Platform

• Focus: Comprehensive men’s health including herpes
• Medications: Herpes outbreak management treatments
• Consultation: Online health assessment
• Best for: Men managing multiple health concerns
• Website: rexmd.com

State-Specific Requirements

States requiring live video consultation for herpes prescriptions:

• Alaska (AK)
• Arkansas (AR)
• Washington D.C. (DC)
• Delaware (DE)
• Idaho (ID)
• Kansas (KS)
• Louisiana (LA)
• Mississippi (MS)
• New Mexico (NM)
• Oklahoma (OK)
• Rhode Island (RI)
• Vermont (VT)
• West Virginia (WV)

All other states typically allow asynchronous (questionnaire-based) consultations.

How Online Herpes Treatment Works

Step 1: Initial Consultation

• Complete confidential health questionnaire
• Outbreak history (frequency, severity, triggers)
• Medical history and current medications
• Sexual health information
• Treatment goals (episodic vs. suppressive)

Step 2: Provider Review

• Licensed physician or nurse practitioner evaluates
• Determines appropriate treatment approach
• Prescribes medication if medically appropriate
• May require live video visit depending on state

Step 3: Prescription

• Provider prescribes valacyclovir or acyclovir
• Episodic or suppressive therapy based on your needs
• Dosage customized to your situation

Step 4: Discreet Delivery

• Medication shipped in plain, unmarked packaging
• Typically arrives within 2-3 business days
• Free shipping on most platforms
• No indication of contents on package

Step 5: Ongoing Care

• Easy prescription refills
• Adjust treatment as needed
• Unlimited messaging with providers (many platforms)
• Switch between episodic and suppressive therapy as needed

Cost Comparison

Consultation Fees

Platform	Initial Consultation	Follow-Ups
Ro (Roman)	$15	Unlimited (free)
Nurx	Varies/included	Included
Lemonaid	Included in medication	Included
Everlywell	Varies	Varies
Call-On-Doc	$45-79	As needed

Medication Costs (Monthly)

Episodic Therapy (per outbreak):

• Generic valacyclovir: $15-30 per outbreak (3-5 day supply)
• Generic acyclovir: $10-25 per outbreak

Suppressive Therapy (monthly):

• Generic valacyclovir 500mg daily: $30-60/month
• Generic acyclovir 400mg twice daily: $20-40/month
• Brand-name Valtrex: $200-400/month (rarely needed)

Insurance: Most telehealth platforms don’t accept insurance for herpes treatment, but generic prices are often lower than insurance copays.

Transmission Prevention

With Suppressive Therapy

• Reduces transmission risk to partners by approximately 50%
• Most effective when combined with:
  • Consistent condom use
  • Avoiding sex during outbreaks
  • Open communication with partners

Additional Prevention Strategies

Always:

• ✅ Disclose herpes status to sexual partners
• ✅ Use condoms consistently and correctly
• ✅ Avoid sexual contact during active outbreaks
• ✅ Take suppressive therapy if in serodiscordant relationship
• ✅ Recognize prodrome symptoms and abstain during that period

Consider:

• Daily suppressive therapy to reduce asymptomatic shedding
• Extra precautions during times of high viral activity
• Partner getting tested to confirm serostatus

Reality: Even with all precautions, transmission risk cannot be reduced to zero, but can be minimized significantly.

Triggers and Outbreak Prevention

Common Outbreak Triggers

Lifestyle Factors:

• Stress and anxiety
• Lack of sleep/poor sleep quality
• Fatigue and exhaustion
• Weakened immune system

Physical Factors:

• Illness or infection
• Sun exposure (especially for oral herpes)
• Hormonal changes
• Physical trauma to affected area

Dietary Factors:

• High arginine foods (chocolate, nuts, seeds)
• Alcohol consumption
• Poor nutrition

Preventing Outbreaks

Daily Habits:

• ✅ Get 7-9 hours quality sleep
• ✅ Manage stress (meditation, exercise, therapy)
• ✅ Eat balanced diet rich in lysine
• ✅ Stay hydrated
• ✅ Regular exercise (boosts immune function)
• ✅ Take daily suppressive medication if appropriate

Avoid:

• ❌ Excessive stress
• ❌ Sleep deprivation
• ❌ Excessive alcohol
• ❌ Prolonged sun exposure without protection

Supplements (some evidence):

• Lysine: 1000-3000mg daily (may reduce outbreak frequency)
• Vitamin C, zinc: Support immune function
• Consult provider before starting supplements

When to Choose Episodic vs. Suppressive Therapy

Choose Episodic Therapy If:

• You have 5 or fewer outbreaks per year
• Outbreaks are mild and manageable
• You can recognize prodrome symptoms early
• Not currently in a sexual relationship
• Prefer to minimize daily medication use
• Cost is a primary concern

Choose Suppressive Therapy If:

• You have 6 or more outbreaks per year
• Outbreaks significantly impact quality of life
• You’re in a sexual relationship (especially serodiscordant)
• You want to minimize transmission risk to partners
• Outbreaks are severe or prolonged
• Psychological distress from unpredictable outbreaks

Switching Between Therapies

• You can switch from episodic to suppressive anytime
• Keep episodic medication on hand even while on suppressive therapy (for breakthrough outbreaks)
• Discuss with provider to adjust as your needs change

First Outbreak vs. Recurrent Outbreaks

Initial/First Outbreak

• Severity: Usually most severe
• Duration: 2-4 weeks
• Symptoms: Painful sores, flu-like symptoms, swollen lymph nodes
• Treatment: Longer course (7-10 days) of higher-dose antivirals
• Importance: See provider for proper diagnosis and testing

Recurrent Outbreaks

• Severity: Milder than first outbreak
• Duration: 3-7 days typically
• Symptoms: Localized sores, tingling/itching prodrome
• Treatment: Shorter course (1-5 days) or suppressive therapy
• Pattern: Frequency often decreases over time

Safety and Long-Term Use

Safety Profile

• Valacyclovir and acyclovir are very safe medications
• Extensive safety data from decades of use
• Can be taken long-term for suppressive therapy
• Few drug interactions
• Safe for most people

Who Should Avoid or Use Caution

• Kidney disease: Requires dose adjustment
• Immunocompromised: May need higher doses under supervision
• Pregnancy: Generally safe but consult OB-GYN first
• Breastfeeding: Small amounts pass into breast milk, discuss with doctor
• Allergies: To acyclovir, valacyclovir, or famciclovir

Long-Term Suppressive Therapy

• Safe for years of continuous use
• Many people take suppressive therapy for 5-10+ years
• Periodic re-evaluation with provider recommended
• Can stop and restart as needed

Privacy and Discretion

Confidentiality

• ✅ All telehealth platforms are HIPAA-compliant
• ✅ Medical information kept strictly confidential
• ✅ No indication of condition on packaging
• ✅ Discreet credit card billing
• ✅ Secure messaging with providers

Packaging

• Plain boxes with no medical labeling
• No indication of medication type or condition
• Sender listed as pharmacy or telehealth company (generic name)
• Home delivery or shipping to alternative address available

Prescription Records

• Since most platforms don’t bill insurance, no insurance records created
• Prescriptions kept in confidential medical records
• Not shared without your consent

When to See a Doctor In Person

See a healthcare provider in person if:

• First suspected outbreak (need proper diagnosis and testing)
• Severe symptoms or complications
• Outbreaks not responding to treatment
• Eye involvement (herpes keratitis - serious)
• Frequent, severe recurrences despite suppressive therapy
• Immunocompromised (HIV, cancer treatment, organ transplant)
• Pregnancy or planning pregnancy
• Neurological symptoms (rare but serious)

Summary

Online herpes treatment provides:

Convenience: No awkward in-person visits, consultations from home Affordability: Generic valacyclovir $15-60/month, much cheaper than brand-name Discretion: Plain packaging, confidential consultations, HIPAA-compliant Effectiveness: Same medications prescribed in doctor’s offices Accessibility: Easy refills, flexible switching between episodic and suppressive therapy

Best Medication: Valacyclovir (once or twice daily, better compliance) Best for Frequent Outbreaks: Suppressive therapy (70-80% reduction in outbreaks) Best for Occasional Outbreaks: Episodic therapy (treat only when needed) Best Platforms: Ro (fast 2-day shipping), Nurx (easy refills), Lemonaid (affordable)

Living with herpes is manageable with modern antiviral medications and the convenience of telehealth makes treatment more accessible than ever. The key is finding the right treatment approach for your specific situation and maintaining it consistently.

Related Resources

Sexual Health Guides:

• Understanding Erectile Dysfunction
• When to See a Doctor About ED

Service Reviews:

• Ro Review - Best overall, fast 2-day shipping
• Nurx Review - Best for privacy and discretion
• Lemonaid Health Review - Most affordable option

Popular Comparisons:

• Ro vs Nurx - Which offers better value?
• Nurx vs Lemonaid Health

Consult with a healthcare provider to determine the best herpes treatment plan for your individual needs.