Adult Genital Herpes Treatment (HSV-2) in California
MD-only genital herpes care by secure video in California, $49 flat-fee, no insurance required.
Genital herpes is a common sexually transmitted infection caused by herpes simplex virus, most often HSV-2. Many adults experience periodic outbreaks with painful blisters or sores, tingling, itching, or burning. Telehealth is appropriate for most adults with a known or suspected outbreak and for those seeking suppressive therapy.
- $49 flat-fee visit
- MD-only evaluation and prescribing
- Outbreak and suppressive therapy options
- Confidential, secure video visits
- Adults only, California-based care
Clinician note: TeleDirectMD care is MD-only and guideline-based. Your visit is reviewed by a physician (Parth Bhavsar, MD). We prescribe antivirals when appropriate, discuss transmission risk and partner protection, and clearly tell you when in-person testing is needed.
Online HSV Care by California-Licensed MDs
- First-episode vs recurrent outbreak assessment
- Daily suppressive therapy when indicated
- Partner counseling and transmission education
- Testing guidance when diagnosis is uncertain
Adults only (18+). You must be physically located in California at the time of your visit. Severe pain, inability to urinate, neurologic symptoms, pregnancy, or a first-ever outbreak without prior testing may require in-person evaluation.
What Is Genital Herpes?
Genital herpes is a lifelong viral infection caused by HSV-2 and sometimes HSV-1. After initial exposure, the virus remains dormant and can reactivate, causing outbreaks. Some people have frequent recurrences, while others have rare or mild symptoms.
TeleDirectMD focuses on adult management of known or suspected genital herpes. During your video visit, the MD reviews your symptoms, prior testing, outbreak history, and risk factors to determine whether antiviral treatment is appropriate, whether you may benefit from suppressive therapy, or whether in-person testing is needed.
Symptoms and Red Flags
Herpes outbreaks often cause clustered blisters that become ulcers, along with burning or tingling. The table below summarizes typical patterns and when in-person care is safer.
| Finding | What it suggests | Telehealth appropriate? | Red flag requiring in-person care |
|---|---|---|---|
| Grouped blisters or open sores | Typical herpes outbreak pattern | Often yes | Extensive lesions with severe pain or inability to care for self |
| Tingling, itching, burning before sores | Common prodrome | Yes | New neurologic symptoms or rapidly worsening numbness |
| Swollen groin lymph nodes | Possible first episode or larger outbreak | Sometimes | High fever or severe systemic illness |
| Pain with urination | Lesions near urethra | Sometimes | Inability to urinate or urinary retention |
| First-ever genital sores | Needs confirmation testing when possible | Sometimes | Pregnancy, severe symptoms, or uncertain diagnosis |
What Else Can Look Like Genital Herpes?
- Folliculitis: irritated hair follicles or ingrown hairs, often bumps rather than ulcers.
- Yeast infection or dermatitis: irritation and itching, usually without grouped blisters.
- Syphilis: can cause a painless ulcer, testing recommended if risk is present.
- Chancroid and other ulcerative STIs: less common but considered based on history and exam.
- Trauma or friction injury: can cause superficial sores.
When a Video Visit Is Appropriate vs. When to Go In-Person
When a Video Visit Is Appropriate
- Adult 18+ with typical outbreak symptoms
- Known HSV diagnosis or strong prior outbreak pattern
- Recurrent outbreaks seeking episodic treatment
- Considering suppressive therapy for frequent outbreaks or partner protection
- No pregnancy
- Physically located in California at the time of the video visit
Red Flags Requiring In-Person or Urgent Care
- First-ever genital sores without prior testing and uncertain diagnosis
- Pregnancy
- Inability to urinate or urinary retention
- High fever, severe systemic symptoms, or severe pain
- Severe headache, stiff neck, confusion, or neurologic symptoms
- Significant immune compromise
Treatment Options for Adult Genital Herpes
Antiviral medications reduce symptom duration and viral shedding. They work best when started early, ideally within 24 hours of symptom onset or during the tingling phase. Treatment options include episodic therapy for outbreaks and daily suppressive therapy for people with frequent recurrences or those who want to reduce transmission risk.
Supportive Care
- Keep the area clean and dry. Avoid picking or popping lesions.
- Warm sitz baths can reduce discomfort.
- Acetaminophen 650 mg by mouth every 6 hours as needed, maximum 3000 mg per day.
- Ibuprofen 400 mg by mouth every 6 to 8 hours as needed with food if safe for you.
- Avoid sexual contact during symptoms and until lesions fully heal.
Antiviral Medication Options
| Medication | Dose | Duration | When used |
|---|---|---|---|
| Valacyclovir | 1 g by mouth 2 times daily | 7 to 10 days | First episode when appropriate and diagnosis is reasonably established |
| Acyclovir | 400 mg by mouth 3 times daily | 7 to 10 days | First episode alternative regimen |
| Valacyclovir | 500 mg by mouth 2 times daily | 3 days | Recurrent outbreak episodic therapy, start early |
| Valacyclovir | 1 g by mouth 1 time daily | 5 days | Recurrent outbreak episodic therapy, alternate regimen |
| Acyclovir | 400 mg by mouth 3 times daily | 5 days | Recurrent outbreak episodic therapy, alternate regimen |
| Valacyclovir | 500 mg by mouth 1 time daily | Daily | Suppressive therapy for selected adults, may reduce transmission risk |
| Valacyclovir | 1 g by mouth 1 time daily | Daily | Suppressive therapy for frequent recurrences or breakthrough outbreaks |
| Acyclovir | 400 mg by mouth 2 times daily | Daily | Suppressive therapy alternative regimen |
| Famciclovir | 250 mg by mouth 2 times daily | Daily | Suppressive therapy alternative regimen |
TeleDirectMD does not prescribe controlled substances. Antivirals reduce outbreaks and shedding but do not eliminate HSV. If your symptoms are severe, you cannot urinate, you are pregnant, or this is your first episode with uncertain diagnosis, in-person evaluation is recommended for testing and safety.
Home Care, Partner Safety, and Return to Work
Many adults can continue work as tolerated. The most important priorities are symptom control, early antiviral treatment when indicated, and reducing transmission risk.
- Avoid sexual contact during outbreaks and until lesions have fully healed.
- Condoms reduce risk but do not eliminate risk because HSV can shed from nearby skin.
- Daily suppressive therapy may reduce outbreaks and transmission risk for some adults.
- If sores are new or diagnosis is uncertain, testing can help confirm HSV and rule out other STIs.
What to Expect From Your TeleDirectMD Visit
TeleDirectMD provides adult-only, MD-only virtual urgent care by secure video. Visits typically last about 10 to 15 minutes and cost $49 as a flat cash fee with no insurance involvement. During your visit, the MD will review symptoms, timing, prior testing, outbreak history, partner risk, and red flags.
If your presentation is appropriate for telehealth, we can send an electronic prescription to your preferred local pharmacy in California when appropriate. If you need in-person testing or urgent evaluation, we will explain why and guide you on the safest next step.
We do not prescribe controlled substances.
Genital Herpes Treatment FAQ
Can I get genital herpes medication online today?
Often, yes. If your symptoms and history fit a typical HSV outbreak and there are no red flags, TeleDirectMD can prescribe an antiviral and send it electronically to your local California pharmacy. If this is a first-ever outbreak with uncertain diagnosis, in-person testing is often recommended.
What is the difference between HSV-1 and HSV-2?
Both viruses can cause genital herpes. HSV-2 is more commonly associated with recurrent genital outbreaks, while HSV-1 more often causes oral herpes but can also cause genital infection. Testing can help identify the type.
How soon should I start antivirals for an outbreak?
As soon as possible. Antivirals work best when started early, ideally within 24 hours of symptoms or during tingling and burning before sores appear.
Can herpes be cured?
No. HSV is a lifelong infection. Antivirals reduce symptoms, shorten outbreaks, and can reduce shedding and transmission risk, but they do not eliminate the virus from the body.
Should I take daily suppressive therapy?
Daily suppressive therapy can be helpful if you have frequent outbreaks, severe symptoms, or want to reduce transmission risk to a partner. During your visit, the MD will discuss your outbreak pattern and goals to decide if suppressive therapy fits.
Can I have herpes without symptoms?
Yes. Many people have mild or unrecognized symptoms and can still shed virus intermittently. Testing and counseling can help clarify risk and prevention strategies.
When should I avoid sex?
Avoid sexual contact during symptoms and until lesions fully heal. Even without visible sores, HSV can shed, so condoms and suppressive therapy may reduce risk but do not eliminate risk.
Do I need testing for other STIs?
Often, yes. If you have a new diagnosis, new partners, or other symptoms, STI screening may be recommended. First-episode genital ulcers are commonly tested to confirm HSV and rule out other causes.
Is TeleDirectMD available throughout California for HSV care?
Yes. As long as you are physically located in California at the time of your visit, you can use TeleDirectMD for genital herpes evaluation and treatment guidance. Prescriptions are sent electronically to your local California pharmacy when appropriate.
Can TeleDirectMD provide a work note?
TeleDirectMD can provide a brief work note when medically appropriate as part of the $49 visit.
When should I seek urgent in-person care?
Seek urgent evaluation for inability to urinate, severe pain, high fever, severe headache or neurologic symptoms, pregnancy, significant immune compromise, or a first-ever outbreak with uncertain diagnosis.