Adult Genital Herpes Treatment (Genital Herpes, HSV-2 Infection)
MD-only online genital herpes evaluation for adults with guideline-based antiviral treatment when appropriate, discreet counseling, and clear safety screening. $49 flat-fee video visit, no insurance required.
Genital herpes is viral. Antibiotics do not treat HSV. TeleDirectMD focuses on safe, evidence-based antiviral prescribing and helps identify when in-person evaluation is safer, including severe pain, urinary retention, pregnancy, eye symptoms, or neurologic symptoms.
- Assessment for typical HSV outbreak vs other causes of genital sores
- Episodic antivirals for outbreaks and suppressive therapy options when appropriate
- Partner counseling, transmission risk reduction, and STI testing guidance
- Adults only (18+)
What Is Genital Herpes (HSV-2 Infection)?
Genital herpes is a sexually transmitted infection caused most often by herpes simplex virus type 2 (HSV-2), and less commonly by HSV-1. HSV remains in the body lifelong and can reactivate, leading to recurrent outbreaks of painful genital or anal blisters or shallow ulcers with burning, tingling, or itching.
Many adults have mild or no symptoms but can still transmit HSV through asymptomatic shedding. When symptoms occur, a first recognized episode may also include swollen groin lymph nodes, fever, fatigue, or headache.
Antiviral medications do not eliminate HSV, but they can shorten outbreaks, reduce symptom severity, and reduce transmission risk when used correctly. TeleDirectMD focuses on safe antiviral prescribing, clear counseling, and triage to in-person testing when needed.
Genital Herpes Symptoms and Red Flags
Genital herpes can look similar to other causes of genital ulcers or irritation. TeleDirectMD evaluates symptom pattern, recurrence, exposures, and risk factors, and focuses on safety screening.
| Symptom or pattern | What it suggests | Telehealth appropriate? | Red flag requiring urgent in-person or ER care |
|---|---|---|---|
| Painful grouped blisters or ulcers in genital or perianal area | Typical HSV outbreak, especially recurrent in the same location | Often yes if stable | Rapidly spreading rash, necrotic-appearing lesions, or uncontrolled pain |
| Tingling, burning, itching before lesions | Prodrome of recurrent HSV | Yes, ideal for early episodic antivirals | New numbness, weakness, bowel or bladder dysfunction |
| Painful urination with genital sores | HSV near urethral opening or irritated surrounding skin | Yes if able to urinate and hydrate | Urinary retention, severe pelvic pain, fever with rigors |
| Fever, body aches, swollen groin nodes during first episode | Possible first episode HSV or another infection | Sometimes | High fever with confusion, stiff neck, severe headache, dyspnea |
| Severe headache, light sensitivity, neck stiffness | Concern for meningitis or encephalitis | No | Emergency department evaluation now |
| Pregnancy with new genital sores | HSV with neonatal implications | Limited role | Late pregnancy primary outbreak, labor with active lesions, ruptured membranes |
| Immunocompromised adult with extensive lesions | Higher risk of severe or disseminated HSV | Sometimes | Widespread lesions, systemic illness, eye symptoms, inability to hydrate |
Conditions That Can Mimic Genital Herpes
Several infections and skin conditions can cause genital sores, ulcers, bumps, or irritation. If your symptoms are atypical, new, or severe, in-person evaluation and testing may be the safest next step.
Syphilis
Often a painless ulcer early. Requires in-person testing and antibiotic treatment.
Chancroid and other ulcerative STIs
Less common in many regions, typically requires in-person evaluation and targeted antibiotics.
HPV genital warts
Fleshy growths rather than blisters. Managed with topical therapy or procedures.
Irritant dermatitis or friction
Redness or superficial skin breakdown from shaving, products, latex, or friction.
Folliculitis or ingrown hairs
Tender bumps centered on hair follicles, sometimes with small pustules.
Noninfectious ulcers
Inflammatory disease or medication reactions can cause ulcers and need in-person workup.
When Genital Herpes Can Be Managed Through Telehealth
TeleDirectMD is best for adults with typical HSV symptoms who are stable and able to safely recover at home. The visit focuses on safety screening, antiviral eligibility, and education.
When a Video Visit Is Appropriate
- Adult 18+ with known HSV history and typical recurrent outbreak.
- Early prodrome and ability to start episodic therapy promptly.
- Mild to moderate pain, able to hydrate and urinate.
- Questions about episodic vs suppressive antiviral therapy.
- Partner counseling and STI testing guidance.
Red Flags Requiring In-Person or ER Care
- Urinary retention or inability to urinate.
- High fever with severe headache, stiff neck, confusion, or light sensitivity.
- Extensive or rapidly spreading ulcers or rash.
- Eye pain, redness, or vision changes.
- Pregnancy with new genital sores, especially late pregnancy.
- Severe symptoms with immune compromise.
How TeleDirectMD Treats Genital Herpes in Adults
Treatment is focused on shortening outbreaks, reducing pain, reducing transmission risk, and providing clear next steps. Antivirals work best when started early in an outbreak, especially at the first prodromal symptoms.
Supportive Care
- Lukewarm sitz baths or cool compresses for comfort.
- Loose cotton underwear and breathable clothing.
- Acetaminophen or ibuprofen when appropriate for you.
- Keep lesions clean and dry, pat dry gently.
Episodic Antivirals
- Short course started at first tingling, burning, or earliest lesions.
- Best results when started quickly.
- Your MD selects regimen based on history and kidney function.
Suppressive Therapy and Counseling
- Daily therapy for frequent or distressing recurrences.
- May reduce transmission risk in some couples.
- Partner notification and safer-sex counseling are part of care.
Medication Table for Adult Genital Herpes
These are common adult dosing patterns used for genital herpes. TeleDirectMD individualizes recommendations based on your history, kidney function, and medication interactions.
| Medication | Dose | Duration | When used |
|---|---|---|---|
| Acyclovir | 400 mg by mouth 3 times daily | 7 days to 10 days | First recognized episode when appropriate, continued until lesions are healing. |
| Valacyclovir | 1,000 mg by mouth 2 times daily | 7 days to 10 days | Alternative first episode regimen with twice daily dosing. |
| Famciclovir | 250 mg by mouth 3 times daily | 7 days to 10 days | Alternative first episode option when appropriate. |
| Valacyclovir | 500 mg by mouth 2 times daily | 3 days | Episodic treatment for recurrent outbreaks started at earliest symptoms. |
| Acyclovir | 800 mg by mouth 3 times daily | 2 days | Short-course episodic regimen for recurrent outbreaks. |
| Valacyclovir | 500 mg by mouth once daily to 1,000 mg by mouth once daily | Ongoing | Suppressive therapy for frequent recurrences or transmission risk reduction in some couples. |
| Acyclovir | 400 mg by mouth 2 times daily | Ongoing | Suppressive therapy option when valacyclovir is not preferred. |
TeleDirectMD does not prescribe controlled substances for genital herpes visits.
Home Care and Return to Work
Most adults can recover at home. HSV is transmitted through direct skin contact, not by casual contact in workplaces. Return-to-work guidance depends on how you feel and your job demands.
Home Care Checklist
- Keep the area clean and dry, pat dry gently.
- Use cool compresses or sitz baths for comfort.
- Use pain relievers when appropriate for you.
- Avoid topical steroids or topical antibiotic creams on open lesions unless directed.
When to Recheck
- Worsening pain, spreading rash, or new severe symptoms.
- Inability to urinate or severe pelvic pain.
- Severe headache, stiff neck, confusion, or eye symptoms.
- Concern for another STI or atypical lesions that do not improve.
TeleDirectMD Genital Herpes Care: What to Expect
TeleDirectMD provides MD-only virtual urgent care for adults for $49 flat-fee video visits in 25+ states. Your physician reviews symptoms, timing, recurrence history, exposures, and risk factors. When appropriate, we prescribe antiviral treatment and provide counseling on transmission risk, partner notification, and STI testing guidance, with clear red-flag thresholds for urgent in-person care. No controlled substances are prescribed.