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Herpes simplex is caused by a virus, so the treatment needs to target viral replication. Antiviral medications act as nucleoside analogs that are activated inside infected cells and then inhibit viral DNA polymerase, which slows or stops the replication of the virus. This directly reduces the duration and severity of lesions, symptoms, and viral shedding. Antibiotics target bacteria, so they won’t affect a viral infection. Antifungals treat fungi by interfering with fungal cell processes, which also won’t help with a herpes infection. Anti-inflammatory drugs may ease pain and swelling but don’t suppress the underlying viral replication.

Starting antiviral therapy early—ideally at the first sign of symptoms or shortly after lesion onset—offers the best outcomes for acute herpes episodes and can shorten healing time. In recurrent cases, episodic antiviral use is often effective, while immunocompromised individuals may require longer or IV therapy and, in some instances, alternative antivirals if resistance occurs.