Genital herpes is a sexually transmitted disease caused by the herpes simplex virus that infects the skin and mucous membranes of the genital and anal areas of the urinary tract. Since genital herpes is very prone to recurrence, it often causes a lot of psychological stress to patients. Many patients are inquiring about how to treat recurrent genital herpes. Here are my views on the issues that concern us. 1. Why is genital herpes prone to recurrence? Because the existing antiviral drugs, although they can reduce the symptoms and improve the signs of herpes virus infected people, do not prevent the establishment of latent infection and recurrence. Therefore, when the body’s resistance decreases, such as when drinking alcohol, fatigue, staying up late or suffering from diseases such as the flu, recurrence of genital herpes is likely to occur. 2. What is the purpose of antiviral drug treatment? A patient once asked, “If it can’t be cured, then why do we need to treat it? In fact, antiviral treatment is meaningful, and the purpose of its treatment is to control genital herpes from attacking, or to reduce the number of recurrences. For patients with herpes who have already had an episode, it can promote rapid healing of the lesions and reduce the pain and psychological stress of the disease. It can also reduce asymptomatic detoxification and reduce the infectiousness of the disease. 3. What is the difference between recurrent and initial genital herpes? Recurrent genital herpes is compared to primary genital herpes in that the number of lesions is smaller and the systemic symptoms are less severe. The first recurrence occurs mostly 1 to 4 months after the primary infection. The frequency of recurrences varies widely among individuals, averaging 3 to 4 times per year. More than six episodes per year can be classified as frequent recurrent genital herpes. Most recurrent genital herpes has prodromal symptoms hours to 5 days prior to the onset of the rash, manifested by local itching, burning pain, tingling, numbness, and perineal swelling. The clusters of small blisters quickly rupture to form vesicles or superficial ulcers. Some patients also show atypical skin fissures or erythema. The choice of treatment options for recurrent genital herpes: The treatment of recurrent genital herpes varies from person to person. The choice of treatment options is based on the following factors: frequency of recurrences, severity of recurrences, infection of sexual partners and the psychological pressure the infection puts on the patient. For patients with few recurrences or relapses with mild symptoms, treatment is generally not necessary, but patients should be aware of the risk of transmission and take precautions. For patients with severe symptoms but few relapses or severe psychological disturbances, intermittent treatment options are available. For patients with frequent recurrences (more than 6 recurrences per year), long-term suppressive therapy may be used. 5. Intermittent treatment of recurrent genital herpes: intermittent treatment regimen can be either vaxilovir, 300 mg or 500 mg twice a day, or acyclovir tablets, 200 mg each time, 5 times a day. The duration of administration is 6 days for both regimens. The earlier the treatment of recurrent genital herpes, the better, and effective intermittent treatment must be administered at the earliest possible stage of the attack. Therefore, for patients with a history of genital herpes, it is important to have the medication ready at home even when there is no attack and to start taking it when you feel discomfort or itchiness before a recurrence, so that you can get effective treatment when the herpes attacks before. 6. Suppressive therapy for recurrent genital herpes apparatus: For patients with frequent recurrences of more than 6 times a year, suppressive therapy is more effective. Daily oral viral suppressants can reduce the frequency of recurrences in more than 75% of people with genital herpes infection. The method is to use valacyclovir tablets, 300 mg or 500 mg per day, twice a day when symptomatic, and after 1 week of taking them, if the symptoms subside, change to once a day, on an empty stomach. It is important to abstain from alcohol and avoid fatigue while taking the drug. If the number of relapses decreases to less than 5 times per year, intermittent therapy or discontinuation of the drug is possible. If the number of relapses still exceeds 6, suppressive therapy may be continued. Suppressive therapy can also be used with acyclovir tablets, 400 mg each time, twice daily. The duration of dosing is 5 days for both. Vaciclovir tablets are more expensive than acyclovir, but they have better efficacy and safety than acyclovir, are less frequent and more convenient than acyclovir, and have better adherence. Long-term suppressive therapy can also reduce asymptomatic detoxification. 7, the efficacy and safety of suppressive therapy: after long-term suppressive therapy treatment, many patients can greatly reduce the frequency of relapse, after 1 year of continuous oral drug discontinuation, the frequency of relapse can be re-evaluated. In some cases, treatment can be discontinued. Long-term suppressive therapy is very safe and does not require laboratory testing. 8, how to reduce the recurrence of genital herpes: the frequency of recurrence of genital herpes is related to the triggering factors, alcohol, spicy food, fatigue, cold, anxiety, tension, sexual intercourse and other common triggers, so try to reduce these triggering factors. Regular life, proper physical exercise, good psychological state and avoidance of triggering factors are important measures to reduce and prevent recurrence.