Kashif J. Piracha, MD, is a board-certified physician with over 14 years of experience treating patients in acute care hospitals and rehabilitation facilities.

Monkeypox is a disease similar to smallpox. It is self-limited (resolves without treatment), usually lasting two to four weeks. Most people with monkeypox get better without treatment.

Currently, there is no specific treatment approved for monkeypox virus infection. The treatment is focused on managing symptoms such as headaches, fever, chills, muscle aches, sore throat, swollen lymph nodes, and a chicken pox–like rash that can develop on the hands, feet, face, chest, mouth, tongue, genitals, or anus.

Monkeypox rarely causes death, but complications such as vomiting and diarrhea may require supportive care to prevent dehydration. Some people may also require treatment for rare eye complications such as blepharitis  (infection of the eyelid) or conjunctivitis ("pink eye").

This article explains how monkeypox is currently treated, including self-care, over-the-counter (OTC) medications, and prescription drugs. It also explores which complementary and alternative therapies may be useful in supporting standard treatments.

The symptoms of monkeypox can vary from one person to the next. Some people experience flu-like symptoms before the outbreak of rash, some get the rash first followed by symptoms, and others get only the rash.

The main approach to resolving the flu-like symptoms of monkeypox is rest. Most people who get monkeypox will experience fatigue and lethargy and will benefit from many of the same self-care treatments for flu, namely getting plenty of rest and plenty of fluids.

The monkeypox rash may be difficult to deal with because it can be extremely painful. Even after the blistering rash starts to heal, many people will experience intense itching and find it hard to resist scratching.

You must never pop, scratch, or pick at a monkeypox rash. Doing so can lead to scarring and secondary bacterial infection (in which the ruptured skin allows bacteria access to vulnerable underlying tissues).

To better cope with the monkeypox rash and reduce pain, itching, and the risk of infection, try the following:

Certain OTC medications may be helpful in managing the rash, flu-like symptoms, and other complications of monkeypox infection, including:

There are no drugs approved or licensed for the treatment of monkeypox virus. However, because monkeypox is closely related to smallpox, an antiviral drug called TPOXX (tecovirimat ) may be used off-label in people with severe infections or at increased risk of complications.

People at risk include children (especially those under age 8), people who are pregnant or breastfeeding, and immunocompromised people (such as those with untreated human immunodeficiency virus, HIV). People with atopic dermatitis (the most common form of eczema) or other chronic skin conditions may also be candidates for treatment.

TPOXX is delivered in capsule form and taken by mouth twice daily for 14 days with a high-fat meal. Side effects include headache, nausea, abdominal pain, and vomiting.

Most people with monkeypox do not require TPOXX. The drug is currently under investigation, and it is not yet known what long-term risks the drug may pose to people with monkeypox.

If you are prescribed TPOXX, you will be asked to sign a consent form stating you understand TPOXX is an investigational drug (still being researched) and not yet licensed for the treatment of monkeypox.

Other prescription drugs may be used to treat complications of monkeypox, such as secondary bacterial infections and eye infections. This may involve:

Although no complementary or alternative medicines (CAMs) can alter the course of a monkeypox infection, certain ones may help ease symptoms or complications.

The evidence supporting the use of CAMs in treating any poxvirus infection is generally weak, but four natural compounds that may be of benefit based on research are:

There are no approved or licensed treatments for monkeypox. The treatment instead is focused on managing symptoms and preventing complications. Most monkeypox infections will resolve on their own within two to four weeks.

People with severe symptoms or those at risk of complications may be prescribed TPOXX, a drug currently licensed for the treatment of smallpox.

The outbreak of monkeypox in the United States in 2022 spurred alarm in hard-hit communities, particularly among men who have sex with men (MSM). While the infection can be painful and unsightly, most cases will resolve on their own without incident.

Until there is an effective treatment for monkeypox, your best defense may be to get the monkeypox vaccine if you are at risk of exposure through sex or intimate contact. If you think you've been exposed to monkeypox by any means, you may still benefit from vaccination. Speak with a healthcare provider.

Monkeypox is contagious until the sores have fully healed. This means that the scab needs to fall off and the underlying skin is smooth and unbroken. Don't rush the process by picking at scabs. This can delay healing and lead to infection and scarring.

At the present, it is not known if TPOXX (tecovirimat) speeds healing, although there is some speculation that it might. TPOXX is intended for people who either have severe monkeypox symptoms or are at risk of complications, such as immunocompromised people, children, people who are pregnant or breastfeeding, and those with chronic skin conditions like eczema.

It is unlikely the drug Zovirax (acyclovir) will be of any use in people with monkeypox. Acyclovir is active against herpesviruses, including those that cause genital herpes, oral herpes (cold sores), shingles, and chickenpox. Monkeypox is a poxvirus, and, although "monkeypox" and "chicken pox" both share "pox" in their names, they belong to entirely different families of viruses.

Centers for Disease Control and Prevention. Monkeypox signs and symptoms.

National Institute of Allergy and Infectious Diseases. Monkeypox treatment.

British Columbia Centre for Disease Control. Monkeypox.

Abdelaal A, Serhan HA, Mahmoud MA, Rodriguez-Morales AJ, Sah R. Ophthalmic manifestations of monkeypox virus. Eye (Lond). 2022 Jul 27. doi:10.1038/s41433-022-02195-z

Centers for Disease Control and Prevention. Monkeypox: clinical recognition.

American Dental Association. Aphthous mouth ulcers.

Centers for Disease Control and Prevention. Patient's guide to monkeypox treatment with TPOXX.

SIGA Technologies. TPOXX (tecovirimat) capsules for oral use.

Reynolds MG, McCollum AM, Nguete B, Lushima RS, Petersen BW. Improving the care and treatment of monkeypox patients in low-resource settings: applying evidence from contemporary biomedical and smallpox biodefense research. Viruses. 2017;9(12):380. doi:10.3390/v9120380

Bristol-Myer Squibb. Kenalog (triamcinolone acetonide cream USP).

Bausch & Lomb. Lotemax (loteprednol etabonate ophthalmic gel) 0.5%.

Allergan. Restasis (cyclosporine ophthalmic emulsion) 0.05%.

Food and Drug Administration. Over-the-counter (OTC) monograph M016: skin protectant drug products for over-the-counter human use.

Marx W, Kiss N, Isenring L. Is ginger beneficial for nausea and vomiting? An update of the literature. Curr Opin Support Palliat Care. 2015;9(2):189-95. doi:10.1097/SPC.0000000000000135

Arndt W, Mitnik C, Denzler KL, et al. In vitro characterization of a nineteenth-century therapy for smallpox. PloS One. 2012;7:e32610. doi:10.1371/journal.pone.0032610

Markum E, Baillie J. Combination of essential oil of Melaleuca alternifolia and iodine in the treatment of molluscum contagiosum in children. J Drugs Dermatol. 2012;11(3):349-54.

World Health Organization. Perceptions of monkeypox from those most at risk: men who have sex with men having multiple sexual partners.

Centers for Disease Control and Prevention. Considerations for monkeypox vaccination.

American Medical Association. What physicians need to know about tecovirimat (TPOXX) for treatment of monkeypox.

By James Myhre & Dennis Sifris, MD Dennis Sifris, MD, is an HIV specialist and Medical Director of LifeSense Disease Management. James Myhre is an American journalist and HIV educator.

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