There are several treatment options to improve the symptoms of mpox, including antiviral treatment and supportive care. We recommend that residents infected with mpox reach out to their health care provider to discuss these options to ensure they are safe and appropriate.  

Antiviral treatment or TPOXX: 

You may be eligible for antiviral treatment, tecovirimat or TPOXX, if you have or are at high risk of severe disease, including if:

• you have an immunocompromising condition
• you have mpox lesions in the mucus membranes, including eyes, mouth, genitals, or anus
• you are pregnant or breastfeeding
• you experience other complications from mpox infection, such as secondary skin infections, nausea, vomiting, diarrhea, or dehydration.

Supportive care 

Supportive care includes:

• maintenance of adequate fluid balance
• pain management
• treatment of bacterial superinfections of skin lesions, and
• treatment of co-occurring sexually transmitted or superimposed bacterial skin infections.

Below is general information on treatment options to improve the most common symptoms of mpox infections, including itching and pain. However, we recommend discussing these symptoms directly with your health care provider for specific guidance. 

Skin care and itching 

• Skin lesions should be kept clean and dry when not showering or bathing to prevent bacterial superinfection.  
• Pruritus or itching can be managed with oral antihistamines and unscented or plain topical agents such as calamine lotion or petroleum jelly. 
• For oral or mouth lesions, compounds such “magic” or “miracle” mouthwashes (prescription solutions used to treat mucositis) can be used to manage pain. Oral antiseptics can be used to keep lesions clean (e.g., chlorhexidine mouthwash). Topical benzocaine/lidocaine gels can be used for temporary relief, especially to make eating and drinking easier, but should be limited to recommended doses. 

Pain control 

• For painful genital and anorectal lesions, warm sitz baths lasting at least 10 minutes several times per day may be helpful. Pat the area dry. Topical benzocaine/lidocaine gels or creams at the recommended doses may also provide temporary relief.
• Proctitis can occur with or without internal lesions and, though often manageable with appropriate supportive care, can progress to become severe and debilitating. Stool softeners such as docusate should be initiated early. Sitz baths, as described above, are also useful for proctitis, and may calm inflammation. Similarly, over the counter pain medications such as acetaminophen can be used. Pain from mpox proctitis may require prescription medications, use of which should be balanced with the possibility of side effects, like constipation. Proctitis may additionally be accompanied by rectal bleeding. Though rectal bleeding has been observed to be self-limited, patients with rectal bleeding should be evaluated by a healthcare provider. 

Nausea and vomiting 

• Nausea and vomiting may be controlled with anti-emetics as appropriate. Diarrhea should be managed with appropriate hydration and electrolyte replacement. The use of anti-motility agents is not generally recommended given the potential for ileus, unless discussed or prescribed by a healthcare provider. 

References: 

NYC Health, “Interim Guidance for Treatment of Mpox”, July 2, 2022

Mpox is not a gay disease. The risk of mpox is not limited to people who are sexually active or men who have sex with men. Anyone can get or spread mpox. Mpox is most commonly spread through close and sustained intimate contact, including:

• Direct skin-to-skin or skin-to-mouth contact with mpox rash, sores, or scabs
• Sexual contact
• Touching, hugging, massaging, kissing
• Prolonged face to face contact with respiratory droplets from a person with mpox (less common)
• Pregnant people can spread the virus to their fetus through the placenta
• Animal to human transmission is also possible (ex. by being scratched or bitten by the animal or by preparing or eating meat or using products from an infected animal).

A person with mpox is considered infectious from the beginning of symptoms. They can stay that way until sores have crusted, scabbed over, fallen off, and a fresh layer of healthy skin has formed underneath. This can often take several weeks.

• Call your health care provider.
• Stay home and away from others, including pets.
• Avoid gatherings, especially if there will be close or skin-to-skin contact.
• Avoid sex and intimacy until you have visited a health care provider and received guidance. 
• When you visit a health care provider, call beforehand, cover your lesions and wear a mask if possible.
• Think about your close or sexual contacts within the last 21 days, including people you met through dating apps. You might be asked to share this information to help stop the spread.

The best way to protect yourself and others is to:

• Talk to your health care provider about getting vaccinated against mpox infection.
• Avoid sex of any kind.
• Do not kiss or touch each other's bodies while you are sick, especially any rash or sores.
• Do not share things like towels, clothing, linens, fetish gear, sex toys, and toothbrushes.

The following can lower the chance of spreading the virus:

• Have virtual sex with no in-person contact.
• Masturbate together at a distance of at least six feet.
• Have sex with your clothes on, or cover areas where there are rashes or sores, to avoid skin-to-skin contact.
• Avoid kissing.
• Wash your hands, fetish gear, sex toys and any fabrics (bedding, towels, clothing) after having sex.
• Limit your partners to avoid chances for mpox to spread.

• Wear a mask and gloves when you are close to them or touching their bedding, clothing, or linens. 
• Wash your hands often for at least 20 seconds with soap and water.
• Practice physical distancing when possible.
• People who work in healthcare, such as providers and support staff who may be in contact with people with mpox and their linens or items, should wear personal protective equipment (PPE) to avoid exposure.