What Are The Symptoms Of Herpes Simplex
Many people with the infection never experience any herpes symptoms. If you do notice symptoms, youll experience them differently depending on whether youre having your first herpes outbreak or a repeat outbreak. Recurring symptoms are usually milder than the first outbreak. Symptoms dont last as long with later outbreaks. Some people may only have one or two outbreaks during their lifetime. Others may have as many as four or five outbreaks a year.
People who do have herpes symptoms may experience:
- Cold sores around their lips, mouth or tongue. They may look crusty or like fluid-filled blisters.
- Tingling, itching or burning.
- Pain while urinating.
Suppressive Therapy For Recurrent Hsv
Suppressive therapy reduces frequency of genital herpes recurrences by 70%80% among patients who have frequent recurrences . Persons receiving such therapy often report having experienced no symptomatic outbreaks. Suppressive therapy also is effective for patients with less frequent recurrences. Long-term safety and efficacy have been documented among patients receiving daily acyclovir, valacyclovir, and famciclovir . Quality of life is improved for many patients with frequent recurrences who receive suppressive therapy rather than episodic treatment . Providers should discuss with patients on an annual basis whether they want to continue suppressive therapy because frequency of genital HSV-2 recurrence diminishes over time for many persons. However, neither treatment discontinuation nor laboratory monitoring is necessary because adverse events and development of HSV antiviral resistance related to long-term antiviral use are uncommon.
Valacyclovir 500 mg orally 2 times/day for 3 daysOR
Valacyclovir 1 gm orally once daily for 5 days
*Acyclovir 400 mg orally 3 times/day is also effective, but are not recommended because of frequency of dosing.
How Long Do Sores From Herpes Simplex Last
If youre infected with HSV-1, commonly known as oral herpes, you may notice tingling or burning around your mouth in the days before a cold sore appears. These blisters break open and ooze fluid before forming a crust. Usually, sores last for seven to 10 days.
If youre infected with HSV-2, commonly known as genital herpes, your first outbreak may last between two to four weeks. Recurrent outbreaks usually last between three to seven days.
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What Are The Symptoms Of Genital Herpes
The symptoms of genital herpes vary a lot. Most people have very mild symptoms or none at all.
Symptoms can vary from a mild area of irritation to more painful blisters or sores and generally feeling unwell. Common symptoms may include:
- sometimes sores on the cervix
If you are having a first episode of genital herpes, you are more likely to also feel generally unwell and have fever, headache and general bone and muscle aches.
This may last for several days, during or after which reddened areas may appear on your genitals. These may develop into painful blisters. The blisters then burst, generally to leave sores that gradually heal, usually without scarring.
The severity of this first episode varies between people, but for some it may be severe and last for up to 3 weeks if not treated. These symptoms should quickly resolve with treatment. There is effective treatment available if symptoms are problematic.
Is Herpes Simplex Related To Herpes Zoster
Herpes simplex and the varicella-zoster virus are related, but they arent the same. VZV causes chickenpox and shingles.
Like HSV-1 and HSV-2, shingles can cause a painful, blistering rash. The shingles rash usually shows up on the back, side, abdomen , neck and face. It is often only on half of your body, following the pattern of your nerves. See your healthcare provider if you have a new rash and suspect you may have shingles.
A note from Cleveland Clinic
Herpes simplex is a virus. Once you have herpes, its a lifelong condition. A herpes infection can lead to outbreaks , but youll also have times when you have no symptoms. The main sign of herpes is sores that appear on the infected skin. Some people choose not to treat herpes, especially if symptoms are mild. Others take antiviral medications to reduce the severity and frequency of outbreaks.
Last reviewed by a Cleveland Clinic medical professional on 05/17/2022.
References
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How Long To Take Them
For the treatment of herpes infections, the usual course of treatment is five days. However in some instances your doctor may want you to take your tablets for ten days.
For prevention of herpes infections, you should continue to take this medicine every day as prescribed by your doctor.
Do not stop taking Valtrex tablets just because you feel better. The herpes outbreak may not be completely over.
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What Triggers Herpes Outbreaks
If youve had herpes for a while, you might have identified things that cause your herpes to crop up. Some of the most well-known triggers for herpes are things that stress your body, like lack of sleep or even a common cold. While your body is off dealing with some other stress, your immune system is essentially distracted, allowing your herpes to wake up. Thats why theyre called cold sores or fever blistersbecause they often appear when you have a cold or fever.
Other common triggers include:
- Hormonal changes
- Reduced immune function
And while herpes viruses might be best known for causing cold sores and genital herpes, theres a whole range of herpes viruses. Different ones are responsible for causing various diseases. These include chickenpox and shingles, eye infections, mono , and more. Classic cold sores and genital herpes are typically caused by herpes simplex virus 1 or herpes simplex virus 2 .
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Simple Treatments For The Relief Of Discomfort
- Wear loose underclothes, preferably cotton , to help minimise discomfort and allow healing.
- Use plain water or saline solution with cotton wool to clean and soothe the area. To make a saline solution, use 1 teaspoon of salt in 600ml of water or a handful of salt in a shallow bath.
- Don’t use scented soaps, bubble bath, etc in the area, as these may irritate it.
- Using a hairdryer on its lowest setting to dry the area may be more comfortable than using a towel.
- Pain relief medication such as paracetamol and ibuprofen may ease the pain. Check with your pharmacist or other health professional whether taking these is suitable for you.
- Ice wrapped in a face cloth or flannel and placed over the sores for 510 minutes may be soothing. Don’t apply ice directly to the sores as this can cause ice burn.
- If you find peeing painful, try applying Vaseline® to the area or sitting in a warm bath before urinating or using a pump bottle full of water and spraying water on yourself while peeing.
- You can also try applying a pain relief cream such as lignocaine cream to the painful area. This is applied 5 minutes before peeing and should be used for a maximum of 12 days.
- Drink plenty of fluids as this dilutes your pee and may help reduce stinging.
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How To Cope After Diagnosis
Many posters were occupied with the issue of passing on the infection. Yolandayw points out that you can minimise the risk of transmission by postponing sex until all the sores have healed. She also mentioned that condoms should be used. They won’t completely prevent transmission but they will help.
Ending on a positive note, many posters emphasised that there was light at the end of the tunnel. Learning of the diagnosis may feel stressful at first, but it’s a manageable condition and certainly nothing to be ashamed of. Lucy03934 has had genital herpes for 25 years. She’s been married for 18 years and has two sons – living proof that there is life after herpes.
Support And Advice For Genital Herpes
If you have just found out you have genital herpes, you may feel shocked and may have a lot of questions. It may help you to gather as much information as you can about herpes. This can help you to make fully informed decisions about your treatment, safe sex and preventing further recurrences. Talking to a counsellor about your concerns may also help.
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Is It Safe To Breastfeed If I Have Genital Herpes
Yes as long as there isnt an open lesion on your chest or breast. If you have an active outbreak while breastfeeding, its possible to spread the infection to your nipples through touch. Careful hand-washing can prevent this spread. You shouldnt nurse from a breast that has herpes sores. You can pump breast milk until the sores heal. Dont give your baby expressed breast milk if the pump comes into contact with an open sore.
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The Virus And Pathogenesis
HSV is a double-stranded DNA virus that may enter the host through abraded skin or intact mucous membranes.1 Epithelial cells are the initial targets. Once infected, these cells die, releasing clear fluid intradermally to form vesicles and merging with other cells to create multinucleated giant cells.
Retrograde transport through adjacent neural tissue to sensory ganglia leads to lifelong latent infection.1 Reactivation of the virus is triggered by local or systemic stimuli such as immunodeficiency, trauma, fever, menstruation, ultraviolet light and sexual intercourse.13 Although emotional stress is assumed to trigger HSV recurrence, recent research fails to show a definite causative role.4 Once reactivated, the virus is transported by the neuron back to the epithelium, where more replication occurs, and another outbreak ensues.
HSV exists as two separate types, labeled 1 and 2, which have affinities for different body sites.2 Ninety percent of infections caused by HSV-2 are genital, and 90 percent of those caused by HSV-1 are oral the reason for this division is unknown.5 In addition, oral HSV-1 infection recurs more frequently than oral HSV-2, and genital HSV-2 recurs more often than genital HSV-1.
How Can I Reduce My Risk Of Herpes Simplex
Preventing HSV-1
You can reduce your risk of contracting HSV-1 by avoiding physical contact with someone who has a cold sore. People can still spread HSV-1 when cold sores arent present, but its less likely.
If someone has an active HSV-1 infection, avoid:
- Sharing utensils, cups, lip balms or other personal care products.
- Touching the skin near their mouth.
Preventing HSV-2
If youre sexually active, you can take these steps to protect yourself and others from the herpes virus and other STIs:
- Be monogamous with one sexual partner or limit your number of partners.
- Get tested for STIs and complete any prescribed treatment.
- Tell your sexual partners if you have genital herpes so they can get tested.
- Use condoms during intercourse and dental dams during oral sex.
Wash your hands often if you have an outbreak or are around someone with symptoms.
If your sexual partner has genital herpes, these actions can lower your risk of getting the virus:
- Dont have sex when your partner has active symptoms. Condoms may not cover all sores, so you may still get the virus.
- Make sure your partner takes antiviral medication as prescribed.
- Wait to have sex until scabs fall off active lesions.
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When Treatments For Genital Herpes Are Given
- Initial treatment. If you have symptoms such as sores when you’re first diagnosed with genital herpes, your doctor will usually give you a brief course of antiviral therapy to relieve them or prevent them from getting worse. Your doctor may keep you on the drugs longer if the sores don’t heal in that time.
After the first treatment, work with your doctor to come up with the best way to take antiviral therapies. There are two options:
- Intermittent treatment. Your doctor may prescribe an antiviral drug for you to keep on hand in case you have another flare-up this is called intermittent therapy. You can take the pills for two to five days as soon as you notice sores or when you feel an outbreak coming on. Sores will heal and disappear on their own, but taking the drugs can make the symptoms less severe and make them go away faster.
- Suppressive treatment. If you have outbreaks often, you may want to consider taking an antiviral drug every day. Doctors call this suppressive therapy. For someone who has more than six outbreaks a year, suppressive therapy can reduce the number of outbreaks by 70% to 80%. Many people who take the antiviral drugs daily have no outbreaks at all.
There is no set number of outbreaks per year that doctors use to decide when someone should start suppressive therapy. Rather, more important factors are how often the outbreaks happen and if they are severe enough to interfere with your life.
Continued
Genital Herpes Is Spread By Skin
The virus can be spread when someone with HSV has an episode or an outbreak characterised by having a sore, blister, ulcer or skin split . It can also be spread between episodes, when there is no sore, blister, ulcer or skin split present called asymptomatic viral shedding.
During viral shedding the virus is on the skin surface and can be spread through genital skin-to-skin contact, or from the mouth or face to genital skin during contact.
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Treatment Of Genital Herpes
Currently, the only commercially available treatments for recurrent genital herpes are the antiviral agents aciclovir, famciclovir and valaciclovir. These agents act to prevent viral replication, and thereby limit viral spread to other cells. They may be used for the primary outbreak, on an episodic basis for recurrences, or chronically as suppressive therapy.
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Im a 23-year-old softball player. I had a HPV culture that came back positive. It was so painful to pee while having warts, especially at night. And when I did finally pee, it would run over the lesions, and it was so painful.
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* These are actual customer comments about their experience with VidaroX. Names have been changed for their privacy. Your results may vary.
1. Traditional creams are onlyactive on the surface
2. HPV viruses hiding underneathare not reached
3. HPV viruses are re-activated
4. Recurrence of HPV outbreak
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How Is Genital Herpes Spread
Genital herpes is usually transmitted by having sexual contact with someone who carries HSV. You can get genital herpes through direct contact with an infected blister or sore, usually through sexual contact. You can also transmit or get the virus when you or your partner have no symptoms present .
Most people who infect others don’t realise they are putting their partners at risk.
- Around 80% of people with genital herpes don’t know they have the virus because they have very mild symptoms or none at all.
- More than 75% of people who have genital herpes get it from people who are entirely unaware that they have it themselves.
Using condoms reduces your risk of passing on the virus by about 50%, but does not remove it completely.
You cannot catch genital herpes by sharing cups, towels or bath water, or from toilet seats. It can only be spread by close skin-to-skin contact.
HSV that causes genital herpes does not cause cervical cancer.
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