Understanding Herpes With H Hunter Handsfield Md
Herpes expert H. Hunter Handsfield, MD, explains the basics about genital herpes, including the difference between genital HSV-1 and HSV-2 infection, testing options and the importance of knowing virus type, and the three-prong strategy for prevention. See more herpes videos at sexualhealthTV.com.
Have a question about herpes youd like Dr. Handsfield or our other experts to answer? Visit our Ask the Experts page to learn how.
Some Important Facts Affecting The Risk Of Herpes Transmission
- Herpes is transmitted through skin-to-skin contact
- The first outbreak is the most contagious
- There is a greater statistical chance of passing herpes when youâve been recently diagnosed whether you have symptoms or not
- Herpes infects skin areas that are thin and moist because itâs easier for the virus to penetrate those areas. For that reason, females are three times more likely to be infected than males
- Younger people having casual sex are more likely to contract herpes
- HSV-1 in the genital area recurs less often than HSV-2
- Being positive for HSV-2 gives some protection against getting HSV-1. The opposite is not true
- If a person with one type of herpes acquires a different type, the flare-up symptoms are milder
- Sex toys should not be shared. But if they are shared, they should be cleaned with water and soap before being used
If You Have Symptoms Find Out What Youre Dealing With
With genital herpes, the biggest mistake people make is not seeking medical advice, says Gade.
People often find the signs or symptoms of a first herpes outbreak confusing, says Gade. You may mistake herpes symptoms for those of a yeast infection and try curing that condition on your own. But if your healthcare provider diagnoses you with herpes, the first line of treatment will be antiviral medications.
, you can make matters worse by putting things on the herpes sores that you shouldnt put on the sores, she says. People often try using Vaseline, bacitracin, or Aquaphor to soothe the itchy or painful eruptions.
Honestly, not putting anything on the sores is best, says Gade. Do keep the area clean and dry, though.
Warm compresses applied to tender or painful areas can help. So can sitting in a warm bath, using Epsom salt.
Sometimes people have enormous pain with urination, says Gade. For relief, you can urinate in your bathwater or while taking a shower to dilute the urine stream and lessen the sensation. You can also use warm water in a spray bottle to dilute the stream while youre urinating.
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How Is Genital Herpes Treated
There is no cure for herpes and no way to remove the virus from your body. Potential vaccines are, however, in clinical trials.
If you have an active outbreak, your doctor may prescribe antiviral medications, which can shorten the duration and severity of the outbreak. The most common medicine used is acyclovir.
If you are in a relationship and want to have unprotected sex, daily suppressive therapy can reduce the likelihood of transmission to your partner. It can also reduce the risk of transmitting herpes to a baby during delivery.
When experiencing an outbreak, you should take an over-the-counter pain reliever to reduce symptoms. Cool compresses applied directly to the sores can also reduce pain and itching. If you have sores on your labia, urinating in a tub of water can reduce pain.
You should wash your sores gently with soap and water and pat dry. Wearing loose-fitting underwear can also help.
Avoid doing the following, as these can make your sores worse and more painful:
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Bandaging sores
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Picking at sores, can result in an infection and also potentially transmit the virus to your hands
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Using any kind of ointment or lotion unless recommended or prescribed by your doctor
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Wearing pantyhose
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Wearing tight-fitting pants
Can I Breastfeed If I Have Genital Herpes
Yes, you can breastfeed if you have genital herpes, but not if you have a herpes sore on one of your breasts. If you have genital herpes, it is possible to spread the infection to any part of your breast, including your nipple and areola.
If you have any genital herpes sores on one or both of your breasts:
- You can keep breastfeeding as long as your baby or pumping equipment does not touch a herpes sore.
- Do not breastfeed from the breast with sores. Herpes is spread through contact with sores and can be dangerous to a newborn baby.
- Pump or hand-express your milk from the breast with sores until the sores heal. Pumping will help keep up your milk supply and prevent your breast from getting overly full and painful. You can store your milk to give to your baby in a bottle for another feeding. But if parts of your pump also touch the sore while pumping, throw the milk away.
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Protecting Your Partner And Preventing Herpes Transmission
Research shows that the single greatest fear is the fear of transmission to partners, says Dr. Handsfield.
The main ways to avoid transmitting herpes are:
- Learn to recognize how you feel when an outbreak is on the way, and stop having sex immediately.
- Dont have sex during active outbreaks.
- Always use condoms but dont rely on them during outbreaks. They dont completely cover infectious areas.
- Only after all sores have scabbed over and healed should you have sex again.
- Avoid touching your herpes sores, because you can spread them to other places on your body that way. Whenever you touch a sore, wash your hands immediately.
- Dont kiss people or have sex if you have a cold sore.
- Tell potential partners about having herpes before having sex with them, even though it may be hard.
- Ask your doctor about taking antiviral drugs regularly.
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How Is Herpes Simplex Diagnosed
Healthcare providers may diagnose herpes simplex based on how the sores look. Your provider may take a sample from the sore. Laboratory analysis of the sample can confirm or rule out the herpes virus.
If you dont have sores, your healthcare provider can use a blood test to check for HSV-1 and HSV-2 antibody, a marker showing youve been exposed to the virus. The blood test doesnt show an active infection . But it informs your provider whether youve been exposed to the herpes virus in the past. If this is your first infection, you may not test positive for herpes if there hasnt been enough time for your body to develop antibodies. The HSV-1and HSV-2 antibody test may be repeated in eight to 12 weeks.
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I Had Lesions When I Was Evaluated But My Culture Was Negative Does This Mean That I Dont Have Herpes
Not necessarily. Although lesions can be caused by something other than herpes, false negative herpes tests can occur if the samples are not taken appropriately, if there is a long transport time between the clinic and the laboratory, or if cultures were taken late in the course of the lesions. Lesions that occur early in the course of a herpes outbreak are much more likely to have positive cultures than cultures taken after the lesions crust over.
How Can I Best Learn To Cope With Herpes Simplex
Some people feel distressed or embarrassed about their herpes simplex infection. Its important to understand that the herpes virus is common. For most people, herpes doesnt significantly interfere with daily life.
To cope with negative feelings, you may consider:
- Connecting with others through support groups or online forums.
- Sharing your feelings with a trusted friend or loved one.
- Speaking with a therapist.
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Valacyclovir For Preventing Hsv
There are antiviral medicines that can prevent outbreaks. Using daily valacyclovir or Valacyclovir treatment can help to reduce asymptomatic shedding as well as outbreaks. In the study mentioned above, there were 743 of the 1484 couples who were instructed to take 500 mg Valacyclovir daily. Doctors also told them to use a condom for extra protection. Amongst these couples, only 14 were infected, and of those, four experienced outbreaks.
The study results were promising because taking 500 mg Valacyclovir daily can reduce the transmission of Genital Herpes. However, Valacyclovir can help reduce transmission of HSV-2, but it is not yet confirmed that Valacyclovir can be effective in treating genital sores due to HSV-1. HSV-1 is the herpes virus that causes cold sores around the mouth. HSV-2 most commonly causes genital herpes cases, but now there are increasing cases of genital herpes due to HSV-1. The reason for this cause is the growing social sexual change and high rate of oral sex.
The dosage of Valacyclovir is 500 mg for people who have fewer than nine outbreaks. However, doctors can adjust the dosage for those people who have more outbreaks and different organ problems.
Can I Be Treated To Prevent Genital Herpes Transmission To My Partner
Yes. A large study showed that if one partner has herpes and the other partner is uninfected, treating the infected partner with suppressive therapy can prevent transmission of symptomatic herpes in over 90% of cases. This is an option for couples who are interested in having unprotected sex or who are planning to become pregnant.
If you are entering into a new relationship and are aware that you have herpes simplex infection, you owe it to your partner to notify them before having sex.
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How Far Away Is A Cure For Herpes
Theres currently no cure for herpes, but that might change in the future.
According to 2020 research published in Nature, scientists from the Fred Hutchinson Cancer Research Center removed 90 percent of the HSV-1 virus from cells in mice using gene editing.
However, it takes time to transition potential treatments from animals to humans. In a 2020 news article, one of the researchers that authored the Nature paper estimated that it would be at least 3 years before human trials.
Scientists are also researching the possibility of creating a vaccine to prevent herpes. A 2022 study outlined a new approach to developing an mRNA vaccine for herpes. The vaccine mentioned in the study worked well in mice and guinea pigs.
The researchers say that theyre aiming to conduct human trials before the end of 2022, and the vaccine could be available within the next 10 years.
What Other Drugs Will Affect Zovirax
Acyclovir can harm your kidneys, especially if you also use certain medicines for infections, cancer, osteoporosis, organ transplant rejection, bowel disorders, high blood pressure, or pain or arthritis .
Other drugs may interact with acyclovir, including prescription and over-the-counter medicines, vitamins, and herbal products. Tell your doctor about all your current medicines and any medicine you start or stop using.
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Drug Treatment For Genital Herpes
If you are infected with genital herpes, your doctor may prescribe oral antiviral drugs to help ease your symptoms during both a first episode and recurrent episodes. Your doctor may also suggest taking antiviral drugs daily as a suppressive therapy to reduce symptoms and protect partners.
Remember, though, that antiviral drugs do not wipe out the virus completely. It continues to live in your body, so if you stop taking the drugs that suppress it, you may have more frequent or more intense symptom outbreaks, and the risk of your transmitting the virus to others rises.
Three antiviral drugs, all taken by mouth, are used to treat genital herpes:
What Are The Complications Of A Herpes Meningitis Infection
If the meningeal infection spreads over to the brain, the symptoms may turn more aggressive. Such a condition is known as herpes meningoencephalitis. It leads to high-grade inflammation in and around the brain. As a result, there will be fluid collection and swelling in both the meninges and brain raising the pressure inside the head dangerously high. Excess fluid compresses the brain, spinal cord, and other structures inside the head and causes serious damage. If left untreated, the damage cannot be reversed, and the individual may develop seizures, fall into a state of coma, or die. Those who recover from this condition may have long-lasting debilitating disabilities both at a physical and intellectual level.
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Course And Possible Complications Of Nasal Herpes
The fluid-filled cold sores on or in the nose usually heal after two to ten days. However, crusted wounds can open up again and again, which means that complete healing can take several weeks.
Those affected should absolutely avoid touching herpes on the nose and thereby spreading it. There is a risk that the course of the disease will be prolonged or that the infection will spread to the eyes. Eye herpes is shown by a reddened conjunctiva, the eyes burn and itch. The disease is dangerous and, if left untreated, can lead to blindness. Therefore, contact lens wearers should be particularly careful and wash their hands thoroughly before inserting or removing contact lenses or wear glasses.
Complications can also occur in people with neurodermatitis. Due to the disturbed immune system, herpes eczema can spread all over the face and the rest of the body . In this case, rapid treatment is required, otherwise it can lead to a severe course with complications such as meningitis.
But nasal herpes can also be dangerous for people with a weakened immune system . In the worst case, they can also develop meningitis. Emergency medical help should be sought immediately if signs such as stiff neck, nausea, headache or rapidly increasing fever appear.
What Questions Should I Ask My Doctor
You may want to ask your healthcare provider:
- What is the best treatment for me?
- What happens if I dont treat a cold sore?
- What are the side effects of antiviral medications?
- How can I reduce the risk of future outbreaks?
- Whats the best way to prevent getting another STI?
- How can I protect my partner from getting genital herpes?
- Should I lookout for signs of complications?
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Does A Cold Sore On My Mouth Mean I Have Genital Herpes
No, a cold sore on your mouth usually means you have herpes simplex virus type 1 . You can get HSV-1 by kissing someone or sharing utensils, towels, razors, or lipstick with someone who has HSV-1.
HSV-1 cannot turn into HSV-2 , but you can get a cold sore on your mouth from HSV-2 if you give oral sex to someone with HSV-2. Cold sores caused by HSV-1 or HSV-2 are contagious. You can spread it to other people or other parts of your body if you touch an open sore and then touch another part of your body. That means if you have a cold sore and give oral sex to someone, that person will get the herpes virus on his or her genitals.
Avoid touching your cold sore as much as possible. If you touch your cold sore, wash your hands right away to avoid spreading the infection to other parts of your body or other people.
Is There A Cure For Herpes Simplex
There is no cure for herpes simplex. Once you have the virus, its a lifelong infection.
What is the outlook for people with herpes simplex?
For many people, the first herpes outbreak is the most severe. Many outbreaks are less frequent and milder after the first year of infection. Some people may have only one outbreak and never have another again.
Herpes infection doesnt usually pose a serious health risk. The risk of a health complication due to herpes is higher in infants and if you have HIV/AIDS, cancer or an organ transplant.
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What Are The Risks Of Getting Hsv From An Infected Person
HSV-2 most commonly causes genital herpes through contact with genital sores. However, it can even spread when there are no visible sores or partners who dont even know that they are infected. According to statistics, around 87% of people infected with HSV-2 dont know that they have the disease.
Several studies have experimented with the rate of transmission between partners. According to a 2004 study of the New England Journal of Medicine, there were 1484 couples, and one of the partners had the virus. The asymptomatic partner had monthly checkups to check for symptoms of the disease. Doctors educated 741 couples about protection using condoms to avoid herpes transmission. Amongst those couples, only 27 became infected, and 16 of them had an outbreak.
According to the CDC, almost 775,000 people contract genital herpes infection. Moreover, it is common in women because it transmits from men to women during sexual contact. Other than avoiding sexual contact, there is no other way to prevent the transmission completely. Using condoms can reduce the transmission, but it doesnt eliminate the risk. Alternatively, there is another method to reduce the risk of using antiviral medicines.
Do Condoms Help Prevent The Spread Of Genital Herpes
Yes. To prevent transmission of herpes, we recommend that condoms be used 100% of the time. Many patients will shed the virus and be contagious when they dont have symptoms. Studies have shown that asymptomatic shedding occurs between 1% and 3% of the time in patients with HSV II genital infections. Many new herpes infections occur from partners who are shedding the virus asymptomatically, so condoms are highly recommended.
Condoms may not be an attractive option for monogamous couples or for couples who desire to become pregnant. Couples may opt to have serological tests to determine if either partner has an asymptomatic infection. In close monogamous relationships, the risks of transmission can be weighed against other relationship issues, such as intimacy and pregnancy.
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