Management Of Sex Partners
The sex partners of persons who have symptomatic genital herpes can benefit from evaluation and counseling. Symptomatic sex partners should be evaluated and treated in the same manner as patients who have symptomatic genital herpes. Asymptomatic sex partners of patients who have symptomatic genital herpes should be asked about a history of genital symptoms and offered type-specific serologic testing for HSV-2. For partners without genital herpes, no data are available on which to base a recommendation for PEP or PrEP with antiviral medications or that they would prevent acquisition, and this should not be offered to patients as a prevention strategy.
What Are The Causes Of Genital Herpes
Genital herpes is spread by skin-to-skin contact with someone who has the HSV virus, usually during genital or oral sex. It can also be spread through kissing, foreplay or non-penetrative sex.
- HSV1 commonly causes cold sores on the lips or face.
- HSV2 causes most genital herpes.
The HSV virus is most easily spread when there are blisters or sores, but it can still be passed even if a person has no current blisters or sores or other symptoms.
You cannot get genital herpes from things like hugging, swimming pools or toilet seats.
What Happens If Herpes Is Not Treated
Herpes can be painful, but it generally does not cause serious health problems like other STDs can.
Without treatment, you might continue to have regular outbreaks, or they could only happen rarely. Some people naturally stop getting outbreaks after a while. Herpes typically does not get worse over time.
The information on this page is adapted from the CDC and Planned Parenthood.
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What If I Am Pregnant
It is important to tell your obstetrician that you or a partner have had genital herpes, so that they can monitor you for symptoms and manage your pregnancy safely. There is a risk you can pass the virus on to your baby if you have a vaginal delivery during a first attack of genital herpes. If this happens you may be recommended to have a caesarean delivery.
Talk With Your Doctor About Herpes Medications
Its important to first talk with your doctor before using over-the-counter products like docosanol or other home remedies.
If this is the first time you have symptoms of HSV with blisters or sores, your doctor will first diagnose if you have HSV, the type and discuss options to manage your condition. They will tell you about prescription and nonprescription alternatives to treat your HSV infection.
Tell your doctor if you have any serious health conditions including if you have a weakened immune system.
Your doctor will also tell you what you can expect with an HSV infection, how long it may last, and what do to prevent spreading HSV to others while you have an active infection.
Here are answers to a few commonly asked questions about herpes simplex virus.
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Continue Learning About Genital Herpes
Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.
Herbs Vitamins And Other Supplements
It isnt always possible to eat foods containing the high levels of nutrients your body needs to fight genital herpes, but herbs, vitamins, and supplements can help. The following choices are known to boost immune system function and help the body combat herpes outbreaks.
Zinc. Chickpeas, pork, lamb, and wheat germ all contain high levels of zinc. Research shows that zinc ions are active against the herpes simplex virus and may even extend the time between outbreaks.
Lysine. Research is still ongoing, but recent reports suggest that daily lysine supplementation may reduce the recurrences of herpes outbreaks. Though lower doses of lysine show little effect, high doses of up to 3,000 mg a day may be beneficial.
Probiotics. Probiotics are well known for their immune-boosting abilities. Now research also shows that certain probiotic strains can limit herpes infections as well.
Vitamin B Complex. The full range of B vitamins serves many critical roles in your body, including healthy cell growth, metabolism, and energy. You need all of these functions in full force to respond to an active outbreak of herpes.
Aloe vera. Aloe vera isnt just for sunburn! Pure aloe vera offers antimicrobial, antifungal, and wound healing properties that soothe herpes symptoms and encourage rapid healing.
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Herpes Medication: Treatment And Drug Information
Herpes is a common, lifelong viral infection that affects nearly half of American adults under the age of 50.
Most infected individuals do not develop herpes symptoms at all, but for some people, herpes infections can cause painful sores, blisters, or lesions, often on the mouth or genitals.
People who carry the herpes virus can spread it to others through close, direct, and intimate contact.
In this article, Ill review the medications that doctors use to treat both oral and genital herpes.
These include the oral antiviral medications acyclovir , valacyclovir , and famciclovir .
Ill discuss how long it typically takes for these treatments to work, as well as the various dosages available with these treatments.
Ill examine the different kinds of herpes strains and look at the major side effects of herpes medications.
Finally, Ill discuss when to see a doctor if you think you may be experiencing a herpes breakout. .
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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.
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What Is Genital Herpes
Genital herpes is a common viral infection caused by a virus known as the herpes simplex virus .
There are two types of the virus, types 1 and 2 . As well as genital herpes, HSV can infect your mouth and cause cold sores. HSV-1 and HSV-2 infections look the same and you can only tell them apart by lab testing.
Because genital herpes can be passed to others through sexual contact, it is often referred to as a sexually transmitted infection .
As many as 1 in 3 adults has the virus that causes genital herpes. Once you have HSV it remains in your body and becomes active again from time to time.
On average, symptoms of genital herpes are likely to recur 45 times in the first 2 years after being infected with HSV. However, over time the virus tends to become active less often and each time you get symptoms they are less severe.
A Blood Test Can Determine If Someone Has Genital Herpes
To find out if you have genital herpes, a doctor can take a sample from a sore and test it in the laboratory. There is also a blood test that looks for antibodies to the virus that your immune system would have made. HSV-2 almost always infects the genitals, so if antibodies to HSV-2 are detected in your blood, you probably have genital herpes.
A blood test that shows antibodies to HSV-1 means you could have genital or oral herpes. Thatâs because oral herpes, typically caused by HSV-1, can be spread to the genitals during oral sex.
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Myth #: Your Sex Life Is Over
While theres no cure, herpes treatment is simple and can shorten or prevent outbreaks, so you can still have a love life.
People have a disproportionate fear of herpes in relation to any other STI, Grimes says. They feel like their sex lives are ruined forever and thats in no way the case.
If you have the virus, your doctor may prescribe a medication like Zovirax or Valtrex to keep on hand in case of a flare-up. And if you experience outbreaks often, your provider may recommend daily dosing. However you treat it, its worth remembering that herpes is a condition to manage it doesnt define you.
If you have to be perfect for your new partner, that partner will be looking a very, very long time to find a match! Grimes says. Everyone has something, and since one in six Americans between 14-49 have HSV-2, odds are very high that your next partner is in the same boat. The main issue is to have productive conversations around these issues.
So theres no reason for all the stigma and secrecy surrounding herpes, since its safe to assume more people have it than you think. And if youre diagnosed with the virus, your provider will help you find a treatment plan thats easy, effective, and fit for your lifestyle.
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
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Why Genital Herpes Comes Back
Genital herpes is caused by a virus called herpes simplex. Once you have the virus, it stays in your body.
It will not spread in your body to cause blisters elsewhere. It stays in a nearby nerve and causes blisters in the same area.
If you can, avoid things that trigger your symptoms.
Triggers can include:
- surgery on your genital area
- a weakened immune system for example, from having chemotherapy for cancer
Treatment For Oral Herpes
The antiviral medications available in pill form have been specifically developed for the treatment of genital herpes. However, it is not uncommon for healthcare providers to prescribe the antiviral drugs to those who have frequent or severe outbreaks of oral herpes.
A recent study found valacyclovir to be effective for treating oral herpes in a one-day treatment of 2 grams taken at the first sign of a cold sore, and then again about 12 hours later.
There are two topical antiviral medications prescribed for the treatment of oral HSV symptoms: acyclovir ointment and penciclovir cream. Both work to speed up the healing process and reduce the viral activity. These topical drugs are put directly on the lesions themselves, but can also be used at the onset of prodrome.
Other topical treatments for oral herpes are available over-the-counter , but are not antiviral compounds like acyclovir and penciclovir. Some also contain ingredients that numb the area and induce temporary relief from the discomfort of an outbreak. Unfortunately, some OTC treatments may actually delay the healing time of symptoms because they can further irritate the area with repeated applications. There is only one OTC FDA-approved cream, called Abreva®, which has been clinically proven to help speed the healing process.
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Stages Of Herpes Outbreaks
Like any other infection, every case is different. The duration of a herpes outbreak will depend on factors such as:
- Your individual immune system
- How many outbreaks youâve had in the past
- Treatment history
Keep in mind that no matter your history or treatment, thereâs help.
The stages of a herpes outbreak can last between two and 14 days and can be broken down into stages:
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Suppressive Therapy For Herpes
If you have frequent recurrences of genital herpes
Taking medication every day for many months will stop recurrences completely, or their frequency and severity are greatly reduced. This is called suppressive or prophylactic treatment. Generally, after a year, it is recommended you stop the medication for a few months to see if recurrences have become less frequent. This type of continuous treatment can be repeated if necessary. This type of daily treatment tends to be prescribed if you have frequent or severe recurrences of genital herpes more than six times per year.
Suppressive treatment is valaciclovir 500mg taken daily. This may be increased to 500mg taken twice daily on individual basis of clinical presentation and/or if you are having breakthrough recurrences on 500mg daily. The alternative is oral aciclovir 400mg taken twice daily .
A Doctor can give you a prescription every 3 months for up to 12 months and ongoing if your recurrences are still frequent.
Effectiveness is optimised if taken regularly as prescribed.
For special events
A course of medication may help to prevent a recurrence during special times. This may be an option even if you do not have frequent recurrences, but want to have the least risk of a recurrence – for example, during a honeymoon, holiday or during exams.
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When Is Preventive Treatment Considered
Some people have outbreaks of genital herpes very often or experience especially severe symptoms. Then it may be a good idea to take antiviral medication for a longer time including during symptom-free phases. The goal is to prevent further outbreaks and to keep the symptoms from becoming so severe. Also, the antiviral medication reduces the likelihood of infecting others. As preventive treatment, the WHO recommends the following:
- aciclovir: 400 mg two times per day,
- famciclovir: 250 mg two times per day or
- valaciclovir: 500 mg once per day.
Research shows that preventive treatment can considerably lower the risk of further outbreaks. The people participating had four or more herpes outbreaks per year before the start of the studies, and then took an antiviral medication or a fake treatment for up to one year. A comprehensive analysis of the study results shows that
- 96 out of 100 people who took a placebo had at least one further outbreak of genital herpes.
- 46 out of 100 people who were given antiviral medication had at least one further outbreak of genital herpes.
In other words, the medication prevented further outbreaks in 50 out of 100 people within one year.
People with very frequent herpes outbreaks also benefited from preventive treatment: In one study involving people with very frequent outbreaks, the medication lowered the number of episodes in one year from 11 to 2.
Different Types Of Herpes Hsv
People with herpes can experience viral symptoms in widely different ways: across this population, there is a large range in both the frequency and severity of peoples herpes outbreaks.
Ultimately, all herpes infections are caused by one of two strains of the herpes simplex virus: HSV-1 and HSV-2.
Herpes simplex virus-1 is the strain that is primarily responsible for oral herpes outbreaks, which are also known as cold sores.
In some cases, HSV-1 infections can also cause genital herpes outbreaks, for example if the virus is spread through oral sex.
Herpes simplex virus-2 , meanwhile, is the herpes simplex strain that causes most outbreaks of genital herpes.
Typically, most herpes outbreaks will resolve on their own in 1-2 weeks.
At this point, the herpes virus will move from your skin cells and into your nervous system, where it will lay dormant until it is reactivated, if for example, your immune system is under stress.
However, certain medications can make the resolution of a herpes outbreak quicker, and more tolerable.
In some cases, they can even prevent outbreaks from occurring with frequency .
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What Are The Treatment Options For Genital Herpes
Treatment with antiviral medication is a good idea the very first time people have an outbreak of genital herpes. Later outbreaks are often milder, and then medication isnt always needed. Preventive treatment may be considered if the outbreaks are frequent.
Genital herpes may clear up on its own. But the symptoms are often more severe the first time you have an outbreak. Most people then use antiviral medication to relieve the symptoms and prevent complications. These medications include aciclovir, famciclovir and valaciclovir.
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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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