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.
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Recurrent Episodes Of Genital Herpes
Recurrences are usually less painful and shorter in duration than the first episode of genital herpes. Over time, episodes usually become less frequent and may eventually stop altogether. Infections caused by HSV1 are less likely to recur in the genital area than infections caused by HSV2.
Recurrences may be triggered by:
How Herpes Is Treated
There is no cure for herpes.
- The health care provider may prescribe antiviral medicine to help speed up the healing process. It also shortens the time when the virus can spread from the herpes sores.
- Pain may be treated with medicine such as Tylenol or Motrin or by applying an ice pack wrapped in a towel to the affected area.
- If sores are in the mouth, avoid foods high in acid, like citrus fruits and juices.
- The infected area should be kept clean and dry.
- Wash hands often and avoid touching the sores to prevent spreading the virus.
- It is important to stay healthy by getting enough rest, having proper nutrition and exercise and managing stress well.
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Can Genital Herpes Be Cured Or Treated
There is no cure for herpes. However, there are medicines that can prevent or shorten outbreaks. One of these anti-herpes medicines can be taken daily, and makes it less likely that you will pass the infection on to your sex partner.
What happens if genital herpes is left untreated?
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.
When To See A Doctor
People should see their doctor if they think they might have herpes, or if they have any symptoms of herpes. Getting tested for herpes is also important to rule out other sexually transmitted infections.
People can visit their doctor or a sexual health clinic for a test. If people have any sores or blisters present, a healthcare provider will use a swab to take a sample from the sores. The sample will indicate whether or not the sores are due to a herpes infection.
Some people may be concerned that they have the herpes virus but no symptoms. In such cases, a doctor might be able to order a blood test to check for the virus in a persons blood. However, the
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How Is Herpes Treated
There is no cure for the herpes simplex virus. The blisters usually heal and go by themselves, so you may not always need treatment. If treatment is needed, there are antiviral medicines which can help. These can shorten outbreaks, relieve discomfort and stop symptoms from getting worse.
The antiviral treatment is most effective when you take it within the first five days of symptoms appearing. Avoid touching the blisters as this can spread the infection. If treatment requires you to apply cream to a sore, gently pat the cream on, being careful not to rub around the surrounding area.
You can ease your symptoms by:
keeping the affected area clean using plain or salt water to prevent blisters or ulcers from becoming infected
applying petroleum jelly, such as Vaseline, to any blisters or ulcers to reduce pain when passing urine
asking a healthcare provider to recommend painkilling creams
avoiding tight clothing because it may irritate the blisters and ulcers.
Donât have sex until you or your partner have finished your treatment, and the blisters or ulcers have gone. Recurrent outbreaks are usually milder than the first episode of genital herpes and over time they tend to occur less often.
Valacyclovir For First Herpes Outbreaks
For first-time herpes outbreaks, valacyclovir is most effective when its used within 48 hours of symptoms appearing.
The standard dosage of valacyclovir for first-time herpes outbreaks is 1,000 mg two times per day over a period of 10 days. Valacyclovir usually starts treating herpes symptoms as soon as its in your system, but can take several days to produce a noticeable improvement.
It can take up to 10 days for herpes blisters to heal even with valacyclovir treatment. This makes it important to start treatment as soon as you notice herpes symptoms.
In some cases, your doctor might prescribe valacyclovir for a longer period than 10 days or at a different dosage. In this case, follow your doctors instructions and make sure you complete the full course of the medication, even if the herpes blisters heal before the end of the period.
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How Long Does A Herpes Outbreak Last
Herpes outbreaks usually last for about one to two weeks, though the first outbreak after infection may last longer. The symptoms typically go away on their own without treatment. However, there are at-home remedies and prescription treatments which may help to ease symptoms and shorten the length of outbreaks. Herpes outbreaks may continue to occur, but many people find that they become shorter and less severe over time.
Can Genital Herpes Be Prevented
The only sure way to keep from getting genital herpesor any other sexually transmitted infection is to not have sex. If you do have sex, practice safer sex.
- Before you start a sexual relationship, talk with your partner about STIs. Find out whether he or she is at risk for them. Remember that a person can be infected without knowing it.
- If you have symptoms of an STI, dont have sex.
- Dont have sex with anyone who has symptoms or who may have been exposed to an STI.
- Dont have more than one sexual relationship at a time. Having several sex partners increases your risk for infection.
- Use condoms. Condom use lowers the risk of spreading or becoming infected with an STI.
- Dont receive oral sex from partners who have cold sores.
Taking medicine for herpes may lower the number of outbreaks you have and can also prevent an episode from getting worse. It also lower the chances that you will infect your partner.
If you are pregnant, you should take extra care to avoid getting infected. You could pass the infection to your baby during delivery, which can cause serious problems for your newborn. If you have an outbreak near your due date, you probably will need to have your baby by cesarean section. If your genital herpes outbreaks return again and again, your doctor may talk to you about medicines that can help prevent an outbreak during pregnancy.
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How Are Genital Herpes Diagnosed
Other STIs, like syphilis, cause similar symptoms. In addition to a physical exam, your healthcare provider will take a fluid sample from the blisters to test for the herpes virus. If your blisters are healed or you dont have blisters, a blood test can check for HSV-2 antibody, a marker that shows you have been exposed to the virus.
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What Are The Different Types Of Herpes
There are two types of herpes simplex virus: HSV I and HSV II. HSV I commonly causes oral herpes, or cold sores. This virus can show up as an upper respiratory tract infection during early childhood. HSV II is the cause of most cases of genital herpes. However, it is possible for HSV I to cause genital herpes and HSV II to cause oral herpes.
Clinicians cannot tell the difference between the two types by physical examination alone, but there are differences between the two viruses. For example, genital herpes caused by HSV II is much more likely to recur. This diagnosis can be helpful in establishing a health care plan.
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Cycle And Duration Of A Herpes Outbreak
When an individual is first infected with herpes and exhibit active symptoms, the duration of the primary outbreak will be the worst and most painful and can take 3 to 6 weeks to resolve. Subsequent recurrent outbreaks will be less severe, typically lasting 3 to 14 days and the frequency will become farther and farther apart with each recurring attack.
A typical cycle and duration of a herpes outbreak may look like the following:
Why You Should Go To A Sexual Health Clinic
You can see a GP, but theyll probably refer you to a sexual health clinic if they think you might have genital herpes.
Sexual health clinics treat problems with the genitals and urine system.
Many sexual health clinics offer a walk-in service, where you do not need an appointment.
Theyll often get test results quicker than GP practices and you do not have to pay a prescription fee for treatment.
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Fever Blister On Nose
Herpes labialis, commonly known as cold sores, is a type of infection by the herpes simplex virus that affects primarily the lip. Symptoms typically include a burning pain followed by small blisters or sores. The first attack may also be accompanied by fever, sore throat, and enlarged lymph nodes. The rash usually heals within ten days, but the virus remains dormant in the trigeminal ganglion.
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Is Herpes Simplex Related To Herpes Zoster
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.
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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.
Where Does The Herpes Virus Live In The Body
The herpes simplex viruses are latent, meaning they can live in the body without causing symptoms. After the initial infection, the virus gets into the nerve roots and spreads to the sensory nerve ganglia, the junctions where nerves from different parts of the body come together. For the genital area, the ganglia are adjacent to the spinal cord in the lower back. For orofacial herpes , the ganglia are located behind the cheek bone.
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How Do You Avoid Getting Or Passing On Genital Herpes
If either you or your partner has a herpes outbreak , its best to wait until the symptoms have cleared up before having sex.
Herpes can also be transmitted by sharing sex toys. To reduce your risk, either avoid sharing your sex toys or make sure that they are washed and covered with a new condom between each use.
Use a new dental dam or latex gloves for rimming and fingering or use latex gloves for fisting, especially if you get herpes on your hands.
Talking about your sexual health with your partners, and letting each other know about any infections that you have, can help you make decisions about safer sex together. Reducing your number of sexual partners can help you reduce your risk of getting sexually transmitted infections, like genital herpes. If you are having sex with multiple partners, its even more important to use condoms and to have regular STI checks.
Im Pregnant How Could Genital Herpes Affect My Baby
If you are pregnant and have genital herpes, it is very important for you to go to prenatal care visits. Tell your doctor if you have ever had symptoms of, or have been diagnosed with, genital herpes. Also tell your doctor if you have ever been exposed to genital herpes. There is some research that suggests that genital herpes infection may lead to miscarriage, or could make it more likely for you to deliver your baby too early.
Herpes infection can be passed from you to your unborn child before birth but is more commonly passed to your infant during delivery. This can lead to a potentially deadly infection in your baby . It is important that you avoid getting herpes during pregnancy. If you are pregnant and have genital herpes, you may be offered anti-herpes medicine towards the end of your pregnancy. This medicine may reduce your risk of having signs or symptoms of genital herpes at the time of delivery. At the time of delivery, your doctor should carefully examine you for herpes sores. If you have herpes symptoms at delivery, a C-section is usually performed.
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How Is Herpes Simplex Treated
Some people have few to no herpes outbreaks and choose not to have treatment. But many people prefer to use medications that shorten outbreaks and reduce symptoms.
During an outbreak, you may use an antiviral ointment or cream to help lessen your symptoms and help them go away faster, but it only works if you start it soon after you start an outbreak. Many people with HSV-2 take daily oral medications to keep outbreaks at bay.
Your provider may prescribe a topical medication or oral medication such as:
More Questions From Patients:
Many people with genital herpes have no symptoms, or have very mild symptoms that go unnoticed.
The first time genital herpes symptoms appear is called the “first episode” or “initial herpes.” Initial herpes symptoms are usually more noticeable than later outbreaks.
Symptoms of genital herpes in men may include
burning when you pee if you have sores
trouble peeing if you have sores covering your urethra
itching or pain around your genitals
During initial herpes, symptoms may also include
swollen, tender glands in the pelvic area, throat, or under the arms
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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.
What Are The Complications Of Genital Herpes
Genital herpes may cause painful genital ulcers that can be severe and persistent in persons with suppressed immune systems, such as HIV-infected persons. 5 Both HSV-1 and HSV-2 can also cause rare but serious complications such as aseptic meningitis . 5 Development of extragenital lesions may occur during the course of infection. 5
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Im Pregnant What Do I Need To Know
To get the best care, tell your doctor you have genital herpes, because it could make you more likely to have a miscarriage or give birth too soon.
Its possible to pass along the virus to your baby. For infants, it can be life-threatening. Your doctor can talk to you about how to lower the chances that this will happen.
If you have an outbreak while youre pregnant, your doctor can give you medicine to treat your symptoms and stop them sooner.
Your doctor may give you a drug to prevent an outbreak as your due date gets closer. This is because your baby could get herpes by passing through your birth canal if youre having an outbreak when you go into labor. If thats a possibility, your doctor will most likely want to do a C-section, which is surgery to deliver the baby.