Recurrence Course Triggers And Timing
Course of Recurrence
Most cases of herpes simplex recur. The site on the body and the type of virus influence how often it comes back. Recurrences of genital herpes are more likely with HSV-2 infection than with HSV-1 infection.
The virus usually takes the following course:
- Prodrome. The outbreak of infection is often preceded by a prodrome, an early group of symptoms that may include itchy skin, pain, or an abnormal tingling sensation at the site of infection. Headache, enlarged lymph glands, and flu-like symptoms may occur. The prodrome, which may last from 2 hours to 2 days, stops when the blisters develop. About 25% of the time, recurrence does not go beyond the prodrome stage.
- Outbreak. Recurrent outbreaks feature most of the same symptoms at the same sites as the primary attack, but they tend to be milder and briefer. After blisters erupt, they typically heal in 6 to 10 days. Occasionally, the symptoms may not resemble those of the primary episode, but appear as fissures and scrapes in the skin or as general inflammation around the affected area.
Triggers of Recurrence
Herpes outbreaks can be triggered by different factors. They include sunlight, wind, fever, physical injury, surgery, menstruation, suppression of the immune system, and emotional stress. Oral herpes can be triggered within about 3 days of intense dental work, particularly root canal or tooth extraction.
Timing of Recurrences
Prevention Of Genital Herpes
The best protection against STIs is to always use barrier protection such as condoms, female condoms and dams . Because herpes is spread by skin-to-skin contact, condoms will reduce the risk of transmission, but it will not protect sexual partners completely as condoms do not cover the entire genitals.
Using lubricant with a condom during sex will also reduce the risk of trauma to the genital skin. This has been shown to reduce HSV transmission, especially in the first six months of a sexual relationship. Silicone-based lubricants are recommended.
Remember that herpes transmission can occur when symptoms are present , but may also occur even if there are no genital symptoms through asymptomatic viral shedding.
For people who have frequent episodes of genital herpes, antiviral medication, taken daily, helps to reduce transmission of herpes to a sexual partner.
How Has My Partner Caught Genital Herpes
If your partner has only just been diagnosed with genital herpes, this does not necessarily mean that they have been unfaithful to you or sexually promiscuous in the past.
- Your partner may have caught genital herpes from you. You can carry the virus without knowing you have it as some people have no symptoms.
- It is also possible that your partner caught the virus from a cold sore on your mouth or face during oral sex. You can pass the virus on even if you dont have a cold sore at the time of contact.
- Your partner may have contracted the virus from a previous sexual partner, even several years ago. The virus can remain inactive in your body for long periods.
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If You Have Genital Herpes Already Can It Be Spread To Other Parts Of The Body Such As The Arms Or Legs
No. Genital herpes cannot be transmitted to another part of your body such as your arm, leg or hand after the first infection occurs. If you have genital HSV II, you will not get HSV II at another site in your body. The immune system produces antibodies that protect other parts of your body from infection. However, there are cases where a person has multiple site infections from the same virus. This is usually acquired at the time of the first infection. For example, if someone has never had herpes but then has oral and genital sex with an infected partner, they can acquire the infection at both sites.
What You Need To Know
- Herpes simplex virus , also known as genital herpes, is most likely to be spread when an infected person is having an outbreak, but it can also be transmitted without any symptoms being present.
- Medications can help reduce your symptoms, speed up the healing of an outbreak and make you less contagious.
- If you know you have genital herpes before becoming pregnant, your physician will monitor your condition throughout your pregnancy. If you have an active outbreak at the time of delivery, cesarean section may be recommended.
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Valacyclovir For Recurrent Herpes Outbreaks
Herpes can remain dormant in the body for weeks, months or years in between outbreaks. On average, people with HSV-1 experience about one outbreak per year, while people with HSV-2 will usually experience four to five outbreaks per year.
When these outbreaks occur, valacyclovir can provide fast and effective relief, helping to control herpes outbreak symptoms.
The typical valacyclovir dosage for recurrent herpes outbreaks is 500 mg two times per day over a period of three days. Like with first-time herpes outbreaks, valacyclovir is most effective when its taken as soon as you notice a herpes outbreak developing.
When taken as soon as you notice a herpes outbreak, valacyclovir can provide relief in as little as two to three days, minimizing symptoms and reducing the risk of you passing genital herpes to sexual partners.
How Soon Can You Be Tested
The incubation period for herpes is 2 to 12 days, which means that the best time to get tested for the herpes virus if you havent had an initial outbreak is after 12 days. If youre worried that youve been exposed to herpes but have not yet been diagnosed, here are some steps you can take:
- If youre currently sexually active, stop all sexual activity until you can receive a formal diagnosis.
- Reach out to your doctor and schedule an appointment for once the incubation period is up.
- If youre having an outbreak, you dont have to wait to get tested. Its possible to receive a diagnosis based on the lesions.
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Contact Dermatitis Can Be Mistaken For Herpes
Contact dermatitis is a skin condition that can cause red, itchy, cracked, dry, or scaly skin, blisters, or a rash. Like herpes, it recurs, and while it’s not an STD, when it appears in the mouth or genital area, it may be mistaken for herpes. However, unlike herpes, contact dermatitis can happen anywhere on the skin and is caused by direct contact with an irritant or something you’re allergic to, per the Mayo Clinic. It’s not caused by a virus.
Contact dermatitis usually occurs within minutes to hours after touching an irritant. Common causes include poison ivy and reactions to medication, cosmetics, detergents, and jewelry. The skin rash from contact dermatitis usually clears up in a few weeks.
The best way to prevent contact dermatitis is to identify whats causing it and avoid touching that item or substance again. Allergy testing can help identify the cause.
While contact dermatitis is generally not a serious condition, it can be itchy and uncomfortable. When the rash is present, try using cool, wet compresses or anti-itch creams to soothe it. Antihistamine pills can help reduce the itchiness. Avoid scratching the area: Doing so can make symptoms worse and open the door to a bacterial or fungal infection. If your itching is severe, you should see your primary care provider or a dermatologist for topical steroid medication.
How Is It Passed On
Most HSV type 1 infections are acquired during childhood.
You cannot get genital herpes from sharing baths or towels, from swimming pools, toilet seats or from sharing cups, plates or cutlery.
The virus will not pass through a condom but as condoms do not cover all of the genital area it is possible to infect genital skin that is not covered by the condom.
If you already have one type of HSV it is still possible for you to get the other type .
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What Is The Outlook
The main concern with corneal infection is that it can cause scarring of the transparent front part of the eye . With scarring, the normally clear cornea can become like frosted glass. This may sometimes seriously affect vision.
- Epithelial keratitis tends to settle and go away within a few weeks. It has a good outlook and often causes little or no scarring.
- Stromal keratitis is more likely to result in corneal scarring and loss of vision.
- Recurring episodes of active infection can make any existing scarring worse.
- Prompt treatment with antiviral eye ointment or drops helps to minimise damage during each episode of active infection.
Overall, good vision remains in about 9 in 10 eyes affected by herpes simplex infection â that is, vision good enough to drive. However, severe and recurrent herpes simplex eye infections may lead to serious scarring, impaired vision and even severe sight impairment in some cases. If severe sight impairment does develop, a corneal transplant may be the only option to restore vision.
What Are The Possible Side Effects Of Valacyclovir Tablets
Kidney failure and nervous system problems are not common, but can be serious in some patients taking valacyclovir tablets. Nervous system problems include aggressive behavior, unsteady movement, shaky movements, confusion, speech problems, hallucinations , seizures and coma.
Kidney failure and nervous system problems have happened in patients who already have kidney disease and in elderly patients whose kidneys do not work well due to age. Always tell your healthcare provider if you have kidney problems before taking valacyclovir tablets.
Common side effects of valacyclovir tablets in adults include headache, nausea, stomach pain, vomiting and dizziness. Side effects in HIV-infected adults include headache, tiredness and rash. These side effects usually are mild and do not cause patients to stop taking valacyclovir tablets.
Other less common side effects in adults include painful periods in women, joint pain, depression, low blood cell counts and changes in tests that measure how well the liver and kidneys work. The most common side effect seen in children < 18 years of age was headache.
Talk to your healthcare provider if you develop any side effects that concern you. These are not all the side effects of valacyclovir tablets. For more information ask your healthcare provider or pharmacist.
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Most Outbreaks Occur Within Two Weeks Of Herpes Exposure
If youve been infected with herpes and are symptomatic, youll usually start to experience some effects of the virus within one to two weeks.
An initial herpes outbreak usually lasts for two to three weeks and involves a range of different symptoms. Many people with herpes note that the initial outbreak has the worst symptoms and that subsequent outbreaks are less severe, although this isnt always the case.
Most people start to become aware that they might have herpes after a tingling sensation starts to develop in the area affected by the virus. For oral herpes, this is the start of the development of oral cold sores for genital herpes, the sores develop on the genitals, thighs and buttocks.
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Over the course of two to three weeks, this tingling/itching feeling leads to the development of blisters. The blisters eventually open into sores, then dry out and heal. Most herpes outbreaks do not leave any permanent scarring.
During your first herpes outbreak, you might also experience flu or cold-like symptoms. About 70% of women and 40% of men experience some level of flu-like symptoms, such as muscle pains, gland swelling, headaches and fever.
What Does Genital Herpes Look Like
While some people with genital herpes will never have any symptoms, other people can develop symptoms within a few weeks of being infected.
Often, before the lesions appear, patients describe a prodrome, characterized by a tingling or burning sensation in the area where the lesions will develop that can be noticed during urination, along with itching or discomfort in the genital area.
You can also have the following symptoms:
- Blisters on the mouth or lips
- Fever, headache or pain in the joints
- Trouble urinating
The symptoms of genital herpes often go away and come back as recurring outbreaks. For most people, the first outbreak is the worst, and can last from two to three weeks. Future flare-ups are often less severe and do not last as long. Still, some people shed the virus regularly. The following triggers can make outbreaks more likely to occur:
- Viral or bacterial infections
- Menstrual periods
Recurrent genital herpes is most common in the first year after the initial infection and decreases as time goes on.
In many cases, anti-herpes medicine can help patients. When a person experiences a prodrome and suspects a recurrence is going to happen, they begin taking anti-herpes medications that lessen symptoms and shorten the time of the outbreak.
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Treatment If The Blisters Come Back
Go to a GP or sexual health clinic if you have been diagnosed with genital herpes and need treatment for an outbreak.
Antiviral medicine may help shorten an outbreak by 1 or 2 days if you start taking it as soon as symptoms appear.
But outbreaks usually settle by themselves, so you may not need treatment.
Recurrent outbreaks are usually milder than the first episode of genital herpes.
Over time, outbreaks tend to happen less often and be less severe. Some people never have outbreaks.
Some people who have more than 6 outbreaks in a year may benefit from taking antiviral medicine for 6 to 12 months.
If you still have outbreaks of genital herpes during this time, you may be referred to a specialist.
Herpes Pregnancy And Newborn Infants
Herpes can pose serious risks for a pregnant woman and her baby. The risk is greatest for mothers with a first-time infection because the virus can be transmitted to the infant during childbirth. Guidelines from the American Academy of Pediatrics recommend using specific diagnostic tests for women in labor to determine the risk of transmission. Babies born to mothers infected with genital herpes are often treated with the antiviral drug acyclovir, which can help suppress the virus.
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What Does Herpes Look Like
Symptomatic herpes can cause skin sores or lesions. These can range from very small bumps or pimples to blisters that leak fluid. Someone with herpes may have just one of these bumps or blisters, or they may have clusters of them.
Crusty or irritated skin, with or without blisters or bumps, is also a symptom of herpes. The initial outbreak is usually the worst .
Areas affected by herpes include :
- On the buttocks
- Around the mouth or lips
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.
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How Long Does It Take For Herpes To Show Up After Exposure
Herpes is not just one type of infection. Its a family of related viruses that can cause several different medical conditions. The herpes infection were talking about when it comes to sex is caused by the herpes simplex virus or HSV .
Typically, HSV-1 is responsible for cold sores on the lips and around the mouth. HSV-2 is most commonly transmitted sexually and causes genital herpes, a common sexually transmitted infection . However, HSV-1 can also spread from the mouth to the genitals through oral sex and cause genital herpes.
While the symptoms of herpes usually show up anywhere from a couple of days to about two weeks following exposure, thats not always the case. In some cases, you may be asymptomatic for weeks or months before your first outbreak .
Long story short, if a few weeks have gone by after exposure and you dont have any symptoms, that doesnt necessarily mean youre out of the woods.
Reactivation And Recurrent Outbreaks
- Extreme temperatures
- Menstrual periods
The virus then travels to the skin and can cause another, often milder, outbreak. However, reactivation may not cause any symptoms.
Before an outbreak, some people experience prodrome. This is characterized by tingling, itching, or pain in the affected areas before the lesions appear.
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Potential Complications Of Oral Herpes
For most people, herpes is more of an inconvenience than it is a serious medical condition. Mild scarring might be a concern following a particularly severe outbreak.
There are two instances in which herpes poses a more severe risk, but neither of these instances involves oral herpes. For example:
- Neonatal herpes is a risk for infants born to mothers with genital herpes. It can lead to neurological disability and is potentially fatal.
- Herpes simplex encephalitis occurs when herpes infects a persons central nervous system . Its treatable, but can be fatal if not treated properly.
Many people have herpes but are asymptomatic, meaning they dont even know they have it.
Can Oral Herpes Come Back?
Oral herpes sores can come back. The virus remains in your body forever once youve contracted it.
However, it can remain dormant for a certain period and then reactivate. When this occurs, a person is likely to develop mild symptoms, including sores.
Some people refer to this as herpes coming back, even though its better described as a flare-uporrecurrence.
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