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
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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Antiviral Tablets To Stop The Herpes Virus Multiplying
Antiviral medicines taken by mouth, such as valaciclovir or acyclovir, are the most effective in controlling symptoms, although they cant cure genital herpes. They stop the virus from multiplying in body cells where the virus is present. The medicine only works while you are taking it. The infection can come back when you stop taking it.
Antiviral tablets are used in the following two ways:
- To treat outbreaks as they happen : The aim is to shorten the time each outbreak lasts and to relieve symptoms. This works best when taken as soon as you get symptoms and before the blisters appear.
- To prevent or reduce recurrences : If you get frequent or severe recurrent outbreaks, your doctor may recommend you take antiviral tablets every day to help prevent recurrences. Suppressive therapy is taken continuously, every day, for months or years. Suppressive antiviral therapy may help reduce the risk of transmitting the virus to sexual partners.
Antiviral creams bought over the counter from the pharmacy are not recommended as a treatment for a first episode or recurrent genital herpes as they are of little benefit. Antiviral tablets are the preferred treatment.
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Upgrade Your Eating Habits
Are you eating a standard American diet, or SAD? That means eating lots of meat, fast foods, and processed foods, and few fresh fruits and vegetables. Such habits not only work against living comfortably with herpes, they also raise your risk for many diseases such as diabetes, heart disease, and cancer. Consider upgrading your eating habits through a few, not-so-hard-to-make changes.
Eat more veggies. Try to prepare home-cooked food more often. Eat until you are satisfied, not stuffed, says LeeAnn Weintraub, RD, MPH, a registered dietitian based in Los Angeles. She considers those three tips to be the first steps to follow for anyone who wants to eat more healthfully.
What Are The Symptoms Of Herpes
Many people with genital herpes wont get any symptoms, or may get symptoms for the first time months or even years after they were infected.
For most people, the first blisters go away within a month. Although the outbreaks clear-up by themselves, the virus stays in the body. This means that people usually get blisters again which is called having a recurrent outbreak. Outbreaks usually become shorter and less severe over time.
Other symptoms can include:
-
tingling or burning around the genitals
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feeling unwell, with aches, pains and flu-like symptoms
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unusual vaginal discharge in women.
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What Stands Out About Yale Medicines Approach To Genital Herpes
As an academic medical center, Yale Medicine provides a wide range of treatment options for patients. Our doctors are expert at diagnosing and treating difficult cases and helping manage the condition for people at risk, such as pregnant women. Our doctors have access to the most advanced technology for diagnosing herpes and other medical conditions.Also, our researchers continue to look for new information about the herpes virus.
Do Natural Remedies Help
There are several options that can be tried to ease the pain. A73612 and Donnor52059 suggest dabbing cornstarch directly on the sores. I can’t find any scientific studies that have researched this, but I can’t see that it would do any harm.
A73612 also recommends squirting water from a bottle over the sores when you pee. This is a time-honoured method that will help to ease the pain.
Yolandayw mentioned taking a simple painkiller such as paracetamol during an outbreak. Feelbroken advised putting Vaseline on the sores. Lidocaine 5%, a local anaesthetic gel that numbs the area, is another option. Some people find it helpful to put on five minutes before passing urine. You need to get it on prescription and it doesn’t suit everyone. Some people develop sensitivity to it which makes the symptoms worse.
Yolandayw also advised using ice as a home remedy. Simply wrap the ice in a tea towel and apply for 5-10 minutes. Never put ice directly on the skin as this can cause ‘ice burn’. Drinking plenty of water can also be helpful as it reduces the concentration of urine, making it less painful when you have to pee.
D91907 mentioned putting aloe vera gel on the sores. There is some scientific evidence that aloe vera is useful for both genital and oral herpes.
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Assuring Safety Before Human Trials Can Begin
The researchers are performing additional preclinical studies of the therapy in guinea pigs, which, unlike mice, have naturally recurring outbreaks from latent herpes infections. As with the mice, the initial focus of this research is in HSV-1, which is primarily associated with cold sores. However, Fred Hutch researcher Dr. Anna Wald points out that recent studies, including one she published with colleagues at the University of Washington, are hinting at a shift.
HSV-1 is becoming â particularly in first infections for adults under 30 â the leading cause of genital herpes, the more feared condition that has been traditionally associated with HSV-2. Regardless, if the experimental therapy works for HSV-1, the researchers are confident it can be relatively easily adapted to target HSV-2.
Wald, who also heads the Division of Allergy and Infectious Diseases at UW, has been researching vaccines to prevent or treat HSV infection since 1991. She said that Jerome and Aubertâs work is a paradigm shift in the field, because the assumption has been that once a person is infected with a herpesvirus â and there are eight members of that family â it is impossible to get rid of that particular strain.
âIt is a completely novel approach, in which you can take a member of the herpesvirus group and eradicate it from the host. As a proof of principle, the fact that it could be done on even one of them is kind of mind-boggling,â she said.
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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What Treatment Is Available For Genital Herpes
Though genital herpes is not curable, it can be managed. Your physician may prescribe an antiviral medication, including acyclovir, valacyclovir, and famciclovir, to use during an outbreak. Over-the-counter pain medication can also be used to soothe symptoms. Your physician can provide advice on how to prevent transmission of the virus to sexual partners along with suggestions about how to discuss the topic of genital herpes openly.
Concerns About Potential Toxicities
The Hutch scientists note, however, that the good news is tempered by recent concerns within the gene therapy field about the potential for therapies using AAVs to cause liver and nerve damage.
The toxicity issue has been raised by other gene therapy researchers based on their own experiments. It does not appear to involve the gene-cutting enzymes used in the Hutch herpes studies, where those molecular scissors are performing as expected. Instead, it focuses on the AAVs used to package and transport them.
âAAV vectors in general have been considered quite safe. ⦠However, emerging work has suggested that AAV vectors may not be as fully innocuous as previously assumed,â the Hutch authors wrote in the bioRxiv paper.
They observed liver toxicity in some of their mice, but said it seems to be the result of very high concentrations of AAV, well above what is now known to be needed.
âWe know what the toxic dose is, and we get good results below that,â Jerome said.
The neurotoxicity is potentially more concerning. The Hutch team reported âsubtle evidence of neuronal injuryâ in mice when tissue samples were examined under a powerful microscope. However, they also saw no evidence in those animals of changes in behavior or mobility â such as gait or balance disturbances â after the gene therapy.
A priority in the next round of research will be to solve that mystery and, if necessary, find a way around it. The researchers remain confident the problem is solvable.
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When To Call A Doctor
Check in with your doctor or healthcare provider if you notice or experience any of the following:
- Worsening outbreak symptoms in spite of medicine or proper management
- Sores that do not heal after 2-4 weeks
- Frequent outbreaks
- An outbreak during pregnancy
If you have never had genital herpes before, see a medical provider for an accurate diagnosis and treatment options.
Subsequent outbreaks of herpes do not always require medical care unless you notice any complications, problems healing, or become pregnant.
While there is no cure for genital herpes, a medical provider can recommend OTC and other treatments that may speed the healing time of sores, reduce the frequency of outbreaks, and relieve discomfort.
Genital herpes may feel like an embarrassing problem, but you deserve to be comfortable.
A medical doctor will not shame you, but will help you to get proper care and find relief.
You can even chat with a K Health doctor right in the app, without leaving your home.
How Is Genital Herpes Diagnosed
If you have a herpes sore, your dermatologist can often diagnose you by looking at the sore and taking a swab from the sore. A lab test can tell whether the sore contains the herpes simplex virus , which is what causes genital herpes.
If you dont have a sore or any symptoms, the Centers for Disease Control doesnt recommend testing for most people. You can learn whether you should be tested if you dont have symptoms at:
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What Is Life Like For Someone Who Has Genital Herpes
The virus that causes genital herpes stays inside your body forever. While many people carry this virus, some dont know that they have it because they never have an outbreak.
If you have an outbreak, taking an antiviral medicine can shorten the outbreak and relieve symptoms. Some people have several outbreaks. For most people, the outbreaks become less severe and occur less often with time.
Anyone who has been infected with the virus, however, can spread the virus to others during sex. Even if you never have an outbreak, you can still spread the virus.
Related AAD resources
Centers for Disease Control. Genital Herpes – CDC Fact Sheet . Last accessed December 19, 2016.
Fatahzadeh M and Schwartz RA. Human herpes simplex virus infections: Epidemiology, pathogenesis, symptomatology, diagnosis, and management. J Am Acad Dermatol 2007 57:737-63.
Madkan V Sra K, et al. Human herpesviruses. In: Bolognia JL, et al. Dermatology. . Mosby Elsevier, Spain, 2008:1075-6.
Marques AR, Straus SE, Herpes simplex. In: Wolff K, Goldsmith LA, et al. Fitzpatricks Dermatology in General Medicine . McGraw Hill Medical, New York, 2008: 1199-1204.
US Preventive Task Force. Serologic screening for genital herpes infection: US Preventive Services Task Force recommendation statement. JAMA. 2016 316:2525-30.
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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Facts And Statistics About Herpes
- According to the World Health Organization, an estimated two-thirds of the global population under 50 years old are infected with herpes simplex virus type 1 .
- Estimates for HSV-1 prevalence in the U.S. among people aged 049 years are 178 million women and 142 million men .
- In total, about 75 percent or more of the American adult population has the HSV-1 virus that usually causes oral herpes , and about 20 percent to 30 percent have HSV-2 that usually causes genital herpes.
- Men and women are affected by HSV-1 about equally. Roughly 6 million women in the U.S. become infected with HSV-1 each year, along with 5 million men.
- Slightly more women than men are affected by genital herpes, whether from HSV-1 or HSV-2. Middle-aged women are most likely to acquire genital herpes.
- Transmission of HSV most often occurs without symptoms, so its estimated that 85 percent of people with genital herpes dont know it. Many dont have any symptoms at all after the initial infection, and only about 15 percent ever receive a HSV-2 infection diagnosis in their lifetimes.
- Most primary oral/facial HSV infections are caused by HSV-1 however, facial infection by HSV-2 is increasingly becoming common.
- Less children are becoming infected with HSV-1 than in the past in high-income countries, mostly due to better hygiene and living conditions.
- After someone comes into contact with an active herpes outbreak on another person, the incubation period takes about one week.
Oral Herpes And Cold Sores
Cold sores are a symptom of oral herpes .
Cold sores are blister-like sores that occur near the mouth or lips. They can also occur on other areas of the face. They typically persist for 2 weeks or more. Because theres no cure for herpes, cold sores can come back.
Genital herpes is quite common.
Although genital herpes is typically caused by HSV-2, the infection can also be caused by HSV-1.
According to the WHOs latest available statistics, it was estimated that 491.5 million people had an HSV-2 infection in 2016. This is over one-tenth of the worlds population ages 15 to 49 years.
The WHO also estimates that 3.7 billion people had an HSV-1 infection in the same year, which accounts for around two-thirds of the worlds population under age 50 years.
CDC does not recommend getting tested for herpes.
However, if there are symptoms of genital herpes, its important to see a doctor. They can make a diagnosis and discuss management strategies for the infection.
Additionally, if theres a potential of having been exposed to HSV, or if theres a desire to get a full STI exam and testing, its recommended to schedule an appointment with a doctor.
If an in-person appointment is not possible, an at-home test kit is another option to consider. However, its important to note that an in-person test done by a doctor may be more accurate.
Treatment can reduce outbreaks, but it cannot cure herpes simplex viruses.
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What Triggers Herpes Outbreaks
2018 article , the initial outbreak of genital herpes is usually the result of skin contact, normally during sexual activity, including oral sex. Further outbreaks can be caused by having multiple sexual partners, stress, sunlight, colds, menstruation, and wearing tight clothes.
The American Academy of Dermatology Association writes that cold sores can be triggered by stress, fatigue, colds, flu, strong sunlight, and menstruation.
Can Genital Herpes Be Prevented
Practising safe sex is the best way to help prevent genital herpes infection.
It is safest to:
- always use condoms and dental dams, even when there are no sores or blisters present
- avoid sex when there are sores or blisters present you are most infectious at this time
- avoid sex with someone who has any blisters, sores or other symptoms of genital herpes
- avoid oral sex when there is any sign of a cold sore
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