Hsv 1 Genital Herpes Treatment

How Can You Reduce The Transmission Of Herpes

• Using condoms or dental dams can reduce transmission. Condoms provides around 50% protection. They do not completely stop the risk of infection because the herpes can be in areas not covered by the condom.
• Using suppressive treatment reduces the risk of transmission by at least 50%.
• Using a good silicone lubricant for sex may also reduce the risk of transmission by avoiding skin trauma and micro abrasions.
• If you have a cold sore, you should not perform oral sex on a partner from the time the very first symptom appears until a week after the last symptoms of the cold sore have gone.

Education Is An Integral Part Of Herpes Treatment

If you have genital herpes, its important for you to get educated about herpes and have the opportunity to ask questions in a supportive environment.

Becoming informed will help you learn to cope with the illness. It will also help you prevent sexual transmission of the illness, or transmission to an infant during a pregnancy.

Herpes has a tremendous psychosocial overlay. But knowledge about it and understanding about how well it can be managed can reduce that, says Handsfield.

Your doctor may be able to provide you with all the information you need, or you may choose to seek counseling from a mental health professional or at a clinic that specializes in sexual health, such as Planned Parenthood.

If you have a regular sexual partner, that person should also have the chance to learn about herpes and ask any questions they may have about it.

Symptoms Of Genital Herpes

Many people who have genital herpes may not be aware they have the infection, because they may not have any symptoms.

The first episode of herpes can cause considerable pain and distress. Symptoms of the first episode may include:

• flu-like symptoms such as feeling unwell, headaches and pains in the back and legs, with or without enlarged glands in the groin
• small blisters around the genitals these break open to form shallow, painful ulcers, which scab over and heal after one to two weeks
• small cracks in the skin with or without an itch or tingling
• redness or a distinct rash
• some people also have considerable pain and swelling in the genital area, and hence may have additional pain and difficulty passing urine.

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How Do Dermatologists Diagnose Herpes Simplex

During an outbreak, a dermatologist often can diagnose herpes simplex by looking at the sores. To confirm that a patient has herpes simplex, a dermatologist may take a swab from a sore and send this swab to a laboratory.

When sores are not present, other medical tests, such as blood tests, can find the herpes simplex virus.

Genital Herpes Is Spread By Skin

The virus can be spread when someone with HSV has an episode or an outbreak characterised by having a sore, blister, ulcer or skin split . It can also be spread between episodes, when there is no sore, blister, ulcer or skin split present called asymptomatic viral shedding.

During viral shedding the virus is on the skin surface and can be spread through genital skin-to-skin contact, or from the mouth or face to genital skin during contact.

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Suppressive Therapy For Recurrences

To suppress outbreaks, treatment requires taking pills daily on a long-term basis. Acyclovir and famciclovir are taken twice a day for suppression. Valacyclovir is taken once a day. The doses for these antiviral drugs are reduced in people with impaired renal function.

Suppressive treatment can reduce the frequency of outbreak recurrences by 70% to 80%. It is generally recommended for people who have frequent recurrences . Because herpes recurrences often diminish over time, you should discuss annually with your provider whether you should stay with drug therapy or discontinue it.

There is some evidence that valacyclovir may help prevent herpes transmission, particularly in situations where one heterosexual partner has HSV-2 and the other partner does not. However, this drug does not completely prevent transmission. While taking any suppressive therapy for genital herpes, it is still important to regularly use latex condoms and to avoid any sexual activity during recurrences.

How Common Is Herpes Simplex 1

HSV-1 is extremely common. In 2012 the World Health Organization estimated that a staggering 67% of the population was infected with the virus, and 140 million of those infected were estimated to have genital HSV-1. Oral HSV-1 is most commonly contracted during childhood after receiving kisses from family members who carry the virus. Cases of oral HSV-1 and genital HSV-1 are on the rise.

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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.

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.

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Symptoms Of Oral Herpes

Oral herpes is most often caused by HSV-1, but can also be caused by HSV-2. It usually affects the lips and, in some primary attacks, the mucous membranes in the mouth. A herpes infection may occur on the cheeks or in the nose, but facial herpes is very uncommon.

Primary Oral Herpes Infection

If the primary oral infection causes symptoms, they can be very painful, particularly in children. Symptoms include:

• Tingling, burning, or itching around the mouth are the first signs.
• Red, fluid-filled blisters that may form on the lips, gums, mouth, and throat.
• Blisters that break open and leak. As they heal, they turn yellow and crusty, eventually turning into pink skin. The sores last 10 to 14 days and can be very uncomfortable.
• Blisters that may be preceded or accompanied by sore throat, fever, swollen glands, and painful swallowing.

Recurrent Oral Herpes Infection

A recurrent oral herpes infection is much milder than the primary outbreak. It usually manifests as a single sore, commonly called a cold sore or fever blister . The sore usually shows up on the outer edge of the lips and rarely affects the gums or throat.

Herpes Simplex Cns Infection

• Polymerase chain reaction of cerebrospinal fluid and MRI for HSV encephalitis

Diagnosis of HSV infection is often clinical based on characteristic lesions.

Laboratory confirmation can be helpful, especially if infection is severe, the patient is immunocompromised or pregnant, or lesions are atypical. A Tzanck test often reveals multinucleate giant cells in HSV or varicella-zoster virus infection.

Definitive diagnosis is with culture, seroconversion involving the appropriate serotype , PCR, and antigen detection. Fluid and material for culture should be obtained from the base of a vesicle or of a freshly ulcerated lesion. HSV can sometimes be identified using direct immunofluorescence assay of scrapings of lesions. PCR of CSF and MRI are used to diagnose HSV encephalitis.

HSV should be distinguished from herpes zoster Herpes Zoster Herpes zoster is infection that results when varicella-zoster virus reactivates from its latent state in a posterior dorsal root ganglion. Symptoms usually begin with pain along the affected… read more , which rarely recurs and usually causes more severe pain and larger groups of lesions that are distributed along a dermatome and typically do not cross the midline.

Clusters of vesicles or ulcers on an erythematous base are unusual in genital ulcers other than those due to HSV infection.

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Diseases Caused By Herpes Simplex Virus

Diseases include

• Central nervous system infection

• Neonatal herpes Neonatal Herpes Simplex Virus Infection Neonatal herpes simplex virus infection is usually transmitted during delivery. A typical sign is vesicular eruption, which may be accompanied by or progress to disseminated disease. Diagnosis… read more

HSV rarely causes fulminant hepatitis in the absence of cutaneous lesions.

In patients with HIV infection Human Immunodeficiency Virus Infection Human immunodeficiency virus infection results from 1 of 2 similar retroviruses that destroy CD4+ lymphocytes and impair cell-mediated immunity, increasing risk of certain… read more , herpetic infections can be particularly severe. Progressive and persistent esophagitis, colitis, perianal ulcers, pneumonia, encephalitis, and meningitis may occur.

is a complication of HSV infection in which severe herpetic disease develops in skin regions with eczema.

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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Risk For Genital Herpes

According to the US Centers for Disease Control and Prevention , about 1 in 6 Americans ages 14 to 49 years have genital herpes. While HSV-2 remains the main cause of genital herpes, HSV-1 has significantly increased as a cause, most likely because of oral-genital sex. Except for people in monogamous relationships with uninfected partners, everyone who is sexually active is at risk for genital herpes.

Risk factors for genital herpes include:

• History of an STD
• First sexual intercourse at an early age
• High number of sexual partners
• Low socioeconomic status

Women are more susceptible to HSV-2 infection because herpes is more easily transmitted from men to women than from women to men. About 1 in 5 women, compared to 1 in 9 men, have genital herpes. African-American women are at particularly high risk.

People with compromised immune systems, such as those who have HIV, are at very high risk for genital herpes. These people are also at risk for more severe complications from herpes. Drugs that suppress the immune system, and organ transplantation, can also weaken the immune system and increase the risk for contracting genital herpes.

Research And Statistics: Who Has Genital Herpes

Its estimated that each year, 776,000 people in the United States get new genital herpes infections. Genital herpes is most often caused by herpes simplex virus type 2 .

According to data from the National Health and Nutrition Examination Survey , the prevalence of HSV-2 was 11.9 percent during 2015 and 2016, a decline of 5.9 percentage points from the years 1999 and 2000.

HSV-2 is more common in women than in men. Its suspected that women are more likely to contract the HSV-2 infection because genital infection is more easily transmitted from men to women than from women to men during penile-vaginal sex.

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When To See A Healthcare Provider

The early recognition of genital herpes, ideally during the prodromal stage, allows you to access treatments that can shorten the duration and severity of an outbreak.

Clearly, this can be difficult during your first outbreak, given that you probably won’t be expecting it. But, over time, you will be better able to recognize the tell-tale signs and know when it’s time to act.

Asymptomatic Genital Viral Shedding

In the majority of cases endogenous viral reactivation is characterised by asymptomatic genital viral shedding. Most commonly HSV-2 is shed by HSV-2 seropositive patients, and this is the case for almost anyone who is anti-HSV-2 IgG positive 21. In contrast, HSV-1 shedding is uncommon. These data allow the assumption, with a high level of certainty, that HSV-2 seropositive people should always be regarded as potential virus excretors.

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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?

First And Subsequent Episodes

The first genital herpes outbreak will generally be worse than the ones that follow. During a first outbreak, the appearance of lesions will often be accompanied by:

• Pain or burning with urination
• Unusual vaginal discharge

Subsequent attacks tend to be shorter and less severe. They are often preceded by genital pain or shooting pain in the legs, hip, or buttocks several hours or days before the attack.

Over time, the number of outbreaks tends to decrease and become less severe.

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Take Charge Of Your Health

Oral herpes can be transmitted by kissing, sharing eating utensils or drinks, or during sex. Since oral herpes can be contracted from both Type 1 and Type 2 strains of the Herpes Simplex Virus, our doctors recommend getting tested for both of these HSV strains at the same time.

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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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Can I Treat Herpes Simplex At Home

Avoiding known triggers, such as illness or stress, can help reduce how often you have herpes outbreaks.

How can I ease my symptoms during an outbreak of HSV-1 ?

• Over-the-counter creams such as L-lysine, benzocaine or docosanol .
• Applying ice to blisters or sores.

How can I ease my symptoms during an outbreak of HSV-2 ?

• Apply an ice pack to your genitals. Wrap the ice pack in a washcloth or apply it over your underwear.
• Keep your genitals dry. Wear cotton or other nonsynthetic underpants and avoid tight-fitting clothes. Moist sores take longer to heal.
• Soak in a warm bath.
• Take nonsteroidal anti-inflammatory drugs to relieve pain.
• Topical 1% or 2% lidocaine may be used as a topical analgesic.

Suppressive Therapy For Recurrent Hsv

Suppressive therapy reduces frequency of genital herpes recurrences by 70%80% among patients who have frequent recurrences . Persons receiving such therapy often report having experienced no symptomatic outbreaks. Suppressive therapy also is effective for patients with less frequent recurrences. Long-term safety and efficacy have been documented among patients receiving daily acyclovir, valacyclovir, and famciclovir . Quality of life is improved for many patients with frequent recurrences who receive suppressive therapy rather than episodic treatment . Providers should discuss with patients on an annual basis whether they want to continue suppressive therapy because frequency of genital HSV-2 recurrence diminishes over time for many persons. However, neither treatment discontinuation nor laboratory monitoring is necessary because adverse events and development of HSV antiviral resistance related to long-term antiviral use are uncommon.

Valacyclovir 500 mg orally 2 times/day for 3 daysOR

Valacyclovir 1 gm orally once daily for 5 days

*Acyclovir 400 mg orally 3 times/day is also effective, but are not recommended because of frequency of dosing.

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How Common Is Genital Herpes

According to the Centers for Disease Control and Prevention, approximately 40 million to 50 million adults in the United States have genital herpes. HSV II infection is more common in women and in people who have had more than five sexual partners. Most people with HSV II do not know they have it, because it does not always cause symptoms.

Hsv Hpv Something Else Hopefully

Short version:

What is in the picture? HSV? HPV? Something else?

I have HSV 1 with sores on or around my lips during outbreaks, but never any sores on my genitals or any symptoms around my genitals.

Long version:

About 10 years ago I was diagnosed with HSV 1, which is common on one side of my family. During outbreaks I tend to get only 1-2 sores on my mouth or near my nostrils, with OBs occurring about every 1-2 years. I take vacyclovir at the first sign of outbreaks, and in combination with Abreva my OBs are very mild. I have never had any sign of sores or HSV symptoms on my genitals. All my full panel tests for all other STDs/STIs have always been negative.

I am still with the same partner that I was with when I was diagnosed, and I have been with no one else since. My partner gets tested regularly at the OBGYN, especially when she has an ingrown hair or something like that. As of a August, I have not yet passed it to her. As far as I know, there has been no infidelity.

I’m really hoping it’s some form of irritation and not my partner or I spreading my HSV 1 to my genitals, or even worse a false negative for HSV 2 because all I’ve ever had are the not so great antibody tests for HSV 2 and never having any sores to swab/culture.

So…

• What do I do next???
• Would a PCR test for HSV make sense???

Any advice is appreciated. The last thing I want to do is give this to my partner, especially since we’ll likely try to have children soon.

1 like, 4 replies

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