No Herpes Outbreak For Years

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 To Keep Herpes Dormant

One person with genital herpes may work at a high-stress job and be in a stressful relationship, and be more prone to outbreak recurrences. Another may have a more stress-free lifestyle that potentially keeps the virus dormant for years or even decades.

We cant all be stress-free all the time, and thats life. To minimize the frequency of outbreaks, its helpful to manage stress in a healthy way. Getting out for a walk, meditating, practicing yoga or mindfulness, relaxing in a bath, or writing in a diary are examples of ways to cope with and manage stress.

A healthy diet helps physically as well as emotionally, and a lysine-rich diet may suppress the herpes virus. All these factors can contribute to less frequent flare-ups.

Treatment Of An Initial Outbreak

The first outbreak of genital herpes is usually much worse than recurrent outbreaks. Symptoms tend to be more severe and to last longer. Your provider will prescribe one of the three antiviral medications, which you will take for 7 to 10 days. If your symptoms persist, treatment may be extended. An acyclovir ointment may also be prescribed for topical treatment of initial genital herpes.

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How Can I Reduce My Risk Of Herpes Simplex

Preventing HSV-1

You can reduce your risk of contracting HSV-1 by avoiding physical contact with someone who has a cold sore. People can still spread HSV-1 when cold sores arent present, but its less likely.

If someone has an active HSV-1 infection, avoid:

• Sharing utensils, cups, lip balms or other personal care products.
• Touching the skin near their mouth.

Preventing HSV-2

If youre sexually active, you can take these steps to protect yourself and others from the herpes virus and other STIs:

• Be monogamous with one sexual partner or limit your number of partners.
• Get tested for STIs and complete any prescribed treatment.
• Tell your sexual partners if you have genital herpes so they can get tested.
• Use condoms during intercourse and dental dams during oral sex.

Wash your hands often if you have an outbreak or are around someone with symptoms.

If your sexual partner has genital herpes, these actions can lower your risk of getting the virus:

• Dont have sex when your partner has active symptoms. Condoms may not cover all sores, so you may still get the virus.
• Make sure your partner takes antiviral medication as prescribed.
• Wait to have sex until scabs fall off active lesions.

This Virus May Be Super

Herpes is common. Really common. According to the U.S. Centers for Disease Control and Prevention , about one in six adults has genital herpes, a sexually transmitted infection caused by herpes simplex virus.* . While it may be super-common, there are still a lot of myths out there about ithere are five I hear a lot.

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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:

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My Partner Doesnt Have Genital Herpes So How Can I Have Caught It

Your partner could be one of the two out of three people with herpes simplex who have it so mildly they do not realise. So they could have sex when the virus is active. Mild symptoms can appear as a pimple, a little cut or an itchy bit of skin and yet these are very infectious. When people with these mild symptoms learn to recognise them, then they can avoid sex at these times. Another possibility is that your partner does not have herpes simplex and you caught it from a previous partner. It is possible to have a first outbreak many years after first catchin it.

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How Does Genital Herpes Spread

Herpes can be spread when an infected person has lesions blisters and open sores on their body or when you do not have any symptoms. Taking antiviral medicine can help you reduce the risk of spreading genital herpes to your sexual partners. You can also:

• Inform your sexual partner that you have genital herpes.
• Use a condom every time you have sex.
• Refrain from having sex when you have symptoms.
• Abstain from performing oral sex if you have blisters or open sores around your mouth.

Does A Cold Sore On My Mouth Mean I Have Genital Herpes

No, a cold sore on your mouth usually means you have herpes simplex virus type 1 . You can get HSV-1 by kissing someone or sharing utensils, towels, razors, or lipstick with someone who has HSV-1.

HSV-1 cannot turn into HSV-2 , but you can get a cold sore on your mouth from HSV-2 if you give oral sex to someone with HSV-2. Cold sores caused by HSV-1 or HSV-2 are contagious. You can spread it to other people or other parts of your body if you touch an open sore and then touch another part of your body. That means if you have a cold sore and give oral sex to someone, that person will get the herpes virus on his or her genitals.

Avoid touching your cold sore as much as possible. If you touch your cold sore, wash your hands right away to avoid spreading the infection to other parts of your body or other people.

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Percentage Of Hsv Risk

• If they avoid sexual activity during outbreaks, dont use condoms regularly, and the person with the vulva doesnt take an antiviral therapy every day, the risk of transmission is about 5% per year.

Those percentages represent what studies consider an average sex life incorporating vaginal penetration over the course of one years duration, which, of course, is highly subjective.

Unfortunately, there is no available data yet on the rate of transmission between same-sex partners.

• Armangue, Thaís, et al. Frequency, symptoms, risk factors, and outcomes of autoimmune encephalitis after herpes simplex encephalitis: a prospective observational study and retrospective analysis. The Lancet Neurology 17.9 : 760-772.
• Groves, Mary Jo. Genital herpes: a review. Am Fam Physician 93.11 : 928-934.
• Jonker, Iris, et al. The association between herpes virus infections and functional somatic symptoms in a general population of adolescents. The TRAILS study. PloS one 12.10 : e0185608.
• Verhoeven, Dirk HJ, et al. Reactivation of human herpes virus-6 after pediatric stem cell transplantation: risk factors, onset, clinical symptoms and association with severity of acute graft-versus-host disease. The Pediatric infectious disease journal 34.10 : 1118-1127.
• Croll, Benjamin J., et al. MRI diagnosis of herpes simplex encephalitis in an elderly man with nonspecific symptoms. Radiology case reports 12.1 : 159-160.

What Is The Difference Between Genital Herpes And Genital Warts

Both genital herpes and genital warts are STIs, are spread through skin-to-skin contact, and are caused by a virus. But the viruses that cause genital herpes and genital warts are different:

• Herpes simplex virus is the virus that causes genital herpes.
• Human papillomavirus is the virus that causes genital warts.

There is no cure for either genital herpes or genital warts. But, different medicines can help manage the symptoms of herpes and treat the complications of HPV infections that can cause genital warts.

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Myth : We Didnt Have Sex So Theres No Way I Have Genital Herpes

That said, your risk of getting the virus is higher if youve had contact with a partner who does have a visible sore. Using condoms can majorly decrease the risk of spreading the virus, but doesnt eliminate it completely. Unfortunately, no other type of birth control reduces the risk of this STI.

Why You Should Go To A Sexual Health Clinic

You can see a GP, but they’ll 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.

They’ll often get test results quicker than GP practices and you do not have to pay a prescription fee for treatment.

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Can It Lie Dormant

The herpes virus can lie dormant in the body for years before people experience any symptoms.

After people have the first outbreak of herpes, the virus then lies dormant in the nervous system. Any further outbreaks are due to the virus reactivating, which causes symptoms to appear.

Symptoms are usually less severe during repeat outbreaks. Sores also clear up more quickly, often within 37 days. This is due to the antibodies the body produces to fight the first outbreak of herpes. The body can then use these antibodies to respond more quickly to future outbreaks.

There is currently no cure for herpes. Even if a person stops experiencing symptoms, the virus will remain inside their body.

It is also important to point out that herpes is transmissible even when no sores or other symptoms are present. For this reason, early prevention is advisable.

To help reduce the chance of this happening, people can use condoms or dental dams during sex.

Condoms and dental dams do not offer complete protection against the herpes virus, as herpes can live on areas around the genitals. However, these methods do reduce the likelihood of contracting the infection or passing it on.

A person who has herpes can also take other steps to reduce the chance of passing it on to a sexual partner. Such steps include telling their sexual partner that they have herpes before having sex.

Both people can then take additional steps to reduce the likelihood of transmission. These steps may include:

Myth : Herpes Is Something To Be Ashamed Of

This is the most important myth to bust: While living with herpes can be a pain, its incredibly common and nothing to be ashamed of. For more information on this virus, check out the CDCs Fact Sheet about it. For a more personal take on living with an STIalong with resources and supportcheck out The STD Project, a site founded and run by a woman whos living with herpes.

Editors note: This article was tweaked ever-so-slightly to refer readers to the CDCs fact sheet for more detail about the two types of herpes viruses.

Grace Shih, MD, MAS, is an Assistant Professor at University of Washington. She completed her family medicine residency at Brown University and her family planning fellowship at University of California, San Francisco. When shes not seeing patients, you can find her cooking, playing guitar, or traveling with her family.

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How Is Herpes Simplex Diagnosed

Healthcare providers may diagnose herpes simplex based on how the sores look. Your provider may take a sample from the sore. Laboratory analysis of the sample can confirm or rule out the herpes virus.

If you dont have sores, your healthcare provider can use a blood test to check for HSV-1 and HSV-2 antibody, a marker showing youve been exposed to the virus. The blood test doesnt show an active infection . But it informs your provider whether youve been exposed to the herpes virus in the past. If this is your first infection, you may not test positive for herpes if there hasnt been enough time for your body to develop antibodies. The HSV-1and HSV-2 antibody test may be repeated in eight to 12 weeks.

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What Is The Risk Of Transmission Between Recurrences

Studies have shown that virus may sometimes be found on an infected area, even when there are no visible symptoms. This is called asymptomatic shedding. If enough virus is present when direct skin contact takes place, a partner may become infected.

The fewer recurrences a person has, the less chance there is of asymptomatic shedding.

Asymptomatic shedding tends to decline with time. It may happen during the first year and is much less likely after that. The virus most often transmitted during the first months of a new relationship. But partners can be together for years without the virus passing from one to the other. Studies have shown that a majority of people catch it from someone who does not know that he or she has got this virus. Asymptomatic shedding is something that people find difficult to understand there is a lot more detail in the transmission leaflet you can choose when you join .

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Doctors Don’t Advise Getting A Blood Test For Herpes Without Any Symptoms

Hilda Hutcherson, assistant professor of obstetrics and gynecology at Columbia University Medical Center in New York, is one of those doctors. “I usually dont do tests for herpes someone has a lesion or a sore, something I can see, I will do a swab and take it to a culture or check the DNA on the materials I removed,” she says. “If theres nothing there and I do a blood test and the blood test comes back positive, lets say its positive for type 1, what does that really mean? Most people are positive for type 1.” She adds that someone could be HSV-1-positive and either have or not have genital herpes. The result “doesnt mean much, and it makes people go crazy.”

Hutcherson’s motto is pretty simple: Why stress yourself over something if you haven’t seen anything especially when it’s something as common as herpes? “Let’s say they have a blood test come in positive but theyve never had a lesion. Now what? You may never get a lesion,” she says. It’s for this reason that she recommends people do not get tested for herpes unless they have a visible lesion that can be cultured and sent to a lab. Let’s say you get tested anyway and it comes back positive, despite the fact that you have no symptoms. What do you do?

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 Genital Herpes Come Back

Yes. Genital herpes symptoms can come and go, but the virus stays inside your body even after all signs of the infection have gone away. The virus becomes active from time to time, leading to an outbreak. Some people have outbreaks only once or twice. Other people may have four or five outbreaks within a year. Over time, the outbreaks usually happen less often and are less severe.

Experts do not know what causes the virus to become active. Some women say the virus comes back when they are sick, under stress, out in the sun, or during their period.

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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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.