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.
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.
What Host Factors Protect Against This Infection
Research has shown that T-cell mediated immunity protects an individual from herpes zoster reactivation later in life. The patients most at risk are the elderly, as they have decreased cell mediated immunity, and immunocompromised individuals. Patients on immunosuppressive medications, including, but not limited, to cyclophosphamide, azathioprine, and high dose prednisone are at increased risk.
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Genital Herpes During Pregnancy
Prevention of neonatal herpes depends both on preventing acquisition of genital herpes during late pregnancy and avoiding exposure of the neonate to herpetic lesions and viral shedding during delivery. Mothers of newborns who acquire neonatal herpes often lack histories of clinically evident genital herpes . The risk for transmission to the neonate from an infected mother is high among women who acquire genital herpes near the time of delivery and low among women with prenatal histories of recurrent herpes or who acquire genital herpes during the first half of pregnancy . Women who acquire HSV in the second half of pregnancy should be managed in consultation with maternal-fetal medicine and infectious disease specialists.
All pregnant women should be asked whether they have a history of genital herpes or genital symptoms concerning for HSV infection. At the onset of labor, all women should be questioned thoroughly about symptoms of genital herpes, including prodromal symptoms , and all women should be examined thoroughly for herpetic lesions. Women without symptoms or signs of genital herpes or its prodrome can deliver vaginally. Although cesarean delivery does not eliminate the risk for HSV transmission to the neonate , women with recurrent genital herpetic lesions at the onset of labor should have a cesarean delivery to reduce the risk for neonatal HSV infection.
Acyclovir 400 mg orally 3 times/dayORValacyclovir 500 mg orally 2 times/day
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.
Have a question about herpes youd like Dr. Handsfield or our other experts to answer? Visit our Ask the Experts page to learn how.
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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
What If I Am Pregnant
It is important to tell your obstetrician that you or a partner have had genital herpes, so that they can monitor you for symptoms and manage your pregnancy safely. There is a risk you can pass the virus on to your baby if you have a vaginal delivery during a first attack of genital herpes. If this happens you may be recommended to have a caesarean delivery.
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Risk Factors For Shingles
Reportedly, one in three people in the US will have shingles in their lifetime, making it a fairly common infection. Anyone who’s had chickenpox before can get shingles. That’s because the virus that causes chickenpox becomes dormant in the body after treatment. It later reactivates to cause shingles.²
Several factors can increase the likelihood of the varicella-zoster virus reactivating. A weakened immune system is one risk factor, as your body is less able to fight off viruses, thus allowing the varicella-zoster virus to come alive.
Several factors can cause a weakened immune system, including:
-
Having another illness like cancer or HIV
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.
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Genital Herpes Treatment In Pregnancy
You may be offered antiviral treatment:
- to treat outbreaks in pregnancy
- from 36 weeks to reduce the chance of an outbreak during birth
- from diagnosis until the birth if you first get herpes after 28 weeks of pregnancy
Many women with genital herpes have a vaginal delivery. You may be offered a caesarean, depending on your circumstances.
Can I Get Shingles If I Havent Had Chickenpox
No. You cant get shingles if youve never had chickenpox, but you can get chickenpox from someone who has shingles. If youve never had chickenpox and you come into direct contact with the oozing, blister-like rash of someone with shingles, the varicella-zoster virus can infect you and you would develop chickenpox.
Once youve had chickenpox, you could develop shingles at some point in your life. This is because the varicella-zoster virus never fully goes away after youve had chickenpox. It lies quietly inactive in your nerve tissue. Later in life, the virus may become active again and appears as shingles.
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Is There A Link Between Herpes And Hiv
Genital herpes is one of the most common co-infections for people with HIV. It can be a more serious condition if youre HIV positive – outbreaks may last longer and blisters can be more severe. If youre having recurrent outbreaks of genital herpes, you should have an HIV test, as this may be a sign of a weakened immune system caused by HIV.
Having an STI such as genital herpes can increase your risk of getting and passing on HIV. The blisters and sores provide an easy way for HIV to get into your body and cause an infection.
People with HIV who arent on treatment or who have a lower CD4 count are more likely to get other infections, like herpes.
If youre taking antiretroviral treatment for HIV, its important to discuss this with your doctor. They can advise how treatment for herpes may interact with your HIV drugs.
Are Antiviral Medications Safe
Antiviral medications are considered to be very safe. They are nearly always well tolerated because the active ingredients only have an effect in cells that have been infected by the virus.
People who have kidney failure may need to take a lower dose because the medication is removed from the body through the kidneys.
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How Will My Healthcare Provider Know If I Have Genital Herpes
Your healthcare provider may diagnose genital herpes by simply looking at any sores that are present. Providers can also take a sample from the sore and test it. If sores are not present, a blood test may be used to look for HSV antibodies.
Have an honest and open talk with your healthcare provider about herpes testing and other STDs.
Please note: A herpes blood test can help determine if you have herpes infection. It cannot tell you who gave you the infection or when you got the infection.
Is There A Cure For Herpes Simplex
There is no cure for herpes simplex. Once you have the virus, its a lifelong infection.
What is the outlook for people with herpes simplex?
For many people, the first herpes outbreak is the most severe. Many outbreaks are less frequent and milder after the first year of infection. Some people may have only one outbreak and never have another again.
Herpes infection doesnt usually pose a serious health risk. The risk of a health complication due to herpes is higher in infants and if you have HIV/AIDS, cancer or an organ transplant.
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Ranunculus Bulbosus: For Bluish Vesicles And Intense Itching
Ranunculus bulbosus for shingles is derived from the plant bulbous buttercup or St Anthonys Turnip. This is a perennially growing plant and belongs to the Buttercup family. Ranunculus bulbosus is prepared from the bulb of this plant. This plant is native of Western Europe and the northern Mediterranean coast. As an introduced weed it grows in eastern and western parts of North America.It is the principle medicine for treating Herpes zoster. It is indicated for herpetic eruptions with itching where the eruptions are vesicular and pustular. It is highly recommended for shingles with blue blisters that are filled with serum. There is an intense burning and itching that gets worse with contact.
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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 canât find any scientific studies that have researched this, but I canât 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 doesnât 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 âice burnâ. 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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What Happens If Herpes Goes Untreated
The first outbreak of genital herpes can be the most severe and can cause complications such as vaginal yeast infections, urinating problems, and meningitis.
Treatment may not be necessary for subsequent outbreaks, but anyone experiencing very regular or severe outbreaks should speak with a doctor about preventive treatment.
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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Treatment Of Common Cutaneous Herpes Simplex Virus Infections
DAVID H. EMMERT, M.D., Lancaster General Hospital, Lancaster, Pennsylvania
Am Fam Physician. 2000 Mar 15 61:1697-1704.
Herpes simplex virus infection is increasingly common in the United States. New antiviral medications have expanded treatment options for the two most common cutaneous manifestations, orolabial and genital herpes. Acyclovir therapy remains an effective and often less expensive option. Famciclovir and valacyclovir offer improved oral bioavailability and convenient oral dosing schedules but are more expensive than acyclovir. Patients who have six or more recurrences of genital herpes per year can be treated with one of the following regimens: acyclovir, 400 mg twice daily valacyclovir, 1 g daily or famciclovir, 250 mg twice daily. These regimens are effective in suppressing 70 to 80 percent of symptomatic recurrences. Episodic treatment of recurrent genital herpes is of questionable benefit, but it may be helpful in appropriately selected patients. There is little evidence indicating benefit from treatment of recurrent orolabial herpes, which tends to be mild and infrequent.
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What Is Oral Herpes
More than half of American adults have oral herpes. Some estimates say up to 80% of American adults have oral herpes.
Oral herpes is primarily caused by HSV-1, although it is also possible to have an HSV-2 infection around the mouth.
A person with an oral herpes outbreak may first feel itching, burning, or tingling around the mouth, lips, or tongue. Later, cold sores or small blisters may develop in these areas or anywhere on the skin.
Roughly four to six days after these cold sores start leaking, they start healing by forming a crust. Outbreaks of oral herpes can last for two to three weeks, which can be shorter than the two to six weeks of a genital herpes outbreak.
People who develop symptoms of herpes may first experience tingling, itching, or burning, then notice sores or blisters forming around the mouth or genitals.
Symptoms tend to develop 220 days after exposure to the virus.
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Simple Treatments For The Relief Of Discomfort
- Wear loose underclothes, preferably cotton , to help minimise discomfort and allow healing.
- Use plain water or saline solution with cotton wool to clean and soothe the area. To make a saline solution, use 1 teaspoon of salt in 600ml of water or a handful of salt in a shallow bath.
- Don’t use scented soaps, bubble bath, etc in the area, as these may irritate it.
- Using a hairdryer on its lowest setting to dry the area may be more comfortable than using a towel.
- Pain relief medication such as paracetamol and ibuprofen may ease the pain. Check with your pharmacist or other health professional whether taking these is suitable for you.
- Ice wrapped in a face cloth or flannel and placed over the sores for 510 minutes may be soothing. Don’t apply ice directly to the sores as this can cause ice burn.
- If you find peeing painful, try applying Vaseline® to the area or sitting in a warm bath before urinating or using a pump bottle full of water and spraying water on yourself while peeing.
- You can also try applying a pain relief cream such as lignocaine cream to the painful area. This is applied 5 minutes before peeing and should be used for a maximum of 12 days.
- Drink plenty of fluids as this dilutes your pee and may help reduce stinging.
Clinical Aspects Of Hz
The cause of the dermatomal pain becomes obvious when the characteristic rash appears in that dermatome . The interval from the onset of the prodrome to the appearance of rash represents the time required for reactivated VZV to replicate in the ganglion and to transit down the cutaneous nerve to the nerve endings at the dermal-epidermal junction. There is additional delay while VZV replicates in the skin and induces sufficient necrosis and inflammatory response to cause the rash.
Herpes zoster ophthalmicus
HZ is a dermatomal illness that does not cross the midline except where the normal representation of segmental nerves does so to a limited extent. In immunocompetent patients, only a single dermatome is typically affected however, normal variations in innervation can lead to limited involvement of adjacent dermatomes. In typical HZ, widespread involvement of multiple dermatomes, especially those that are widely separated, does not occur. The rash is usually accompanied by the same pain experienced during the prodrome, but this acute pain can worsen, improve, or appear for the first time during the cutaneous phase of HZ. Pruritis may be as common as pain in patients with HZ, although it has received far less medical attention . Some mild cases of HZ are characterized by more pruritis than pain.
Disseminated herpes zoster
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