What Makes Herpes Flare Up

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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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.

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Meet Nearby People With Herpes

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Things that increase your risk of getting genital herpes include:

• Having more than one sex partner.
• Having a high-risk partner or partners .
• Having unprotected sexual contact .
• Starting sexual activity at a young age. The younger people are when they start having sex, the greater their risk is of getting genital herpes.
• Having a weakened immune system.
• Being a woman. Women are more likely than men to become infected when exposed to genital herpes. And their symptoms tend to be more severe and longer-lasting. Women also are at a greater risk of having complications from a genital herpes infection.

Having herpes, especially if you have open sores, also increases your risk for becoming infected with HIV if you are exposed to HIV.

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Treatment Vs Preventative Vaccines

The biggest difference between treatment and preventative vaccines is which groups of people they would benefit. Treatment vaccines are intended for people who have been infected with HSV, boosting the immune system to fight the virus. They would help improve symptoms, help blisters heal faster, and lower the risk of spreading the virus to other people.

The second type of vaccine a preventative vaccine is the most common type of vaccine we get as children and adults, helping to train our immune system against a germ before we encounter it. In other words, a preventative HSV vaccine would prevent you from being infected with HSV. The and the are examples of preventative herpes vaccines currently available, but they will not prevent HSV-1 and HSV-2.

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What Causes My Genital Herpes To Flare Up

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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 To Cope After Diagnosis

Many posters were occupied with the issue of passing on the infection. Yolandayw points out that you can minimise the risk of transmission by postponing sex until all the sores have healed. She also mentioned that condoms should be used. They wont completely prevent transmission but they will help.

Ending on a positive note, many posters emphasised that there was light at the end of the tunnel. Learning of the diagnosis may feel stressful at first, but its a manageable condition and certainly nothing to be ashamed of. Lucy03934 has had genital herpes for 25 years. Shes been married for 18 years and has two sons living proof that there is life after 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.

Treatment For Genital Herpes

There is no medication to cure your body of the herpes virus. Treatment is aimed at easing symptoms, reducing the frequency of recurrences and reducing transmission.

Symptoms can be improved by:

• ice packs to the affected area
• pain-relieving medication such as paracetamol
• antiviral medication such as acyclovir, famciclovir and valaciclovir. These can reduce the severity of an episode if taken early enough . Topical antivirals usually used for cold sores on the lips or face are not suitable for use on the genitals.

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Treatment The First Time You Have Genital Herpes

You may be prescribed:

• antiviral medicine to stop the symptoms getting worse you need to start taking this within 5 days of the symptoms appearing
• cream for the pain

If you have had symptoms for more than 5 days before you go to a sexual health clinic, you can still get tested to find out the cause.

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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What Questions Should I Ask My Doctor

You may want to ask your healthcare provider:

• What is the best treatment for me?
• 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 look out for signs of complications?

A note from Cleveland Clinic

Millions of people are living with the herpes virus that causes genital herpes. Its a common STI. You shouldnt be embarrassed or put off seeking medical care if you develop symptoms. Treatments can ease symptoms, reduce outbreaks and protect sexual partners from infection. Having the virus shouldnt affect your relationships or sexual health. However, you do need to tell your sexual partners that you have the virus. Your healthcare provider can discuss ways to prevent spreading this STI.

Last reviewed by a Cleveland Clinic medical professional on 11/23/2020.

References

What Are Herpes Recurrences And How Likely Are They

Recurrences are repeat symptoms which appear at or close to the place where the infection was first noticed. These are often fairly minor and may be no more than a small spot that heals in a few days. They may be accompanied by sensations itches or nerve twinges. They are unlikely to be as severe as first symptoms and may be almost unnoticed.

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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

Which Foods Should You Avoid During An Outbreak

If you have symptomatic oral or genital herpes, youll likely experience outbreaks on occasion even with a flawless diet.

During a herpes outbreak, the best way to fight the virus and speed up healing is through the use of an antiviral medication such as valacyclovir. This is a prescription medication that youll need to talk about with your doctor.

While theres no proof that food can worsen or improve a herpes outbreak, many people with herpes report improvements after avoiding certain foods.

Avoiding foods with a herpes outbreak is tough, but generally, stay away from anything spicy, salty or oily, as these foods are most likely to irritate the lips and gums. Acidic drinks, like fruit juices, are also best avoided if you have open cold sores that could potentially become irritated.

Studies also show that arginine, an amino acid found in a variety of foods, can play a role in the spread of viruses such as herpes. Arginine has viral growth properties, meaning it may increase the rate at which viruses like HSV-1 and HSV-2 multiply in the body.

As such, its best stay away from foods high in arginine like turkey breast, pork loin, chicken breast, nuts , pumpkin seeds, chickpeas, soybeans, dairy products and lentils during an outbreak of herpes.

Instead, stick to a simple, healthy diet that gives you a complete supply of vitamins, minerals and essential nutrients without supply excessive amounts of arginine.

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Controlling Cold Sore Flareups

If you already have HSV-1, you can take measures to prevent outbreaks like cold sores. As with most illnesses, its important to eat well, exercise and get enough sleep to manage stress and give your body stamina to fight off sickness. In the case of HSV-1, it also helps to protect your face and lips from sun exposure by using sunscreen and wearing a wide-brimmed hat.

When a cold sore does appear, you can prevent spreading HSV-1 by practicing good hygiene. Try not to touch it, and if you do, make sure you wash your hands right away. That will help keep you from spreading it to other parts of your body, or to other people. Also, change your toothbrush and throw out any creams, balms, ointments or makeup youve been using on your face or lips.

Weve written before about natural ways to treat cold sores, including applying licorice root, peppermint oil, vanilla oil or extract, tea tree oil, lemon balm or manuka honey directly to the sore. Aloe vera gel also can help a cold sore heal and in lab studies has shown the potential to fight viruses, including HSV.

Thymoquinone , one of the active compounds in black cumin seed oil, has been studied for exhibiting antiviral properties. It is considered an immune system modulator, meaning it may help balance an overactive immune response. In one study, TQ was found to inhibit the entry and cell to cell spread of HSV-1.

Is Herpes Still Contagious After 10 Years

WASHINGTON High rates of both overall and subclinical viral shedding continue even beyond 10 years among people with genital herpes simplex virus type 2 infection, suggesting that there is a continued risk of transmission to sexual partners long after initial infection.

Why is my herpes outbreak getting worse? After the first outbreak, the herpes virus stays in the nerve cells below the skin and becomes inactive. It usually becomes active again from time to time, traveling back up to the skin and causing more sores. Things like stress, illness, a new sex partner, or menstruation may trigger a new outbreak.

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What Are The Possible Complications Of A Cold Sore

Cold sores usually go away by themselves within 2 weeks. For most people cold sores are not serious. The viruses that cause cold sores can cause more serious illness, though. People who have a weak immune system may get more serious infections from herpes viruses. These include people being treated for cancer or who have HIV disease. Babies may also become very ill from a herpes infection.

Do Condoms Help Prevent The Spread Of Genital Herpes

Yes. To prevent transmission of herpes, we recommend that condoms be used 100% of the time. Many patients will shed the virus and be contagious when they dont have symptoms. Studies have shown that asymptomatic shedding occurs between 1% and 3% of the time in patients with HSV II genital infections. Many new herpes infections occur from partners who are shedding the virus asymptomatically, so condoms are highly recommended.

Condoms may not be an attractive option for monogamous couples or for couples who desire to become pregnant. Couples may opt to have serological tests to determine if either partner has an asymptomatic infection. In close monogamous relationships, the risks of transmission can be weighed against other relationship issues, such as intimacy and pregnancy.

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How To Treat A Herpes Flare

If you have herpes, you may experience a flare-up from time to time. There are sometimes periods of outbreaks, followed by periods of remission. Although it is more likely to spread the virus if you have sex during an outbreak, you can still spread it when youre in remission.

If you have a herpes flare-up, you may experience the following:

• Small blisters around your genitals, rectum, or mouth
• With your first outbreak, the symptoms may last for 2-4 weeks
• The small blisters break and leave painful ulcers
• Recurring outbreaks may be shorter
• You may have lesions outside of your genital area, including your buttocks, thighs, finger, or eye

If you have symptoms of a herpes flare-up, its important to call the office right away. Dr. Patterson can prescribe an antiviral medication.

The antiviral medication should be a mainstay of managing your herpes outbreaks, especially if they occur regularly. Antiviral medications can suppress herpes outbreaks and prevent future outbreaks, as well as decreasing the likelihood that you can transmit it to your partners.

What Is Neonatal Herpes

Neonatal herpes can be a very serious infection. Babies generally contract the virus from their birthing parent during childbirth even if the parent doesnt have active lesions. They may also get HSV-1 if an adult with an active cold sore kisses them. Breastfeeding babies can also get HSV-1 from the breast if there are lesions present. But babies cant get herpes from breast milk, so its safe to pump and feed.

Herpes simplex can be more dangerous for young babies because they dont have a fully developed immune system. But most babies with neonatal herpes can recover fully with treatment.

The dangers of neonatal herpes are much higher if the infection spreads to the babys organs. If youre pregnant and have herpes, speak with your healthcare provider about how to lower the risk of passing the infection to your baby.

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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.

How Herpes Is Treated

There is no cure for herpes.

• The health care provider may prescribe antiviral medicine to help speed up the healing process. It also shortens the time when the virus can spread from the herpes sores.
• Pain may be treated with medicine such as Tylenol or Motrin or by applying an ice pack wrapped in a towel to the affected area.
• If sores are in the mouth, avoid foods high in acid, like citrus fruits and juices.
• The infected area should be kept clean and dry.
• Wash hands often and avoid touching the sores to prevent spreading the virus.
• It is important to stay healthy by getting enough rest, having proper nutrition and exercise and managing stress well.

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