Genital Herpes: The Painful Facts About A Tricky Virus
- By Monique Tello, MD, MPH, Contributor
A young woman* came into my office complaining of horrible pain and itching in her genital area. She had recently started dating, and her current boyfriend was her first sexual contact. He, however, had had other partners before her. She had telltale sores and tests confirmed that the cause was genital herpes.
Genital herpes is far and away the most common sexually transmitted infection that we see in primary care. I find myself explaining the diagnosis to distressed patients far more often than I would like.
There are two types of herpes, HSV-1 and HSV-2. Generally speaking, HSV-1 is responsible for those annoying cold sores that can pop up during times of stress or lack of sleep. HSV-2 usually causes genital sores. Many people dont realize that HSV-1 can cause genital ulcers as well, though these tend to be less severe and less likely to recur.
It can take as little as a few days and up to a week after a person has been exposed before any symptoms appear. First, there will be redness and tingling, followed by painful bumps that progress to fluid-filled “blisters.” Eventually, these burst to form ulcers which then crust over, healing over several weeks. HSV-2 infections can be more severe, causing terrible pain, as well as flu-like symptoms, and even inflammation of the membrane that covers the brain .
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 won’t 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 it’s a manageable condition and certainly nothing to be ashamed of. Lucy03934 has had genital herpes for 25 years. She’s been married for 18 years and has two sons – living proof that there is life after herpes.
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.
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One Option For Ongoing Therapy: Taking Drugs Regularly
Some people with genital herpes choose to take antiviral medication daily to reduce the number of symptom outbreaks they have. In some cases, daily therapy prevents outbreaks completely.
Numerous studies over the years have demonstrated the safety and effectiveness of all three of the approved antivirals used to treat genital herpes.
Studies have also shown that daily antiviral therapy reduces the rate of transmission from an HSV-2 infected person to an uninfected partner of the opposite sex.
Daily therapy also lowers the odds of infecting other people if you have multiple sex partners or if you are a man who has sex with men.
The drugs work both for people who have had herpes symptoms and for those whose blood tests show they have an HSV-2 infection but who have never had symptoms.
Some people choose to take antiviral drugs only as needed, for outbreaks that occur after the first one. For this to work, you need to start taking the medicine within one day of sores cropping up or during the time period that comes before some outbreaks.
During the prodrome, you may feel
- Burning in the area where the virus first entered your body
- Itching or tingling in that area
- Pain in your back, buttocks, thighs, or knees
Your doctor will probably give you a prescription you can fill and keep handy for timely use, and tell you to start taking the drugs just as soon as symptoms begin.
How Long Does It Take For The Medication To Work
All antiviral herpes medications begin to work quickly, which is why they should be taken as close as possible to the first emergence of symptoms.
This will give the medications the best chance to reduce the severity of the outbreak, and to speed up the resolution of an outbreak .
When taken within the first three days of an initial genital herpes outbreak, antiviral medications can shorten the lifespan of the outbreak by two to four days.
During later occurrences, these medications can shorten the lifespan of these outbreaks by 1-2 days.
Many people with HSV-2 do not experience regular genital herpes outbreaks.
But for people who do experience several episodes per year, preventative treatment can make a big difference.
In clinical studies, many patients who begin daily preventative treatment, go on to experience zero genital herpes outbreaks over the course of the following year.
Preventative antivirals can even help those patients who experience especially frequent and painful outbreaks of genital herpes.
In one study of this population, for instance, preventative antivirals were shown to reduce the average number of yearly outbreaks from 11 to 2.
Its important to remember, though, that none of these medications can completely cure herpes or eliminate the HSV virus from the body.
While preventative medicines, especially, can make it less likely that youll pass on the infection to sexual partners, it cannot completely eliminate this risk.
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What If I Forget A Dose Of Aciclovir
If you forget a dose of aciclovir, take it as soon as you remember, unless it’s nearly time for your next dose. In this case, just skip the missed dose and continue with your next one as normal.
Never have 2 doses at the same time. Never have an extra dose to make up for a forgotten one.
If you forget doses often, it may help to set an alarm to remind you.
You could also ask your pharmacist for advice on other ways to remember your medicines.
How Can I Reduce My Risk Of Herpes Simplex
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.
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.
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What Else Can I Do To Help With A Genital Herpes Outbreak
As well as taking medication to help with symptoms, you can also try:
- using an anaesthetic gel to numb your skin and ease any pain
- soaking the affected area with plain or salt water
- applying Vaseline to the affected area
- drinking plenty of fluids
- wearing loose clothing
- taking pain relief medications, like paracetamol or ibuprofen
The symptoms of herpes outbreaks will usually go away by themselves within 10 days as your immune system fights the infection on its own. You might find the sores painful during that time, so medication can help you by clearing up the infection more quickly.
If youd like to speak to one of our doctors about your symptoms, you can book a telephone consultation. Theyll be able to provide personalised advice on how to cope with genital herpes.
How Is Herpes Simplex Treated
Some people have few to no herpes outbreaks and choose not to have treatment. But many people prefer to use medications that shorten outbreaks and reduce symptoms.
During an outbreak, you may use an antiviral ointment or cream to help lessen your symptoms and help them go away faster, but it only works if you start it soon after you start an outbreak. Many people with HSV-2 take daily oral medications to keep outbreaks at bay.
Your provider may prescribe a topical medication or oral medication such as:
- Acyclovir .
- Valacyclovir .
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Is There Anything I Can Do To Relieve The Symptoms Myself
In some women, genital herpes blisters cause pain when urinating . Many of them find it soothing to pee while sitting in warm, shallow water . You can do this using special tubs that fit into toilet bowls. They are available at a reasonable price, for instance from pharmacies or on the internet. It’s best not to use soaps or bath additives because they can irritate the affected area even more. Other things you can do to avoid irritating it further include wearing loose-fitting clothes and underwear made out of fabrics that have a smooth surface.
Painkillers such as ibuprofen are an option if the blisters become very painful.
Topical antiviral treatments such as creams or ointments don’t provide any relief, but they can increase the risk of viral resistance. Experts advise against using topical treatments for genital herpes.
What Are Recurrences Of Herpes 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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Order Antiviral Treatments For Herpes
If you have genital herpes, you can get an online prescription for antiviral herpes medication discreetly and easily. Our doctor’s prescribe aciclovir, valaciclovir or famciclovir via our online service.
Order for a herpes outbreak: if you have a flare-up of symptoms, you can get a short course of medication to help control the outbreak.
Order to prevent outbreaks: if you get outbreaks more than 6 times a year or find your symptoms are hard to deal with, you can have suppressive treatment. This is where you take a low dose of antiviral medication every day to help prevent outbreaks.
Order a herpes test: if you need to check if youre a carrier of herpes, you can order a herpes test online now.
|1st outbreak – up to 10 days||£25.00|
|Repeat outbreaks – 5 days each, 1/2/3 courses||from £25.00|
|Suppression treatment – 3 months||£49.00|
|1st outbreak – up to 10 days||£70.00|
|Repeat outbreaks – 3 to 5 days each, 1/2/3 courses||from £40.00|
|Suppression treatment – 3 months||£220.00|
|Outbreak – 1 day each, 1/2/3 courses||from £95.00|
Click & Collect: free Next Day Delivery: £3.99Dispensing and standard delivery included.
Treatment For First Episode Of Genital Herpes
Because the first episode is often more severe and lasts longer than recurrences, treatment should always be offered to you after a clinical examination by a Doctor or Nurse Practitioner. You do not have to wait for swab results before receiving treatment.
After taking medication for 7 days it is recommended you visit your doctor again so they can check your symptoms and give you further advice and support.
The treatment is 500mg of valaciclovir twice daily for 7 days for 5 to 7 days).
Most people have no side effects from the medication and it is safe to take with other drugs
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How Long Does Valacyclovir Take To Work
The amount of time required for valacyclovir to control a herpes or chickenpox outbreak varies based on the severity of the outbreak and how soon you take valacyclovir after noticing herpes symptoms.
For most initial herpes outbreaks and cases of recurring herpes, valacyclovir takes effect very quickly and provides some level of relief in as little as two to three days. Generally, the sooner you take valacyclovir after noticing symptoms, the faster it will be to provide relief.
Its important to remember that every outbreak is different, meaning valacyclovir can potentially take less or more time than the figures listed above to provide relief and control over a shingles infection or herpes outbreak.
Our guide to how long valacyclovir takes to become effective covers more about valacyclovirs onset of action and average time to start working for different viral injections.
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.
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Herpes Treatment During Pregnancy
Talk to your doctor if you are pregnant and have genital herpes, or your partner has genital herpes, as it is possible for the baby to be infected with the herpes virus during pregnancy or birth.
Your doctor may recommend you take antiviral treatment before the baby is due, or may recommend delivering the baby via Caesarean section.
Who Can And Cannot Take Aciclovir
Aciclovir can be taken by most adults and children.
Aciclovir is not suitable for some people.
To make sure aciclovir is safe for you, tell your doctor if you:
- have had an allergic reaction to aciclovir or any other medicine in the past
- have kidney problems
- are over 65 years old
- are pregnant, trying to get pregnant or breastfeeding
If your immune system is weakened , talk to your doctor about the best type of aciclovir for you.
They may recommend tablets rather than the cream.
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What Can I Do If I Have Herpes Simplex 2
Many people who find out they have herpes feel depressed knowing they’ll always have the virus and can give it to others. But you arent alone. Herpes is one of the most common STIs, both in the U.S. and worldwide. If you have herpes, you should:
- Learn all you can about it. Information will help you to manage your disease and feel better about yourself.
- Talk about your illness with your doctor.
If you have herpes, you can still:
- Have sex if you use a condom or dental dam , and you tell your partner about your illness. Some couples, who have sexual relations only with each other, may choose not to use condoms even though one partner has herpes. Because each situation is different, you should ask your doctor if this is the right choice for you in your relationship.
- Have children. People with herpes can still give birth to healthy babies. If you have herpes and plan to have children, discuss your illness with your healthcare provider.
If you have herpes, you should also get checked for HIV and other STIs .
Protecting Your Partner And Preventing Herpes Transmission
Research shows that the single greatest fear is the fear of transmission to partners, says Dr. Handsfield.
The main ways to avoid transmitting herpes are:
- Learn to recognize how you feel when an outbreak is on the way, and stop having sex immediately.
- Dont have sex during active outbreaks.
- Always use condoms but dont rely on them during outbreaks. They dont completely cover infectious areas.
- Only after all sores have scabbed over and healed should you have sex again.
- Avoid touching your herpes sores, because you can spread them to other places on your body that way. Whenever you touch a sore, wash your hands immediately.
- Dont kiss people or have sex if you have a cold sore.
- Tell potential partners about having herpes before having sex with them, even though it may be hard.
- Ask your doctor about taking antiviral drugs regularly.
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