MORE: Is Your UTI Actually An STD? The Misdiagnosis Is Way More Common Than You Think A typical attack begins with inflammation, followed by a small cluster of blisters on the genitals that break and weep after a few days, leaving painful ulcers. You may experience fever, headache, and difficulty urinating. Once the initial outbreak of herpes (which is often the worst) comes and goes (usually in 2 to 3 weeks), the virus lies dormant—a sleeping giant—most of the time. Subsequent attacks are usually infrequent and generally not as severe as the first one. The average number for a person with genital HSV-2 is 4 or 5 a year. The average for genital HSV-1 is one a year. There is no cure for the disease, but medications and lifestyle measures can help manage symptoms and reduce outbreaks. Here’s what the experts recommend to help manage genital herpes symptoms.
Take Time To Understand Your Diagnosis
For most people, the social and emotional impact of herpes is greater than the physical distress, at least in the beginning. Society tends to have a judgmental attitude about sexually transmitted diseases. Many people feel embarrassed or isolated after they are diagnosed. With time, accurate information, and support, most people put herpes in perspective, says Mitch Herndon, program manager of the Herpes Resource Center and National Herpes Hotline at ASHA.
Consider An Oral Antiviral Medication
Talk to your doctor about antiviral medications such as Famvir (famciclovir), Zovirax (acyclovir), and Valtrex (valacyclovir). They can be taken either at the first sign of an outbreak to reduce the severity and duration or every day to suppress outbreaks, says Mary Jane Minkin, MD.
How To Manage Herpes Outbreaks
Use plain soap and water. You may be inclined to bombard your newly discovered sores with everything in your medicine cabinet. As with any sores, you do need to be concerned about developing a secondary (bacterial) infection, but soap and water is all you need or want to keep the area sufficiently germ-free. MORE: 5 Types Of Cancer You’ve Never Heard Of
Steer Clear Of Ointments
Genital sores need lots of air to heal. Petroleum jelly and antibiotic ointments can block this air and slow the healing process. Never use a cortisone cream, which can inhibit your immune system and actually encourage the virus to grow.
Warm Water Eases The Discomfort
During your primary attack or bad secondary attacks, a warm bath or shower 3 or 4 times a day may provide soothing relief to the genital area. (Here’s 5 more reasons to take a bath tonight.)
Use 2 Towels
During an outbreak use a separate towel on your genitals than the one you use on the rest of your body. Wash the towel after each use.
Blow Dry
When you get out of the shower or bath, blow dry the genital area with a hair dryer set on low or cool, taking care not to burn yourself. The air from the dryer also proves soothing and may possibly speed up the healing process by helping to dry out the sores.
Wear Loose-Fitting Cotton Underwear
Because air is essential to healing, wear only underpants that allow your skin to breathe—that is, cotton, not synthetic, says Judith M. Hurst, RN. If you wear nylon panty hose, make sure the crotch is made of cotton. If you want to wear a bathing suit without compromising fashion, consider cutting the cotton crotch out of a pair of undies and sewing it into the swimsuit, says Hurst.
Don’t Touch
Although the disease is called genital herpes, it is possible, though not very common, to pass the virus to other parts of the body by touching a genital ulcer and then rubbing, say, your mouth or eyes. For this reason, it’s important to wash your hands if there’s contact with a sore, says Herndon. If you think you might scratch at night, cover the inflamed area with protective, breathable material such as gauze, he says.
Learn Your Triggers
The factors that contribute to a recurrence are highly individual, but with time, many people learn to recognize, and sometimes avoid, factors that seem to reactivate HSV for them. Illness, poor diet, emotional or physical stress, friction in the genital area, prolonged exposure to ultraviolet light (a common trigger for oral herpes) like a beach trip or skiing weekend for example, surgical trauma, and steroidal medication (such as asthma treatment) may trigger a herpes outbreak. The frequency of outbreaks can often be managed through effective stress management, and adequate rest, nutrition, and exercise.
Try An Herbal Approach
Try echinacea to stimulate your immune system and burdock root as a gentle cleansing tonic. Here’s a recipe by herbalist Aviva Romm. Toss 1 ounce each of dried echinacea and burdock root into a quart of boiling water. Let the herbs steep for 4 to 8 hours, then strain the liquid. To treat an outbreak, drink 4 cups a day until the blisters disappear. To prevent recurrent outbreaks, drink 1/2 cup two to four times a day. You can use this infusion for up to 3 months. After that, take a 3-day break after each 27-day stretch. MORE: 7 Reasons Your Vagina Is Itchy Beyond Belief
Consider These Supplements With Caution
The amino acid lysine healed sores and prevented their recurrence in laboratory studies at UCLA in Los Angeles. Other potential supplements that may fight off herpes attacks include zinc, in topical form or capsules, or the food additive butylated hydroxytoluene (BHT), taken as a supplement. But despite mixed studies on their effectiveness, these two are unproven remedies, say most doctors. If you decide to try either, know that high dosages may be dangerous and should be taken only under a doctor’s supervision.
Prevent Transmission Of Herpes
Call For Help
If you have any questions about HSV, help is available, says Herndon. ASHA runs two hotlines that offer free advice to people with herpes. Call the National Herpes Hotline at 919-361-8488, Monday through Friday, 9 AM to 7 PM. (EST); or the toll-free National STD Hotline at 800-227-8922, 24 hours a day, 7 days a week. Visit the ASHA website, where you can send in your questions about herpes.
Talk First, Love Later
Explain to your partner what herpes is and the steps you’re willing to take to avoid passing on the virus. Telling your partner shows respect and concern, allows the person to make an informed choice, and may build intimacy and trust, says Herndon.
Practice Safe Sex
“You don’t have to give up sex,” says Minkin. “But you do need to make some changes in how and when you have it. The herpes virus can be transmitted by both sexual intercourse and oral-genital sex.
Avoid Skin-To-Skin Contact During Outbreaks
When there are signs or symptoms of HSV around the genital or anal region, refrain from sexual activity until all signs have healed. This includes oral, vaginal, and anal sex, says Minkin.
Use Protection Between Outbreaks
Although you are most contagious when you have sores, you can spread the virus even when there are no herpes symptoms through “viral shedding”—small amounts of the virus come to the surface of the skin. Shedding can happen at any time. One study found that 70% of cases were contracted when the sexual partner was symptom-free. Latex condoms used between outbreaks for genital-to-genital contact can reduce the risk of transmission. Although condoms don’t cover all the potential sites of viral shedding, they are useful against the virus by protecting or covering the mucous membranes most likely to be infected.
Talk To Your Doctor About Suppressive Therapy
Valacyclovir (Valtrex) has been shown to lower the risk of herpes transmission to a virus-free partner by 50%. A daily regimen of 500 milligrams of valacyclovir has been effective for partners with a history of recurrent attacks. It’s likely that a combination of suppressive valacyclovir and condoms provides greater protection than either method alone.
Get Help For Herpes From Your Doctor
If you have a stubborn case of genital herpes or are experiencing many recurrences, you may want to consider seeing your doctor for a prescription of valacyclovir (Valtrex), a drug that reduces frequency of attacks, limits their severity, and speeds healing time. This drug, approved by the FDA in 2001, stays in the body longer than acyclovir (Zovirax), so you have to take only one pill a day to fight off recurrences. If you are having your first attack or your recurrences are frequent, or if you believe them to be frequent, talk to your doctor. If you are pregnant, be sure to tell your doctor that you have herpes, since the virus can infect newborns. A strong link was once suspected between genital herpes and cervical cancer. That link is not as strong as once thought, but it’s still important for women with herpes to get a yearly Pap test.
Panel Of Advisors
Mitch Herndon is the program manager at the Herpes Resource Center and the National Herpes Hotline at the American Social Health Association (ASHA) in Research Triangle Park, North Carolina. Judith M. Hurst, RN, is medical advisor to Toledo Help, a support group for people with herpes in the Toledo, Ohio, area. She is also a retired obstetric nurse. Mary Jane Minkin, MD, is a clinical professor of obstetrics and gynecology at Yale University School of Medicine and an obstetrician-gynecologist in New Haven, Connecticut. She is coauthor of What Every Woman Needs to Know About Menopause and A Woman’s Guide to Menopause and Perimenopause. Aviva Romm is a certified professional midwife, herbalist, and professional member of the American Herbalists Guild. She practices in Bloomfield Hills, Michigan, and is coauthor of Naturally Healthy Babies & Children: A Commonsense Guide to Herbal Remedies.
