Some one in eight sexually active Australians and one in five New zealanders is infected with herpes simplex virus, which causes genital herpes (and cold sores). Although there is no cure, effective medications--and a prudent lifestyle--can ease symptoms.
What is happening
Most likely, you contracted genital herpes through a mucous membrane or a small opening in your skin during unprotected sex with an infected partner. If you've just been diagnosed, you may feel a variety of
emotions--fear, anger, betrayal, confusion--but don't panic. You are hardly alone. The herpes simplex virus (HSV), which causes the genital blisters and sores that typically mark this disease, is one of the most common viral infection in Australia and New Zealand today, striking men and women equally. And white it can be
a frustrating and painful condition for some, it is rarely dangerous.
Skin lesions typically begin 2 to 12 days after the virus enters your body. Your first episode (called primary herpes) is likely to be your most severe, with an eruption of painful red blisters on your genitals or in the genital area; itching or burning; fever and body aches; and swollen glands, particularly in the lymph nodes near your groin. Herpes is most painful, and contagious, during the first 24 to 48 hours, when the sores are open and 'weeping'. Once the blisters burst, they crust over and turn into an itchy rash that may continue for another week. After the primary outbreak, you may not get another episode for years, or you could have an attack as often as once a month. Some people continue to suffer extreme symptoms, while others have such mild symptoms they virtually go unnoticed. In fact, the virus is frequently transmitted by people unaware they are infected or who don't recognise that the virus is in an active phase (see on shortly).
LIKELY FIRST STEPS
HSV-1 and HSV-2. Until recently it was assumed that HSV-1 infections produced only cold sores
and fever blisters of the mouth, and did not attack the genital area as HSV-2 does. However, recent research shows that HSV-1 causes just as many new cases of genital herpes as HSV-2. Both types of HSV can be transmitted through vaginal, oral or anal sex, as well as by kissing and other skin-to-skin contact.
Once you are infected, however, the virus remains in your body for life, virtually sleeping in the roots of nerves next to your spinal cord. Each recurring attack is basically the same: the virus 'awakens', travels down the nerves and bursts through the skin. Common triggers include stress, fatigue, excessive exposure to cold or heat or other infections such as cold or the flu. In some women, PMS or mensturation may bring on a flare-up. As time goes by, the number of outbreaks tapers off and symptoms become less severe.Treatments
To date there is no cure for herpes simplex, but there are number of over-the-counter and prescription drugs that can relieve symptoms and shorten the duration of an outbreak. If you have mild symptoms or infrequent episodes, you may prefer to treat herpes on your own with self-help measures. You'll also have to be careful about sex (see on shortly), avoiding it altogether while you have an open sore.
FREQUENTLY ASKED QUESTIONS ABOUT HERPES
Getting herpes can be a troubling event that raises endless question. The following are some of the more common queries about the virus that doctors respond to daily.
Will herpes spread to other places on my body?
It's rare, but possible. Because herpes typically enters your body through a break in the skin, preventing self-infection is simple: don't touch the sore--especially if it's your first out-break, which is the most virulent. If you od, wash your hands as soon as possible.The virus is killed with soap and water.
Can herpes be active with out causing symptoms?
yes, via a process called 'viral shedding', in which the virus beings to multiply and becomes transmittable, but doesn't produce any visible blisters or inflammation. In fact, studies show that nearly 90% of people infected which herpes don't recognise symptoms or else mistake them for something else.
women with HSV-2 are more likely to transmit the virus during asymptomatic periods.
How can I reduce the risk of transmitting herpes?
You should inform your partner and abstain from sex when symptoms are present. Latex condoms offer some protection, but the virus can spread from uncovered lesions or in sweat or vaginal fluids to places the condom doesn't cover. (In addition, sex can irritate sores and slow the healing process.) Medicines may also curb spreadingly: early studies show that antiviral drugs reduce the shedding of the live virus from the sores, thus reducing the risk of transmission.
What if I have herpes when I'm pregnant?
Less than 0.1% of babies born to mothers with herpes contract the disease. But precautions are nevertheless advisable because HSV infection in a newborn is serious, even life threatening. If you suspect that you are having an outbreak during the late stages of pregnancy, your doctor will take a culture to be sure. A caesarean section is required if there are visible lesions when labour begins.
Lifestyle changes
Natural methods
What is happening
Most likely, you contracted genital herpes through a mucous membrane or a small opening in your skin during unprotected sex with an infected partner. If you've just been diagnosed, you may feel a variety of
emotions--fear, anger, betrayal, confusion--but don't panic. You are hardly alone. The herpes simplex virus (HSV), which causes the genital blisters and sores that typically mark this disease, is one of the most common viral infection in Australia and New Zealand today, striking men and women equally. And white it can be
a frustrating and painful condition for some, it is rarely dangerous.
Skin lesions typically begin 2 to 12 days after the virus enters your body. Your first episode (called primary herpes) is likely to be your most severe, with an eruption of painful red blisters on your genitals or in the genital area; itching or burning; fever and body aches; and swollen glands, particularly in the lymph nodes near your groin. Herpes is most painful, and contagious, during the first 24 to 48 hours, when the sores are open and 'weeping'. Once the blisters burst, they crust over and turn into an itchy rash that may continue for another week. After the primary outbreak, you may not get another episode for years, or you could have an attack as often as once a month. Some people continue to suffer extreme symptoms, while others have such mild symptoms they virtually go unnoticed. In fact, the virus is frequently transmitted by people unaware they are infected or who don't recognise that the virus is in an active phase (see on shortly).
LIKELY FIRST STEPS
- Pain relievers to ease body aches and fever.
- Topical anaesthetics for pain and ithcing.
- Antiviral medications to speed healing and prevent recurrent outbreaks.
QUESTIONS TO ASK
HERPES SIMPLEX HAS TWO DIFFERENT FORMS:- Do I have to call the doctor for a prescribing each time I sense a flare-up?
- How long do I need to abstain from sex?
- Does herpes increase my risk of getting another sexually transmitted disease?
HSV-1 and HSV-2. Until recently it was assumed that HSV-1 infections produced only cold sores
and fever blisters of the mouth, and did not attack the genital area as HSV-2 does. However, recent research shows that HSV-1 causes just as many new cases of genital herpes as HSV-2. Both types of HSV can be transmitted through vaginal, oral or anal sex, as well as by kissing and other skin-to-skin contact.
Once you are infected, however, the virus remains in your body for life, virtually sleeping in the roots of nerves next to your spinal cord. Each recurring attack is basically the same: the virus 'awakens', travels down the nerves and bursts through the skin. Common triggers include stress, fatigue, excessive exposure to cold or heat or other infections such as cold or the flu. In some women, PMS or mensturation may bring on a flare-up. As time goes by, the number of outbreaks tapers off and symptoms become less severe.Treatments
To date there is no cure for herpes simplex, but there are number of over-the-counter and prescription drugs that can relieve symptoms and shorten the duration of an outbreak. If you have mild symptoms or infrequent episodes, you may prefer to treat herpes on your own with self-help measures. You'll also have to be careful about sex (see on shortly), avoiding it altogether while you have an open sore.
Treatment Options
MEDICATIONS
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Over-the-counter pain Aspirin, ibuprofen, paracetamol.
relievers
------------------------------------------------------------------------------------------------------------------------------------------
Antiviral drugs Zovirax, Valtrex, Famvir for recurrent cases.
LIFESTYLE CHANGES
---------------------------------------------------------------------------------------------------------------------------------------------
Boost immunity Through proper diet, sleep and exercise.
----------------------------------------------------------------------------------------------------------------------------------------------
Good hygiene Bathe often; urinate with care to avoid pain.
NATURAL METHODS
-----------------------------------------------------------------------------------------------------------------------------------------------
Lysine May reduce flare-ups and promote healing.
-----------------------------------------------------------------------------------------------------------------------------------------------
Melissa cream Can help sore heal.
-----------------------------------------------------------------------------------------------------------------------------------------------
Echinacea extract Apply often to reduce pain from open sores.
TAKING CONTROLMEDICATIONS
------------------------------------------------------------------------------------------------------------------------------------------
Over-the-counter pain Aspirin, ibuprofen, paracetamol.
relievers
------------------------------------------------------------------------------------------------------------------------------------------
Antiviral drugs Zovirax, Valtrex, Famvir for recurrent cases.
LIFESTYLE CHANGES
---------------------------------------------------------------------------------------------------------------------------------------------
Boost immunity Through proper diet, sleep and exercise.
----------------------------------------------------------------------------------------------------------------------------------------------
Good hygiene Bathe often; urinate with care to avoid pain.
NATURAL METHODS
-----------------------------------------------------------------------------------------------------------------------------------------------
Lysine May reduce flare-ups and promote healing.
-----------------------------------------------------------------------------------------------------------------------------------------------
Melissa cream Can help sore heal.
-----------------------------------------------------------------------------------------------------------------------------------------------
Echinacea extract Apply often to reduce pain from open sores.
- Know your body. Take note of itching, tingling and other sensations that precede your herpes attacks (this is called the 'prodrome'). Staying alert makes early treatment possible and helps curb the spread of infection.
- Reduce stress. Cognitive-behavioural methods and other stress-reduction tehniques have been found to be effective in reducing herpes-related depression and may stimulate virus-fighting antibodies.
- Take a break. If you're on daily suppressive drug therapy, stop the pills for a short time each year to see if flare-ups continue to recur. You may find you no longer need the medication.
Medications
To relieve fever, headache or achines at the start of an episode, try an over-the-counter pain reliever, such as paracetamol, or a nonsteroidal anti-inflammatory drug (NSAID), such as aspirin, ibuprofen (Nurofen) or naproxen (Naprogesic). Anaesthetic creams and gels are also available, but it is best to discuss these with your doctor, as some creams can irritate the genital skin. Just be aware that none of these medicines will shorten the course of the outbreak.
If you're experiencing a primary episode or have more than six outbreaks a year, your doctor will probably recommend taking a prescription antiviral medication. It will block the reproduction of the virus, relieve your symptoms and help you recover more quickly. Three prescription medicines are approved to date; all work similarly, are considered safe and have virtually no side effects. Aciclovir (Zovirax) has been used since
1985 and is now available in a generic form. It is most effective against an active infection if taken within 24 hours of the first symptoms and may also reduce the frequency of viral shedding (see box, shortly). Valaciciovir (Valtrex) has aciclovir as its active ingredient, but is better absorbed by the body and can be taken less often. Famciclovir (Famvir) works much the same way as aciclovir does, but it it also better absorbed by the body and can be taken less often. Famciclovir (Famvir) works much the same way as aciclovir does, but it is also better absorbed and requires fewer doses. Both aciclovir and famciclovir are available as a cream, but the capsules and tablets are much more effective.
Antivirals are generally prescribed in two ways: episodic therapy involves taking the medicine for three to five days during an outbreak. While this can shorten the duration by about two days,it does not affect the frequency of future attacks. The other method is suppressive therapy, in which you take one or two doses of medicine every day to prevent attacks. It works only as long as you take the drug, although in some people flare-ups become less frequent and less severe even after the drug is stopped (See Taking control, above)
If you're experiencing a primary episode or have more than six outbreaks a year, your doctor will probably recommend taking a prescription antiviral medication. It will block the reproduction of the virus, relieve your symptoms and help you recover more quickly. Three prescription medicines are approved to date; all work similarly, are considered safe and have virtually no side effects. Aciclovir (Zovirax) has been used since
1985 and is now available in a generic form. It is most effective against an active infection if taken within 24 hours of the first symptoms and may also reduce the frequency of viral shedding (see box, shortly). Valaciciovir (Valtrex) has aciclovir as its active ingredient, but is better absorbed by the body and can be taken less often. Famciclovir (Famvir) works much the same way as aciclovir does, but it it also better absorbed by the body and can be taken less often. Famciclovir (Famvir) works much the same way as aciclovir does, but it is also better absorbed and requires fewer doses. Both aciclovir and famciclovir are available as a cream, but the capsules and tablets are much more effective.
Antivirals are generally prescribed in two ways: episodic therapy involves taking the medicine for three to five days during an outbreak. While this can shorten the duration by about two days,it does not affect the frequency of future attacks. The other method is suppressive therapy, in which you take one or two doses of medicine every day to prevent attacks. It works only as long as you take the drug, although in some people flare-ups become less frequent and less severe even after the drug is stopped (See Taking control, above)
PROMISING DEVELOPMENTS
- A new class of drugs called cdk-blocking agents, if proven safe in humans, could keep HSV in an active state permanently. The compounds stop an invading virus from using the human host's cdk, a substance that drives cell divison.
- Resiquimod, a topicl gel, shows promise in significantly delaying recurrent genital herpes outbreaks. It could provide an alternative to suppressive therapy.
- A long-sought-after herpes vaccine is now the subject of Australian trials. SCientists hope the vaccine will prevent herpes in people unaffected by the disease and halt it in those already infected.
FREQUENTLY ASKED QUESTIONS ABOUT HERPES
Getting herpes can be a troubling event that raises endless question. The following are some of the more common queries about the virus that doctors respond to daily.
Will herpes spread to other places on my body?
It's rare, but possible. Because herpes typically enters your body through a break in the skin, preventing self-infection is simple: don't touch the sore--especially if it's your first out-break, which is the most virulent. If you od, wash your hands as soon as possible.The virus is killed with soap and water.
Can herpes be active with out causing symptoms?
yes, via a process called 'viral shedding', in which the virus beings to multiply and becomes transmittable, but doesn't produce any visible blisters or inflammation. In fact, studies show that nearly 90% of people infected which herpes don't recognise symptoms or else mistake them for something else.
women with HSV-2 are more likely to transmit the virus during asymptomatic periods.
How can I reduce the risk of transmitting herpes?
You should inform your partner and abstain from sex when symptoms are present. Latex condoms offer some protection, but the virus can spread from uncovered lesions or in sweat or vaginal fluids to places the condom doesn't cover. (In addition, sex can irritate sores and slow the healing process.) Medicines may also curb spreadingly: early studies show that antiviral drugs reduce the shedding of the live virus from the sores, thus reducing the risk of transmission.
What if I have herpes when I'm pregnant?
Less than 0.1% of babies born to mothers with herpes contract the disease. But precautions are nevertheless advisable because HSV infection in a newborn is serious, even life threatening. If you suspect that you are having an outbreak during the late stages of pregnancy, your doctor will take a culture to be sure. A caesarean section is required if there are visible lesions when labour begins.
Lifestyle changes
Regardless of whether you use antiviral therapy, maintaining a healthy diet as well as getting plenty of sleep and exercise are important for helping your immune system defend against genital herpes. Here are some additional self-care measures you can try:
- Apply ice. An ice pack wrapped in a thin towel can temporarily relieve the pain of an open sore; don't apply too long.
- Bath often. Take lukewarm baths to soothe burning. To dry off, use a hair dryer on cool instead of a towel to avoid irritation.
- Urinate with care. To prevent the pain caused by urine touching an open sore, urinate in the bathwater at the end of bathing time or in a cool shower. Urinating through a small tube, such as a toilet paper roll, also protects sensitive surrounding tissue.
Natural methods
One of the more popular (and scientifically studied) alternative remedies for herpes simplex is the amino acid lysine, which many people have found reduces flare-ups and quickens healing. A dose of 1000 mg of L-lysine taken four times a day at the first sign of an outbreak has been shown to be safe and free of side effects. A cream
made form melissa, a herb from the mint family, may also promote healing of herpes lesions. Look for a product that contains a concentrated extract of the herb or ask a qualified herbalist to make a cream for you. A few drops of echinacea extract applied gently to sores every few hours can help to relieve pain.
made form melissa, a herb from the mint family, may also promote healing of herpes lesions. Look for a product that contains a concentrated extract of the herb or ask a qualified herbalist to make a cream for you. A few drops of echinacea extract applied gently to sores every few hours can help to relieve pain.
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