- 1. What is herpes, and what does it do to the body?
- Herpes resides in the ganglia, the nerves. HSV (Herpes Simplex Virus) is
very common. Depending on which source you're looking at, anywhere from 80-150
million Americans are believed to have either HSV-1 or HSV-2. HSV-1 usually
presents orally, and HSV-2 genitally. However, either can infect both areas.
If you have either kind in the genital region, it's called genital herpes;
either kind near the mouth is called oral herpes. They key is which *strain*
of the virus is causing the infection. (Type 1 or 2) During an outbreak, the
virus begins reproducing in the ganglion, then travels along the nerve pathways
to the skin, where it can be passed on. After an outbreak, the virus goes
dormant for a time. Usually the first 1-2 years after being infected are the
most difficult, as your body comes to grips with the virus. Outbreaks tend
to be more common in the first year, *usually* tapering off after that.
Some important numbers:
- More than 100 million Americans have oral herpes.
- There are over 30 million cases of genital herpes in the United States
alone.
- More than half a million people will be diagnosed with genital herpes
this year.
- 2. How do you get herpes? Can I protect myself?
- Herpes is passed by skin to skin contact during a period of active viral
shedding. In some people with herpes, this presents as a sore. Scientists
and doctors suspect that roughly 50-75% of cases of genital herpes are completely
asymptomatic. This means that the person has an outbreak
without having any outward symptoms. Condoms can help reduce
the risk, but because the virus doesn't limit itself to the penis or the vagina
they can't protect you from everything.
What can you do to reduce your risk of getting herpes?
- Always know your partner.
- Have "The Talk" about sex, sexual health, and protection before you
have sex.
- Always use condoms or dental dams (properly!)
- Wash thoroughly with soap and water after sex; virii aren't very strong.
Soap and hot water kill and/or wash away the herpes virus if it hasn't
already made it through a break in your skin.
- Ask about your partner's methods of dealing with outbreaks. The more
you talk about herpes, the more you'll learn, and you'll both be more
comfortable with it.
If you have herpes, how can you help protect your partner?
- Get to know your body - learn to recognize prodromal (warning) symptoms.
This will help you know when to avoid sexual activity.
- Talk to your partner about your symptoms, frequency of outbreaks, etc.
Help them understand the importance of avoiding contact with the area
during an outbreak.
- Wash thoroughly with soap and water before sex; virii aren't very strong.
Soap and hot water kill and/or wash away the herpes virus, so this can
lower the odds in case you're having a period of asymptomatic shedding.
(May as well jump in after, too, since s/he's in there. ;)
Things you can do for yourself if you have herpes:
- Don't forget to protect yourself! You may have herpes, but there are
other (and worse) things out there. Make sure to find out about your partner's
history as you're having "The Talk".
- Stay healthy; by doing so you can help your body fight off an outbreak.
- Consider suppressive drug therapy- a daily dose of antivirals can help
your body be more resistant to outbreaks.
- Try to avoid stressful situations - stress is a trigger for many people.
(Illness is, too.)
Did you know? If you touch an active sore, then touch
a part of your body with broken skin, you could potentially pass the virus
to another part of your body. (This is called autoinnoculation.) So be careful
and wash your hands!
- 3. Various things can happen to you with herpes, or (outwardly)
nothing.
- You may find that you get occasional sores/lesions. Some people experience
them as dry, hard, sore bumps; other find they are watery and blister-like.
You may not ever have any sores at all- in fact, between 50-75% of people
with herpes are completely asymptomatic, meaning they don't show any symptoms.
The important thing to remember is that even if a person is asymptomatic,
they can still have periods of "viral shedding", when the virus is active
and contageous. Without the symptoms, you likely won't know when that is.
If you do get the sores/lesions, they should be treated as open wounds,
in the sense of avoiding contact with other people's bodily fluids. Because
they are breaks in the skin it can increase your risk of catching another
STD, or rarely, an infection.
Herpes lesions are as different as the people who have them. They can
be dry, hard bumps, or wet oozing things that scab over, or any combination
thereof. Just because they don't look like your oral herpes sores, or because
they don't ooze and scab over, doesn't mean that's not what it is. "Textbook"
cases of any disease are few and far between- there are many possible variations
of any symptoms. Definitely get a professional opinion on ANY suspicious
bump or sore.
- 4. Herpes is NOT going to kill you.
- It has the potential to annoy the hell out of you, but it isn't deadly.
You can still have a normal, healthy pregnancy, and as long as you don't
have a known active outbreak, vaginal childbirth is completely possible.
If you have herpes, or have reason to suspect you may have been exposed
to it and you are pregnant or planning to become pregnant, be sure to let
your doctor know, so that s/he can test for the antibodies. Better safe
than sorry, and it's easier to deal with a known potential problem than
have it "pop up" at a bad time with no warning.
- 5. Symptoms
- Symptoms of an initial outbreak include (but are not limited to) fever,
body aches, tiredness, headaches, itching and tingling in infected areas,
painful bumps/blisters. Symptoms of recurring outbreaks can be the same as
for an initial outbreak, but are usually milder. If you do have herpes, it's
going to be very helpful to be "in touch with" your body. Learn to recognize
the prodromal symptoms. Prodromal symptoms can be as mild as a slight tingling
in that area, or as bad as the flu. The sooner you start treating an outbreak,
the quicker it will go away, and the less painful it is likely to be.
- 6. Herpes, or just canker sores?
- Canker sores:
- Are NOT caused by a virus
- Are NOT communicable
- Are probably a bruise-type reaction to an irritation of some kind (be
it a bite, acidic or spicy foods, whatever)
Cold sores:
- Are USUALLY caused by herpes simplex type 1 (HSV-1) BUT can also be
caused by herpes simplex virus type 2 (HSV-2)
- Are communicable when present, and the virus MAY also to into periods
of asymptomatic (no symptoms/sores present) shedding
How can you tell the difference?
- Canker sores USUALLY are only inside the mouth cold sores are USUALLY
only outside the mouth
- You cannot tell for sure by sight. Very very few doctors can, either.
- The only way to know FOR SURE is to have an active sore cultured and
tested.
- 7. Testing for herpes:
- The most effective way of finding out if you have herpes is to have the
questionable bump/blister cultured. The doctor will take a sample by swabbing
the sore. (Odds are, this will hurt, but it is over quickly.) If
you are not showing any symptoms but know that you have been exposed, the
Western Blot blood test can be used to look for HSV antibodies. Not many doctors
will do this one on request because of the expense and because the test is
only about 70-80% accurate. But it doesn't hurt to ask, if you are concerned!
- 8. Drugs used to treat herpes outbreaks:
- Various antivirals are used to treat herpes and other viral infections.
(Meaning don't assume that just because someone has a bottle of Valtrex in
their medicine cabinet it must be herpes.)
Zovirax (acyclovir)
has been around the longest, I believe. The other antivirals mentioned below
are variations on this drug. It IS available in a generic form. It has also
been shown in some small studies to be effective in "cutting off" an outbreak
IF the proper dosage is taken at the onset of the prodromal symptoms.
Any later, and the "megadose" will NOT work.
Famvir / Famciclovir is often used to treat primary outbreaks; for some
reason, it seems to be better at beating up on the herpes virus during the
primary outbreak than the other antivirals. It doesn't seem to have as strong
an effect on secondary outbreaks.
Valtrex (valacyclovir) is a drug that breaks down into acyclovir as it
is digested, giving a "time release" effect. Fewer doses are required per
day for both treatment of an outbreak and for suppressive therapy.
- 9. The two primary methods of treatments are:
-
- Treat the outbreaks- only take the antiviral medications during an actual
outbreak.
- Suppressive therapy - a small amount of the antiviral is taken daily
to help the body resist any potential outbreaks. This works well for some
people, but not for others.
- 10. Due
to the length of the current section on herpes and pregnancy, it now has it's
own page.
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- 11. Following is a list of resources on the web that can help you
learn more about herpes:
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