If you suspect you have become infected with the herpes simplex virus, either because symptoms have appeared or because you have had close contact with someone who has the virus, the most important thing is not to panic.
Herpes simplex should be regarded as nothing more than a fairly trivial skin disease and in most cases there is no need to feel anxious or alarmed. Naturally things seem worst at first, especially when the infection is painful and it is accompanied by other signs of illness such as headache and fever, but it is important to remember that you will get better and that any recurrent episodes – if they occur at all – will be considerably smaller.
For most people, the management of a recurrence with herpes simples involves relieving any pain or discomfort as much as possible and following a few basic hygiene rules to avoid spreading the infection to others. In this chapter I shall discuss these issues as well as examining the possible factors that may be triggering recurrences – how to recognize and avoid them.
We will also deal with treatments for herpes simplex, including antiviral drugs , how to build up the immune system through diet and alternative remedies , and finally ways to reduce stress which may be contributing to recurrent infections.
Where To Go
It is best to seek medical advice as soon as the first symptoms of an infection with herpes simplex begin to show, so that antiviral treatment can begin. Drug treatment is shown to be more effective when there is a primary episode.
If a cold sore on the lips or face is not causing much grievance, many people will wait for the sore to go away, or they will consult a pharmacist who may recommend an antiseptic cream. If the sore is no better after two weeks, it is advisable to see a doctor. When oral herpes is more severe and there are several sores, or the infection includes the mouth and surrounding skin, it is worthwhile getting a diagnosis from a doctor; he or she will then be able to prescribe antiviral drugs which can help the infection clear up more quickly.
In the case of genital herpes, many doctors have adequate facilities to test for the virus, or will be able to send a sample to a laboratory for diagnosis. Frequently, a doctor will refer a patient to genital-urinary (GU) clinic to confirm the diagnosis. This is often preferable because doctors at these clinics are very experienced in dealing with genital herpes. Not only can they offer an accurate diagnosis but a counseling service is usually available which can be of tremendous benefit to someone who is worried about the situation.
There has been a considerable amount of false information on the subject of herpes simplex and the importance of receiving correct information and advice cannot be stressed enough. Visiting a GU clinic is also a good idea because the doctors will test for other sexually transmitted diseases that may be accompanying the genital herpes. This will help in eliminating diseases such as syphilis from the suspicion.
You can go straight to a GU clinic without being referred by a doctor . In most countries these are walk-in clinics which usually do not require an appointment first – however it is best to telephone ahead to make sure. In recent years the profile of GU clinics has improved considerably and most people are pleasantly surprised at how efficient and friendly they are. They are also completely confidential, not even your doctor needs to be informed of your visit.
In Britain, all tests, medication, and counseling services at GU clinics are free. Your nearest clinic can be found by looking online.
Rest and Comfort
Once a diagnosis has been made, the next step is to ensure a quick recovery. Medication may be prescribed to help speed up the recovery process. You are likely to be feeling quite delicate at this time and should take extra care of yourself.
If you are feeling unwell with headaches and fever, it is best to take things easy and go to bed for a few days. Children whose oral herpes is accompanied by swollen glands and mouth ulcers may also need bed rest.
Try to ensure the affected area is left exposed to the air as much as possible. It is best to avoid wearing make-up and lipstick anywhere near cold sores. Some women feel tempted to use makeup to cover their sore but this can slow down the healing process. Genital herpes will also benefit from being left exposed as much as possible, so while resting in bed, don’t wear underwear. And when dressed, wear cotton underwear which is cooler and more comfortable than nylon, which may make you sweat.
For the same reason women may feel better wearing stockings as opposed to tights. In general, loose clothing will be a lot more comfortable than tight jeans or trousers.
A mild painkiller such as aspirin will help to ease any pain and reduce inflammation, but make sure the dosage is kept in line with the manufacturer’s guidelines. Placing an icepack on the affected area may also be helpful. Wrap some ice in a cloth and place it gently on the skin for 10 minutes at a time. Do not apply ice straight onto the skin.
A local anesthetic cream such Xylocaine ointment can be very effective in reducing the pain. Bought over the counter from pharmacies, anesthetic creams are suitable for oral, facial, and genital herpes. Some people find aloe Vera gel applied to the area to be very soothing – it also has skin-healing properties. The gel consists of an extract from the aloe Vera plant and can be bought from pharmacies and health food shops.
Going To The Toilet
When the genital area is ulcerated, many women find going to the toilet very painful. This pain is caused by the contact between urine and broken skin. Nevertheless, holding back on going to the toilet is not the solution, as it can cause further problems (see Chapter 7). Instead it is often helpful to dilute the urine by urinating in the bath or shower or pouring warm water over the vulva simultaneously.
Drinking plenty of liquids will help to neutralize the urine; mineral water and soft drinks are a better choice than tea, coffee and alcohol, which can be quite acidic.
Keeping the infected area clean should be a priority. The aim is to keep out bacteria which could cause an additional infection and slow down the healing process. For this reason, your hands should be washed thoroughly before applying any ointment to the sores. It is extremely unlikely that the virus is spread in this way when it is a recurrent infection.
The infected area will be very tender, so it should not be rubbed vigorously or rubbed dry as this will add to the pain and prevent it healing quickly. The area can be kept adequately clean by washing gently twice a day using a gentle soap and warm water. A salt solution is a good option because it is soothing and helping and helps the ulcers to heal. A ratio of about one teaspoon of salt to half a pint of warm water is recommended – you can splash it over the affected area, dab cotton wool in the solution and use it to wash the area or add half a cup of salt to your bath.
To avoid any sensitivity problems make sure that any soap you use is unscented – talcum powder and lotions should not be used either until the area is healed completely. As with any minor injury to the skin, nature will take its course and the sore will heal in the time it takes for the new skin to replace the old. Constantly touching the area and applying a range of different lotions and potions only interferes with this process.
How To Avoid Passing The Infection On
When the symptoms of herpes simplex are very active in a primary episode and sores are present, most sufferers will be aiming to soothe the infection – the last thing they will probably feel like doing is engaging in sex or kissing!
However, if the thought has crossed your mind it should be dismissed until such time as the infection has healed. The friction involved in sexual intercourse makes it easier it easier for the virus to be transmitted from skin to skin. Barrier methods of contraception are not totally protective in this instance because a condom may not cover all the genital sores in a man, or the virus may be transmitted to those parts of a man’s genitals that are left exposed. Intercourse or anal sex should be avoided during every episode of genital herpes, but especially during a primary episode when there are large amounts of the virus present and the likelihood of passing it on is increased.
The only exception to abstaining from sex during an infection is when your partner also has the same virus. This can be established by both partners having a specific antibody-type blood test. Sometimes one partner cannot remember having had the infection. If it turns out that the same type of herpes simplex, either type 1 or 2, is present in both, then neither person can be re-infected and the virus should have little effect on sexual activity.
So unless you and your partner have the same virus when cold sores are present around the mouth, there should not be any kissing. Oral sex must also be avoided by a person who has cold sores around the mouth or when the partner has genital sores.
Recognizing and Avoiding Triggers
Those who have regular, recurrent episodes often find that a specific incident seems to set their symptoms off. Stress, anxiety or depression are some of the most common triggers reported. Many people say they can almost se their watches by when a recurrence will occur. A tight deadline at work, aggravation from the boss, relationship difficulties or problems paying the bills can all precipitate a recurrence for some individuals.
Others find that as soon as they have one too many late nights and become tired, a cold sore will appear the following week. Feeling run down and not eating properly can also be contributing factors. It Is quite common for a cold or flue to be accompanied by an attack of cold sores or genital sores.
These are all conditions which weaken our immune system in some way. Just as we become prone to the flue or colds when we are run down, the herpes simplex virus seems to recur when our defenses are low, which explains why these two often occur simultaneously.
How Triggers Work
There is strong evidence that infections may be triggered by nerve damage on the skin’s surface or mucous membrane which reactivates the virus that is lying dormant in the nerve cells.
One theory is that when nerve endings are damaged in any way the nerve cells be low respond by producing cells that renew and repair the faulty cells. When host cells have been overtaken by a virus, they, too, may have adapted themselves to carry out a response. But the viral response has its own special functions, so that instead of repairing, the virus becomes active and starts to replicate again, resulting in viral shedding or an infection at the skins surface.
When the host cell response ceases, so too does viral reactivation. This explains why genital herpes can sometimes be triggered by sexual intercourse, especially if there is considerable friction, perhaps due to a new position or a different partner.
Menstruation as a Trigger
Some women often have a recurrence of sores around the time of their period. No one is quite sure why this may be so, but there is the suggestion that certain hormonal changes such as those that take place along with menstruation may be immunosuppressive.
UV Exposure as a Trigger
Extreme temperatures which cause trauma to the mucous membranes can have the same triggering effect. Direct exposure to the sun can damage and dry out the lips, causing the virus to be reactivated.
Some unlucky people find that going on holiday to a sunny climate means they almost always return with a cold sore on their lips. Winter skiing can play havoc for some people. The extremes of freezing conditions an direct, bright sunlight can cause damage to the lips and the skin’s surface. Wearing sunblock cream and a hat usually helps to avoid this but , unfortunately for some people, just the change in temperature can be enough to cause symptoms to appear. It is also thought that excessive exposure to the sun has a general immunosuppressive effect.
Stress as a Trigger
As well as being run down physically, our emotions can play a part in the return of an infection too. Many experts feel that stress can influence our immune system and make us more prone to infection. Certainly feeling anxious or depressed seems to bring on symptoms for some people. To some extent stress is needed in our lives to challenge us and drive us on; in fact many people seem to thrive on it.
Problems occur when stress is unrelenting and there is no break from feeling anxious, worried or under pressure. If the body is in a constant state of stress it can cause a person to feel exhausted, which weakens his or her defense system and puts the person at risk of physical or mental illness.
The fear of actually being ill can be a source of stress for some; many people say that one of the worst things about herpes simplex is the worry of not knowing when symptoms are going to flare up again. In rare instance, it is possible that anticipating another ‘dreaded attack’ may actually contribute to symptoms. It is often said that those people who never think about their herpes simplex infection are less likely to be affected by recurrent infections. Learn about the most effective herpes treatments at http://herpes-products.com