What is herpes?

Herpes is a virus.  Other viruses cause colds, mumps, the flu and measles.  Different forms of the herpes virus cause chickenpox, mononucleosis (the “kissing disease”), shingles or herpes zoster.

Many people (some say more than 50%) get herpes and do not know they have it because they never have symptoms.  Others may develop small, sometimes painful sores on or around the mouth (usually type 1) or genitalia or buttocks (usually type 2).  Both types of herpes act the same way.  The information in this article is about both types.  Either type can be found on any part of the body and if it returns it usually comes back in the same place.

What causes herpes?

The herpes lesion usually starts after a cold, sun exposure or trauma such as cutting the lip while shaving.  It appears as a red patch or group of small blisters and is accompanied at first by itching, tingling or tenderness (called "prodrome" symptoms).  Within hours, the lesion enlarges and can be quite painful, especially if the blisters are broken. At this stage, the lesion can take several weeks to heal.  If oral antiviral medication is taken in the early stage before the blisters form , the episode can be aborted within 12-24 hours, so it's important to have a supply of the prescription medication with you.  Most people who get herpes have only two or three episodes a year but some people get repeated infections and this is an indication for chronic suppressive therapy every day with a prescription antiviral medication. 

Active virus can be present on the skin from the first warning signals (prodrome) until the sore completely disappears.  If you touch an active herpes lesion, the viral particles can infect the skin of your fingers, a condition called herpetic whitlow.  Viral particles can also be spread to the cornea leading to keratoconjunctivitis, a serious infection of the eye.  Finally, herpes in the newborn is a serious infection passed from the mother during birth which can result in meningitis and death of the infant. 

The First Infection

The first infection can occur between 2 and 30 days after exposure.  The first infection, usually the most severe, can also occur months or even years after exposure.  The sore untreated lasts 2-3 weeks.  Along with the sore, you might have swollen glands, fever, and overall aches like the flu.  Treated sores resolve in a few days to a week.

The Inactive Virus

The sores go away, but the virus does not.  It enters nerve cells close to the area where the sores were and stays there.  There are no symptoms or signs that the virus is present.  The virus is in the “inactive” stage.  Most of the time you cannot give the virus to someone else while it's inactive, nor can it infect another part of your own body.    Some people (about 1/3) have one herpes outbreak and never experience it again.  The virus stays inactive forever.  Others have recurrences – that is, the virus becomes active again and the sores come back in the same place.

Treatment of Herpes

Treatment of herpes is most effective when started at the first signs of an outbreak.  The sooner you start the medication the better it works.  If you are aware of the prodromal symptoms, this is when you should begin the treatment.  Treatment consists of the following: 

1.       Valtrex (prescription required) two tablets twice a day until the blisters or sores disappear.  If you are in doubt or think you are developing herpes lesions use Valtrex for 12-24 hours and discontinue if no sores develop.  Take with lots of water and some juice or food to avoid stomach irritation.  DO NOT USE IF YOU ARE PREGNANT!  It is probably better if men do not take this pill if they are planning to have children during the months they are taking this tablet.  It does not seem to have any effect on the sperm that we know of, but it is better to be on the safe side.  Nursing mothers should not take this pill.

2.       Some people find that two aspirin, two Tylenol or two Advil begun during the first signs of discomfort will decrease the pain.

3.       Avoid sexual contact or personal contact from the time you feel symptoms until the lesions are clear.  Use condoms as long as there are any sores present.

4.       Side effects from the medication are very rare.  If you experience nausea, vomiting and/or headache, please discontinue the medication and let your doctor know about it.  The following reactions are also possible but very unusual: diarrhea, dizziness, loss of appetite, mild fatigue, skin rash, leg pain or a medicine taste in your mouth or throat.

5.       This medication is used to treat herpes virus in any location on the body.  The pill seems to be relatively safe in that it acts only on those skin cells that have the herpes virus growing in them.  It does not affect normal cells in the body. 

6        In some people, taking Homeopathic Apis can abort an episode.

7.       It's important to treat the area gently, using a topical lubricant such as Aquaphor ointment.  It is NOT recommended to use such over-the-counter remedies as Blistex, Carmex or others containing phenol, menthol or camphor since these will delay healing.

8.       Vitamin C 1-3 g per day can also improve your resistance to viral infections.

UNDERSTANDING HERPES SIMPLEX

Unfortunately, there is an extensive amount of misinformation in the general public in regard to the herpes simplex virus.  Much of this information is not totally accurate.  It can be misleading, frightening, and confusing to people with Herpes simplex.  It is unfortunate that herpes is labeled as a venereal disease.  Venereal means a disease that is spread from one person to another through sexual contact.  The herpes virus is carried by most people and acquired during infancy.  It remains silent in our body and usually does not give us trouble.  We have antibodies too that keeps its activity suppressed.  It is felt that when a person’s resistance to the virus drops, they will develop an attack of herpes virus.  It is possible to spread herpes from one person to another from a fresh sore.  It is very unlikely that herpes virus is spread from one person to another when no active sores are present, however, current research is investigating whether Herpes simplex is contagious when it is in its inactive stage.

When people are under stress or tension or their resistance is down, they are more likely to develop an attack of herpes. The sun, excessive exercise, or heat can also trigger herpes simplex attacks especially on the face and lips.  Excessive friction or rubbing to the skin such as sexual contact can also trigger a herpes lesion in a mucous membrane area.  In the couples that we care for with recurrent Herpes simplex it is very rare for both partners to have recurrent herpes.  Usually only in a very small portion of the people that we care for do both partners have herpes.  This is evidence that one partner has lower resistance to the herpes virus and the other has good immunity and never develops the infection.

The statement in the public press that herpes is an incurable disease and that once you have it you never get rid of it is false.  Most people have been exposed to the virus and have antibodies or resistance against it.  It is possible to give someone one attack of herpes if you have contact with them and they touch your fresh blisters.  Most contact with fresh blisters does not produce a transmissible sore to another person.  As a rule, people do not spread recurrent herpes from one person to another.  Your general immunity to the herpes virus has to be reduced in order for you to develop recurrent Herpes simplex sores.  It is important for us to emphasize that it is very rare for two partners who have frequent sexual contact to both have recurrent Herpes simplex.

Remember, be safe, always practice safe sex, and use condoms, especially during questionable or definite herpes outbreaks.