•  Cold Sores FAQ •  Sexually Transmitted Diseases

Herpes is a common infection that often causes painful sores on the genitals of men and women. It's caused by a virus called herpes simplex virus type 2, or HSV-2.

An estimated one in five Americans over age 12 has genital herpes, and affected women outnumber men nearly three to two. Unfortunately, once you're infected, the virus stays with you, and there's a good chance that you'll have recurrences from time to time. The good news is that there are many things you can do to relieve symptoms and stave off outbreaks.

Most people get genital herpes by having sex with someone who has the virus. It's also possible to get a milder form of genital herpes by receiving oral sex from someone who has cold sores , which are caused by a closely related virus. You can also get oral lesions (mouth sores) from HSV-2.

You can reduce your risk of getting herpes with some simple precautions. For starters, avoid having sex with or sharing personal items with anyone who is having an outbreak, since the risk of infection is highest at that time. If you happen to touch a sore, don't touch anything else and wash the area immediately with soapy water, because that can kill the virus before it infects you.

Use a condom at all other times, because some people with herpes can transmit the virus through their skin even when they don't have any sores. Keep in mind that a condom doesn't cover everything; you can still get herpes from uncovered areas. Also, avoid multiple partners, since this increases the risk that you will come in contact with someone who has the virus. Don't assume you can tell whether your partner has herpes, since many people never have obvious symptoms. Because herpes is at epidemic proportions in the US, it's safer to assume a new partner has it and take appropriate steps to protect yourself.

While many men have silent infections, with no symptoms for years, even decades, women tend to experience symptoms within two to 20 days of infection. During the first attack, you may have flu-like symptoms such as fever, headache, swollen lymph glands, and muscle aches. You'll also likely notice pain, burning, or tingling around your genitals, thighs, or buttocks, where sores will eventually appear. Small red bumps usually follow, which turn into fluid-filled blisters and break open into shallow pinkish sores. These sores can be very tender and painful. In one to three weeks' time, the sores crust up and disappear.

Later flare-ups tend to be milder, sometimes so mild that you may not even notice them. You'll probably have fewer sores, too, and those you have will heal more quickly. Some people have frequent attacks; others have them only rarely. The average is four per year, and that number tends to go down as time goes by.

See your doctor immediately for a diagnosis. If you are having an outbreak, the doctor can diagnose herpes either through visual inspection or through a sample from the sore. Also, blood tests are available that can more tell whether you've been exposed to the herpes simplex virus. The US Centers for Disease Control estimates that 90 percent of people with herpes are unaware they have it, and this lack of awareness has contributed to the infection reaching epidemic proportions. While you're at the doctor's office, it's a good idea to ask to be tested for other sexually transmitted diseases as well.

If you do have herpes, antiviral drugs can ease your symptoms and shorten attacks when taken within 24-48 hours of exposure. These drugs include Zovirax (acyclovir), along with newer ones such as Famvir (famciclovir) and Valtrex (valacyclovir), which are absorbed more easily and don't have to be taken as often as regular acyclovir.

Be sure to let your doctor know if you're pregnant or thinking about becoming pregnant, since it's possible to transmit the virus to your baby during delivery if you have an active infection at the time. Your doctor will want to talk to you about ways to protect your baby's health. You may want to consider having a cesarean delivery, for example.

Having herpes doesn't mean you have to be celibate; it just means you have to be extra careful with sex and relationships. Make sure you tell your partner about your herpes, so you can discuss things openly. And always use condoms.

In 2003, the US Food and Drug Administration announced that the herpes medication Valtrex might help prevent the spread of the virus. In a study of 1,500 heterosexual couples, herpes sufferers who took Valtrex were 48 percent less likely to pass the virus on to their partners. The FDA warns, however, that Valtrex must be used in addition to condoms, not instead of them.

•Take warm baths and showers; the heat can inactivate the virus. Dry off with a hair dryer set on low; the warm air will be much more comfortable than an abrasive towel.

•Take a mild pain reliever, such as aspirin or acetaminophen.

•Wear loose-fitting cotton underwear and clothes during outbreaks. Tight-fitting, synthetic garments can cause you to sweat and chafe, which can irritate sensitive sores.

•To dry up sores and speed healing, keep the area clean, cool, and dry. You may want to take a break from heavy exercise during an outbreak, since perspiration and chafing can aggravate symptoms.

•Dab on a water-based zinc ointment. It helps dry out the sores so they can heal faster, and may also boost the immune system.

•Try lemon balm. German studies show that this fragrant herb helps heal sores faster and with less scabbing, especially if it's applied early in an outbreak. Make a tea of dried lemon balm leaves and apply it to sores with a cotton ball.

•Take echinacea. This popular herbal cold remedy doesn't just fight cold viruses. Research on a topical preparation called ViraMedx (viracea) shows that it's effective against herpes viruses, including strains that are resistant to acyclovir. Take echinacea in capsule or tincture form at the first sign of an outbreak, or dab on a topical formula.

•The best thing you can do is keep your immune system as healthy as possible, since outbreaks are most likely to occur when you're run down. Eat a healthful diet, get enough sleep, exercise regularly, and manage your stress with meditation or other methods.

•If you have a weak immune system, talk to your doctor about antiviral drugs. The same ones used to lessen an attack can help prevent recurrences.

•Eat foods high in the amino acid lysine, such as eggs, potatoes, and dairy products, and avoid foods high in another amino acid, arginine, such as peanuts, rice, and chocolate. The herpes virus needs arginine to replicate, and lysine prevents arginine from getting into your bloodstream. Lysine is also sold as a supplement in health food stores.

•Avoid vigorous sexual intercourse if you have genital herpes, since the friction can trigger outbreaks in some people.

•Talk to a close friend, support group, or counselor. Herpes is for life, and it will probably change how you deal with sex and relationships. It's not uncommon to feel anxious, guilty, or lonely, especially when you've just been diagnosed. Talking to someone about it will help you feel better and reduce your stress, which will help you avoid recurrences.

References

First published December 3, 1998
Last updated February 28, 2008
Copyright © 1998 Consumer Health Interactive

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