Think you have herpes? Here’s what to do

Careful: Just because you don't see any herpes doesn't mean the person's clean. Credit: Wavebreak Media
Careful: Just because you don’t see any cold sores doesn’t mean the person’s clean.
Credit: Wavebreak Media

I am freaking out that I might have been exposed to herpes! What can I do?

Herpes is a common sexually transmitted viral infection that may cause somewhat painful genital blisters. The Centers for Disease Control’s most recent available statistics (2008) indicate that there are more than 24 million Americans with a genital herpes infection, and more than 760,000 new infections every year.

There are two viruses that cause the infection: HSV-1 and HSV-2. HSV-2 has been the predominant source of genital herpes, while HSV-1 causes oral cold sores and canker sores of the lips and mouth. But with changing intimacy practices, both viruses commonly cause genital herpes. Sex and oral sex can spread HSV-1 and HSV-2, as can kissing or even sharing a drinking glass with someone who has active cold sores.

The scary thing about genital and oral herpes is that the virus can be spread even when an infected person lacks visible sores. While symptoms of an initial infection classically include painful blisters on the genitals, lips or in the mouth, herpes infections may exhibit only mild irritation, tingling or itching, or be mistaken for another skin condition. Once exposed, it may take three to five days for a new infection to develop and blisters, called vesicles, to occur. The vesicles break after a day or two, leaving painful ulcers that can take two to three weeks to heal completely.

Subsequent outbreaks are often less severe, and may occur anywhere from every few months, to rarely, to never. There may be warning signs of a reoccurrence in the days preceding the onset of blisters, such as local pain or tingling, fever or general malaise. While the infection remains in the body forever, the immune system keeps it dormant and flare-ups usually decrease over time.

Your doctor can confirm whether or not you have herpes by doing a blood test, and with DNA typing or viral cultures from any lesions when present. Confirmation from a lab can sometimes be challenging as the presence of biological substances that identify the virus can vary with the timing of the exam and duration of symptoms, as well as in differentiating an old vs. new infection.

The treatment of primary HSV outbreaks, as well as reoccurrences, is with various prescription antiviral medications including valacyclovir and acyclovir. Use of latex condoms, abstinence and maintaining a monogamous sexual relationship with a partner known to be HSV-free are the most reliable ways to avoid infection.


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