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Living with Herpes

    • Herpes. Does the word make you nervous? Embarrassed? Confused?

      In some ways, both types of herpes – oral herpes and genital herpes – have reason to make you nervous. Both are caused by a virus that – once it enters your body – will never leave. But with knowledge and awareness, you can live comfortably with this infection.

      Herpes Simplex 1 infection produces what we know as “cold sores” or “fever blisters” on or near the mouth. About 75% of us will have been exposed to that infection by the time we are a mature adult.

      Herpes Simplex 2 infects the genitals, and currently is carried by about one in six of us.

      MyLifeStages spoke with Toni Brayer, MD, an internal medicine physician with California Pacific Medical Center in San FranciscoOpens new window, to sort out facts and myths around herpes.

    • Facts About Herpes

    • Herpes is a virus. It moves into your body and lives inside specific-area nerve cells – forever. There is no cure that will eradicate the virus from your body. However, there are ways to reduce painful outbreaks and medications that can block the virus from emerging.

      Herpes Simplex 1 (oral) and Herpes Simplex 2 (genital) are similar, sharing 50% of their DNA. However, the two viruses typically reside in their own favorite locations. HSV 1 most often chooses the trigeminal nerve in the face , while HSV 2 prefers the branch of nerves around the sacrum, in the lower spine. Therefore HSV 1 eruptions show up in the mouth area, while HSV 2 eruptions occur below the waist, typically on the genitals.

      Herpes is spread through close physical contact. It does not travel on the air or live long on inanimate objects. Most people catch oral herpes through kissing or sharing objects that go into the mouth, such as toothbrushes or eating utensils. However, HSV 1 can be transmitted through a simple kiss, such as a non-sexual greeting kiss between friends or family members. Genital herpes is transmitted through sexual activity and continues to be a common threat, particularly for middle-aged adults. (See our Safe Sex for Women Over 40 article.)

      Herpes outbreaks vary in frequency and intensity. Outbreaks usually occur when your body’s immune system is weakened. Some people can live with the virus and never have an outbreak, while others have frequent, painful and severe bouts of blisters and sores.

      There are common triggers for outbreaks. Sunburn and wind can trigger oral herpes (watch out, skiers and surfers.) Stress, fevers and anything that lowers the immune system can trigger both types.

      You can prevent or lessen outbreaks with medications. There are prescription medications that, if taken immediately at the first sign of an outbreak, can reduce or eliminate the symptoms.

      A herpes outbreak typically lasts 10 days. If you haven’t “caught” the outbreak early, you will have to wait 10 days for the sore areas to heal.

      Not everyone who has the virus will have symptoms. Some people, although exposed to the virus, will not have an outbreak. Therefore, determining the exact time you “got herpes,” and from whom, can be impossible.

      The virus can be spread when the infected person has no symptoms. The virus can shed when the infected person is not having an outbreak. Unfortunately, this makes totally "safe sex” just about impossible, unless barrier methods, like condoms, are always used.

    • Treating Herpes Outbreaks

    • Dr. Brayers suggests that when you feel that first tingle or bump that signals an outbreak, immediately take an aspirin and apply ice to the area.

      Prescription drugs Valtrex, Acyclovir or Famvir are extremely effective if taken within the first 12-24 hours of an outbreak. They can block the infection from emerging and shorten the duration. The key is to start ASAP when the virus is rapidly replicating.

      Dr. Brayer notes that some people who have severe outbreaks take the prescription anti-viral medications daily.

      Once an outbreak is underway, Blistex or Campho-phenique can help with pain.

      Unfortunately, the over-the-counter amino acid Lysine has not been effective in controlled trials, despite claims that it will help.

    • Herpes and Sex

    • The subject of genital herpes is fraught with much more emotion than a discussion of your last cold sore. Dr. Brayer encourages folks to use the same safe practices for genital herpes as for oral herpes: Acknowledge that the virus is annoying. During outbreaks, avoid infecting others. For genital herpes, avoid sex or use condoms from the first signs of an outbreak till the sores are cleared.

      She also reminds us that herpes can lay dormant for years. “If you develop an active herpes outbreak while sexually involved with new partner, don’t make quick assumptions about anything. Either one of you could have acquired the infection earlier, and it is just now making itself known.”

      “Remember that herpes is not a death sentence,” says Dr. Brayer. “It is an annoying medical issue, to be sure, but it can be dealt with. Herpes does not cause cervical cancer or any form of malignancy. Stress less – and you’ll be healthier, all around.”

    Ask our experts your sexual health question(s).