Herpes

Alternative names:

genital herpes; herpes simplex - genital; herpes virus 2

Treatment:

Treatment of genital herpes does not cure the disease but can relieve the symptoms. Treatment can decrease the pain and discomfort associated with an outbreak and shortens the healing time.

Oral acyclovir (Zovirax) does not cure the infection, but it reduces the duration and severity of the symptoms in primary infection, and to a lesser extent in secondary attacks. It also reduces viral shedding, which affects the duration of contagiousness. It may be used in the first episode and for recurrence. For maximum benefit during recurrences, therapy should be started as soon as the tingling, burning, or itching (sensations before the blisters) starts, or as soon as the blisters are noticed.

Topical acyclovir (Zovirax) is also effective but must be used more frequently than the 5 times per day which is typically prescribed. During the first 24 hours, application of the ointment every hour (during the waking hours) will dramatically shorten the duration of the outbreak.

Warm baths may relieve the pain associated with genital lesions. Gentle cleansing with soap and water is recommended. If secondary infection of the skin lesions occur, a topical antibiotic ointment can be used. Oral antibiotics are sometimes necessary.

Acyclovir-resistant strains of herpes virus are appearing rapidly. If symptoms are not rapidly relieved by acyclovir, further evaluation by a physician is indicated.

Support groups:

The stress of illness can often be helped by joining a support group, where members share common experiences and problems. See herpes genital - support group.

Expectations (prognosis):

Once infected, the virus stays in the body for the rest of a person's life. Some people never have another episode, and some have frequent recurrences throughout the year. Subsequent infections tend to occur after sexual intercourse, exposure to the sun, and after stressful events. In individuals with normal immune systems, genital herpes remains a localized and bothersome infection but seldom becomes a life-threatening infection.

Complications:

• Recurrent disease (common).
• Encephalitis (rare).
• Spread of the virus to other organs of the body in immunosuppressed people.
• Transverse myelopathy (damage that extends across the spinal cord).
• Incontinence.

Calling your health care provider:

Call for an appointment with your health care provider if you have any symptoms suggestive of genital herpes.

Call your health care provider if fever, headache, vomiting, or widespread symptoms develop during or after an outbreak of herpes.