Genital Herpes

Herpes simplex virus is spread by direct skin to skin contact from the site of infection to the contact site. Once you are infected, the virus remains with you forever. It causes symptoms, though, only during flare-ups. Symptoms include sores with blisters on the genital area and anus and sometimes on the thighs and buttocks. After a few days, the blisters break open and leave painful, shallow ulcers which can last from five days to three weeks. If infected for the first time, you may experience flu-like symptoms such as swollen glands, fever and body aches. Subsequent attacks are almost always much milder and much shorter in duration. These attacks may be triggered by emotional stress, fatigue, menstruation, other illnesses or even by vigorous sexual intercourse. Itching, irritation and tingling in the genital area may occur one to two days before the outbreak of the blisters or sores. (This period is called the prodrome.) Genital herpes is contagious during the prodrome when blisters are present and up to a week or two after they have disappeared. If a pregnant woman has an outbreak of genital herpes when her baby is due, a Caesarean section may need to be done so the baby does not get infected during delivery.

No cure exists for genital herpes. The prescription medication Zovirax, and self-help measures only treat herpes symptoms. (See “Self-Care Tips for Genital Herpes” in the next column.) Medication can be helpful during the first attack of genital herpes. Self-help remedies may be all that is necessary during recurrent episodes.

[Note: Herpes-like sores and blisters can be a side effect of taking certain prescription medicine in some people. One example is sulfa medications which are often used to treat urinary tract infections. Consult your doctor if you suspect this.]

• Bathe the affected genital area twice a day with mild soap and water. Gently pat dry with a towel or use a hair dryer set on warm. Using Aveeno (colloidal oatmeal soap or bath treatments) may also be soothing.
  
• Take a hot bath if you can tolerate it. This may help to inactivate the virus and promote healing.
  
• Use sitz baths to soak the affected area. A sitz bath device fits over the toilet. You can get one at a medical supply store or at some pharmacies.
  
• Apply ice packs on the genital area for 5-10 minutes. This may help relieve itching and inflammation.
  
• Wear loose fitting pants or skirts. Avoid wearing panty hose and tight fitting clothing. These could irritate the inflamed area. Wear cotton, not nylon, underwear.
  
• Squirt tepid water over the genital area while urinating. This may help decrease the pain.
  
• Take a mild pain reliever such as aspirin, acetaminophen, ibuprofen or naproxen sodium. [Note: Do not give aspirin or any medication containing salicylates to anyone 19 years of age or younger unless directed by a physician due to its association with Reye’s Syndrome, a potentially fatal condition.]
  
• A local anesthetic ointment such as Lidocaine can help during the most painful part of an attack. (Check with your doctor before using.)
  
• Ask your doctor about using the oral anti-viral medicine acyclovir (brand name Zovirax).
  
• To avoid spreading the virus to your eyes, don’t touch your eyes during an outbreak.
  
• Avoid sexual intercourse:
  
  
  
  • At the first sign of a herpes outbreak (this may be evident by the feeling of tingling and itching in the genital area which takes place before blisters are noticeable). Note, though, that herpes can be contracted without visible blisters because viral lesions may be present on the female’s cervix or inside the male’s urethra.
    
  • When active lesions are present
    
  • Two to three days after lesions have disappeared
    
  
  

Questions to Ask

Do you have sores and/or painful blisters on the genital area, anus or tongue and is this the first time you have had this?
Did these sores appear only after taking a recently prescribed medicine?
For persons who have already been diagnosed with genital herpes: Are you experiencing severe pain and blistering and/or are you having frequent attacks?
For pregnant women only: Are these sores present and are you close to your delivery date?
Have you had sexual relations with someone who had sores or blisters on their genital area, anus or tongue or had genital itching, irritation and tingling?