Knowing How to Live with Genital Herpes Helps Put You In Charge

Physical effects of recurring outbreaks

Recurrences are a reminder that you have genital herpes. Even so, any impact they may have can be minimized with appropriate treatment and know-how. The good news is that recurrent outbreaks generally tend to be less severe and shorter-lived than a first outbreak and, for many, become less frequent over time. That’s because the body’s immune system has developed a defense system of antibodies to fight the infection.2

Recurrent outbreaks usually occur at the same place as the first outbreak, although they can occur at other sites too. There is no way of knowing how many outbreaks you will have in any given year because it varies for each individual.2

Recurrent outbreaks run a typical course, as follows:3

Stage 1: Prodrome
This is the pre-outbreak stage which usually begins one to two days before blisters appear when you may first feel the warnings of virus activity. These include: itching, tingling, numbness or burning. You may develop a headache or fever. Your glands might become swollen. Or you may feel pain in the groin, buttocks, thighs, genital area or down the back of your leg. Not everyone with genital herpes develops or can recognize prodromal symptoms.

Stage 2: Inflammation
At this stage the virus has reached the skin surface. The affected skin may redden and swell or be itchy and tender to the touch.

Stage 3: Blisters
The affected area may develop tiny red bumps (or maybe a rash) and small fluid-filled blisters, usually within a few hours.

Stage 4: Sores
At this stage the blisters enlarge and break, forming wet open sores on the surface of the skin.

Stage 5: Scabs
After a few days the sores begin to dry and crust over, forming scabs. This is the first sign of the healing process and even though the outbreak is beginning to subside, the virus may still be present and active.

Stage 6: Healing
During the final stage the sores heal and the scabs fall off. The skin might appear slightly red for a short time but the skin has healed and the virus has retreated to its resting place in the dorsal root ganglion [?].

Although you can’t predict when an outbreak is going to occur, it helps to know what might trigger a recurrence or reactivation of the virus. Some triggers that have been associated with recurrent outbreaks include:2,3,4

  • Stress
    • Hormonal changes
  • Sexual intercourse (causing irritation or friction)
  • Sunlight on the affected area
  • Poor nutrition
  • Lack of sleep
  • Weakened immune system (e.g., after an illness or injury)

 

References

 
1. Clarke P. The Impact of a Herpes Diagnosis and the Implications for Patient Counseling. Clinical Management of Herpes Viruses,1995: 75-85. IOS Print, Washington, DC.

2. Whitley RJ, Kimberlin DW and Roizman B. Herpes Simplex Viruses. Clin Infect Dis 1998;26(3):541-553.

3. Sacks S. The Truth About Herpes. 4th Ed., 1997. Gordon Soules Book Publishing Ltd.

4. Kemeny ME, Cohen F, Zegans LS et al. Psychological and Immunological Predictors of Genital Herpes Recurrence. Psych Med 1989;51:195-208.

5. Aoki FY. Canadian Guidelines on Sexually Transmitted Infections 2006 Edition; Genital Herpes Simplex Virus (HSV) Infections. Public Health Agency of Canada http://phac-aspc.gc.ca/std-mts/sti_2006/pdf/sti2006_e.pdf. Accessed May 15, 2006.

6. Cuisini M and Ghislanzoni M.The importance of diagnosing genital herpes. J Antimicrob Chemo 2001;47(Topic T1):9-16.

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