Q: I went to my doctor for painful sores in my vaginal area, and I was diagnosed with herpes. Tell me more about this condition.

(Part 1 in last Friday’s Searchlight)

Risk factors

There is a higher risk of contracting genital with/ in:

• Unprotected sex
• Multiple sex partners
• Kissing
• Females
• Immunocompromised due to illnesses (e.g. HIV, cancers, autoimmune diseases, etc.) or medications (e.g. steroids, chemotherapy, etc)

Complications

While very rare, the following have been documented:

• Disseminated (generalised spread) herpes
• Ocular (eye) herpes
• Deafness
• Encephalitis
• Increased chances of catching and passing on other STDs.
• Urinary retention
• Proctitis (inflammation of rectum)

Pregnancy precautions

Pregnant women who have or suspect they may have herpes, should share this information with their doctor. The doctor would take preventive measures to reduce the baby’s chances of contracting herpes.

Preventing herpes

Once sexually active, it is impossible to prevent genital herpes. However, there are measures that can be adopted to reduce the chances of contracting or spreading herpes.

• Being monogamous
• Using condoms and dental dams correctly at every sexual encounter – oral, anal or vaginal. However, herpes can be transmitted from the skin not covered by these barriers
• If having > 6 outbreaks in 12 months, your doctor may prescribe daily preventive medication
• Never have sex if you or your partner has a suspected herpes outbreak, including when there is pre-outbreak symptoms – e.g. tingling, burning or itching.
• Sex should be postponed for up to a week after the infected area looks and feels healed.
• Avoid touching areas of active infection. If the area is touched, immediately wash hands with soap and water.
• Do not kiss anyone, including casual kissing, if a cold sore is present around the mouth.
• Be upfront with your sexual parter regarding your herpes. If you are having challenges, ask your doctor if they can help.

It must be emphasised:

• Not all herpes sores occur in areas that a condom/ dental dam cover
• The herpes virus can be released (shed) from skin that has no visible herpes lesion

Treatment of an outbreak

Outbreaks resolve on their own, however, with the judicious use of medication, the severity and frequency of herpes outbreaks can be stymied.

Treatment of initial outbreak

•  Antiviral medication
• Antiviral cream

Treatment of recurrent outbreak(s)

Using antiviral medicines shortens the outbreak. Some doctors recommend the commencement of the antiviral medicines once any pre-lesion symptoms are experienced – e.g. burtning, stinging, itching.

Persons with more than 6 outbreaks in any given 12 month period usually benefit from the continuous use of antiviral meds for 6-12 months.

Self care during outbreak

• Clean area with tap or salt water
• Pain may be reduced by applying ice in a plastic bag or wrapped in a wet cloth
• Applying vaseline to sores reduces the pain when urinating
• Wash hands thoroughly before and after touching the area
• Avoid the wearing of tight underwear or pants during an outbreak
• Avoid touching area unless applying vaseline or cream
• Curtail sexual activity whenever there is an outbreak