|
BASIC QUESTIONS ANSWERED BY THE MEDICAL DIRECTOR
Dr. H. has answered many questions since we started this
feature on Herpes.Org back in 1998. Please know that
he diligently responds to each question personally, and now
we have accumulated much of this information for your benefit.
Please note that nothing written on this page or anywhere
else on Herpes.Org should be construed as either medical advice
OR establishing a physician-patient relationship. If
you have any medical issues, we ask that you visit a health
practitioner licensed to practice medicine in your own locality.
These questions are not in any particular order, but rather
reflect the broad range of the sorts of questions that we
answer.
Alternative treatments
Dr. H.,
I was wondering if you can comment on the potential dangers,
if any, by combining a topical application consisting of :
dimethyl sulfoxide,BHT,H202,aloe vera,glycerin,st. john's
wort extract, lemon balm extract, licorice root extract and
olive leaf extract into a topical solution and applying it
to the shaft and head of the penis for the treatment of hsv2.
Do you perceive there will be any adverse chemical reactions
by the above combination? Based on the individual research
available for each of the above ingredients it appears that
a combination such as the above listed would provide synergistic
treatment and alleviation of symptoms.
Dr.H. writes:
I do not think that anything you list there would be toxic.
Peroxide we put on wounds. The tiny amount of DMSO absorbed
should be harmless. The remainder don't appear that
they would be absorbed in amounts that would be anything substantial.
The DMSO-peroxide routine seems to be one that is circulated
by the Never an Outbreak folks, or something similar.
I have seen no published results. I don't think that
it will hurt you, so you might consider it. As always,
consult your local health care practitioner for final advice,
though he/she may neverhave heard of it. return
to faqs
Medication for Cold
Sores
Dr. H.,
Can you please tell me what some of the best over the counter
medicines to help cold sores?
Dr.H. writes:
Thanks for the question. Sorry you're having the problem.
Well, oral cold sores (and I am assuming that you are speaking about oral lesions
only) are a nuisance. They are usually caused by herpes simplex virus
Type 1. They are very contagious during the blister phase and the draining
ulcer phase. Once they are crusted over and dry, they are probably less
contagious.
The first thing is soap and water. You want to keep them real clean because
they have zillions of viruses in them. By cleaning them, you prevent "autoinoculation",
where the lesion infects the skin around it. I would say that you should
break the blisters and clean them with plenty of soap and water.
Second, though painful, alcohol kills viruses very well. I encourage
patients to get the alcohol swabs that you see used in hospitals, which you
can buy from pharmacies. Clean the wounds frequently for the same reason.
Some people believe that Blistex helps. I believe that it only numbs
up the wound slightly and offers no real value.
Acyclovir, taken in regular doses of probably 400 mg will probably help suppress
the outbreak to some degree. Consult your local health care practitioner
regarding this.
Some people believe that red marine algae, astragalus, copper,
and echinacea may be of some value. Some have said that
taking 1000 mg of lysine per day may help. return
to faqs
Canker Sores Transmission
Dr. H.,
I get those white/pink crater-like ulcers in my mouth about
once every 6 weeks.
Could I have transmitted this to my 2yr old nephew, whom I made non-kissing
physical contact, (holding, hugging, playful head-butting)? I remember
visiting him about the time my current episode was in its initial stage--(that
day, or the previous day, I bit my cheek).
Apparently, he has multiple sores in his mouth and throat.
Dr. H. writes:
Good question. Probably you did not transmit anything to your little relative.
What he has probably picked up is herpetic gingivostomatitis, which about 90%
of children have by the time they are ten years old. It causes a pretty
sick kid for a couple of days, and is essentially harmless. Again, virtually
all children pick it up.
This means, of course, that 90% of humans have had a herpes infection of their
mouths by the time they reach adulthood. We probably pick it up from being
kissed by others, which is course what all of us do with our children.
So, don't worry. Be sure that the little kiddie is
being cared for, and relax. return to faqs
Frequent recurrent
outbreaks
Dr. H.,
I contracted genital herpes about 4 years ago.
Until recently my outbreaks were becoming less frequent and shorter in duration
the longer I had the virus. During the last 2 months, however, I have
had what seems to be one big, long outbreak with perhaps a one-week break in
between at most. In addition to genitally, I even get it on my upper outer
thigh and my lower back (all on the right side of my body).
I am in otherwise basically good health. I have been tested for HIV and
am negative. I do have irritable bowel syndrome which my doctor says is
generally caused and exacerbated by stress. Also, I take 15 mg. Prozac
daily for a "chemical imbalance" (not depression).
Is it possible my "high strung" nature keeps my outbreak from going
away? Are the any foods I should eat or avoid to help? What
about exercise?
Dr.H. writes:
Well, let's see. Yes to the question about stress being an apparent trigger
of herpes. Nobody really knows why, though I believe that adrenalin (epinephrine)
may in some way have a direct cellular triggering effect, based upon some reading
that I have done.
It is important, I think, to get attacks under control.
I would suggest that, with the consultation of your local
health care practitioner, get on suppressive therapy for awhile,
using 400 mg of acyclovir once or twice a day (I assume that
you are an adult). This should rapidly knock out your
symptoms and let your body recover.
I have been told that herpes is an immunosuppressive virus.
That is, it directly suppresses the immune system. You
might say, the more you have an infection, the more likely
you become to have another outbreak, until the outbreaks gradually
come one after the other.
Talk to your doctor. I suggest that you go on suppression
for a few months, while working on the life style stuff, including
enough rest, working on stress-causing events, and so on.
Lysine, red marine algae, astragalus, and echinacea all have
scientific articles that may indicate some slight benefit.
return to faqs
A potential partner
has herpes
Dr. H.,
Someone I am considering a relationship with has discovered
he has herpes. He said he is asymptomatic, and mentioned shedding.
My question: is herpes avoidable when having sex (like
aids safe sex) or should I just forget this guy and avoid
any contact. I have HSV-1 oral, which flares up only infrequently
throughout the year (1 - 3 times/year at most).
Dr.H. writes:
You know, I would ask you, how do you feel about this person? Is this
love or just an attraction? Being pretty old fashioned, I would say, avoid
sex until, if not marriage for you, at least until a firm sense of a monogamous
relationship has been established. It is the right thing to do.
Old fashioned, yes, but a much safer way to sort through feelings and STD issues.
Everything else is dangerous and simplistic, in my opinion. This is what
I think.
Let me respond specifically to your question. Generally, herpes is avoidable.
You must avoid anyone having acute symptoms, including burning, blisters, irritation,
or any other sign of inflammation including referred pain, pain going into the
legs or groin, or similar symptoms.
If your friend has a diagnosis of herpes, he joins 1 of 5 people in America,
meaning that it is very, very common. People with herpes commonly shed
virus, as much as 40% of the time when not on medication. Regularly taken
acyclovir really decreases virus shedding, if the person is taking it, maybe
as much as 95% decrease of shedding.
Is HSV infection avoidable if careful? Definitely. Your consort
should be on medication, acyclovir unless allergic to it, once or twice a day
and, if you are female and he is male, he should wear a condom, preferably with
a virucidal cream in the condom. He should be free of symptoms of any
sort, which usually only he would know. Meeting these criteria, the chance
is probably between one in several hundred to one in several thousand that you
will contract the virus.
You might transmit oral HSV to him, either genitally or orally. How does
that make you and him feel? You should be free of symptoms, and he should
be aware of your condition also, just as you are of his.
Personally, since herpes is almost only dangerous only to newborn babies, I
would say that you should weigh the above information, decide how you feel about
this guy, and think about it from a "love" standpoint. Yes,
there is risk to you. You have to weigh the potential consequences.
(Editor's note: please make sure that you go to
visit your primary health care practitioner before taking
prescription medication, and remember that giving your partner
your medication, if it has not been prescribed for them, is
illegal. They need their own supply. Thanks.)
return to faqs
Herpes and gastroparesis
Dr. H.,
I had my blood tested for HSV I and HSV 2. The IgM antibody
was positive for both HSV 1 and HSV 2, and the IgG antibody
was positive for HSV 1. Because of the positive IgM
antibodies for both types, is it probable that I contracted
the two types at the same time? I am 40 years old.
Since childhood my stomach has always been weak, but after
I acquired the herpes infections, I began experiencing several
harrowing episodes of gastroparesis (verified by a abnormal
gastric emptying test). The fist few episodes were the
most severe and they would last for weeks. I also had
a severe headache during the first episode, and I can't even
remember having had a headache previously in my life.
Do you think it is possible that one or both of the viruses
disrupted the nerves that control the stomach's peristalsis?
It has been 7 months since I was infected, and the episodes
of gastroparesis are less frequent now, but I was very frightened
by the them, thinking that the gastroparesis would never go
away, and I lost weight like crazy. If herpes can cause
gastroparesis, would taking acyclovir, or some other antiviral
lessen the course and severity of the stomach paralysis?
Thank you for any thoughts or advice you might be able to
provide me.
Dr.H. writes:
I doubt that you contracted both at the same time. You
probably contracted type 1 as a child, since some 90% of children
pick up type 1 as a child by the age of ten.
I do emergency medicine mostly, and, yes, I've seen horrible episodes of gastroparesis,
including one guy I thought was having a heart attack. He knew better.
He said that if we would just let him throw up, his pain would go away.
Sure 'nuff, when he barfed, the pain was gone and he was well.
No, I don't think you would find any evidence that there is viral involvement
of the "nerves" causing stomach problems. Now, it IS remotely
possible that you have had a herpes ulcer develop way down in the esophagus
or even, theoretically, in the stomach. You might consult your gastroenterologist
about that. You might have gastric emptying problems if you were developing
a recurrence in the stomach.
Now, having said that, I have never personally seen a patient with such a problem,
though New England Journal this spring published such a patient with an esophageal
herpes lesion (who was, I might add, pretty sick on presentation).
I would suggest that you be "scoped" during one
of the episodes to make sure that there is not some sort of
ulcerative cause to the episodes. Only if you could
prove that it was a herpes lesion would I consider taking
acyclovir. Otherwise I don't think that it would be
of any benefit. return to faqs
Partner with herpes
Dr. H.,
My girlfriend has herpes, but hasn't had an outbreak in 20
years, I have had sex with her numerous times. She claims
she hasn't had any problems with boyfriends in the meantime...am
i at risk?
Dr.H. writes:
Absolutely you're at risk, if it was in fact herpes that she was diagnosed with
20 years ago. That's a long time ago in medicine, in the late 70's.
I don't recall that viral cultures were readily obtainable then, so the diagnosis
MAY be somewhat suspect. A blood test for Herpes simplex Type 2 IgM would
be helpful on her, and on you too for that matter since one in 5 people are
carriers.
Wear non-spermacidal condoms, latex preferred. Don't have sexual relations
if she's having symptoms. Encourage her to take acyclovir 400 mg twice
daily if you're going to be having sexual relations. And, relax.
That should give you a very high protection factor.
Please make sure that you go to
visit your primary health care practitioner before taking
prescription medication, and remember that giving your partner
your medication, if it has not been prescribed for them, is
illegal. They need their own supply. Thanks.)
return to faqs
Had sex with infected
partner
Dr. H.,
About 5-6 weeks ago, I had unprotected sex with a woman who
was infected with genital herpes.
Unfortunately for me, and inconsiderately by her, she didn't tell me until
afterwards. My question is this: Will I EVER know whether
or not I'm infected if I don't show signs of an outbreak? To this point,
I have had no signs of an outbreak, but the whole situation is making me terribly
paranoid, and worried. At the time we had sex, she didn't have an outbreak either
(which was her justification for not informing me).
My doctor (whom I don't particularly trust) told me that if I didn't see any
visible signs within 2-3 weeks, that I didn't need to worry about it.
For some reason, that seems like too simple of an explanation.
Dr.H. writes:
Hmmm, well, you know, it is a dilemma, folks that are less than honest
and who put you at risk, assuming the facts your relayed are true.
Your doctor was about right. Odds are probably above 75% that if you
WERE going to have a first episode herpes thing, it would have happened within
two or three weeks.
Okay, that said, this is what you do. Go get type specific blood
testing for Herpes Simplex types 1 and 2 done now. If these are negative, then repeat them in about ten weeks,
and see if any changes occur. A change from negative to positive in either of the blood tests would be an indication
that a new infection has occurred. On the other hand, if the first one is positive, you were either
already infected with that virus, or have just turned positive. Depending upon how long from the exposure to the test, it may be impossible to know.
What to do? Forgive your friend. Forgiveness is always important, and, as Mark Twain said, "Anger rusts the soul." You have a right to share your feelings with this person, of course, and it is proper to do so. Assuming you have no future problems and that your blood test did not turn positive, tell your consort in the future that you have previously had sex with a person who told you later she had had genital herpes at some time in
her life. And, I recommend using latex condoms. If you ever DO show up with a positive blood test, then refer to my treatments paper on the website.
Finally, we know now that perhaps most people who contract herpes infections do so without being aware of having contracted the virus. Many of these people shed virus asymptomatically from time to time. This is a reason why testing is important.
If this website has helped you in any way, then please support
our work with a donation of any size by clicking HERE.
Your donation is a tax deductible charitable contribution.
|
FREQUENTLY
ASKED QUESTIONS
