Herpes simplex is very common. At least one in six adults in the United States has HSV-2 and half to three quarter of all adults test positive to HSV 1. But only 10% of those exposed get visible sores.

Maintaining general good health and keeping stress to a minimum give the best possible chance to limit recurrences. Fortunately, recurrent infections tend to be milder than the initial attack. Also, HSV-1 infections tend to have fewer recurrences than HSV-2. Both may be set off by a variety of stress factors including fever, stress, irritation at a site previously infected, sun exposure and menstruation. However, for many the recurrence is unpredictable and has no recognizable cause.

Take care of the affected skin area. Keep the area dry and clean during outbreaks to help healing. Avoid physical contact with the area from the time of the first symptoms (tingling, itching, burning) until all sores are completely healed, not just scabbed-over. Wash hands with soap and water if a sore is touched. Better yet, don’t touch the sores as the virus can spread. HSV may infect the eye and lead to a condition called herpes keratitis. It feels like there is something in the eye. There is also pain and sensitivity to light and a discharge. This can cause serious eye damage if not promptly treated.

There is a vaccine to prevent herpes being tested, but it has not been approved by the FDA for general use. Several oral anti-viral medications (Zovirax, Famvir and Valtrex) have been developed for severe or frequently returning infections. Low doses are sometimes helpful in reducing the number of herpes attacks in people with frequent outbreaks. There is some evidence that taking these will make HSV less contagious. People who have taken Famvir with the initial attack seem to have fewer recurrences.

Prevention of this disease, which is contagious before and during an outbreak, is important. If tingling, burning, itching or tenderness — signs of a recurrence — occur in an area of the body where there was a herpes infection, then that area should be kept away from other people. With mouth lesions, one should avoid kissing and sharing cups or lip balms. For persons with genital herpes, this means avoiding sexual relations and oral and/or genital contact during the period of symptoms or active lesions. Towels should not be shared nor clothing exchanged.

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