Pain and discomfort in herpes victims is always worst shortly after a primary infection is contracted. The next most acute pain is associated with the first few recurrent episodes, should they materialize. Some people have pain severe enough to keep them at home, interfering with work and social life. For most people, however, the discomfort of herpes is more an annoying and disturbing pain than a sharp and acute one.
There is activity of the virus in the body just before and during an outbreak. This will often cause dull, uncomfortable aches in the general area. Itching, burning, tingling sensations that precede an outbreak are referred to as the prodrome. Most people who experience recurrences learn to recognize this set of signals which seem to be more easily detected in recurrences than in the first attack. These sensations are not necessarily more acute. The person’s ability to sense something happening below the surface appears to improve with experience.
The disruptions in surface cells as they are attacked by the virus and the movement into the area of white blood cells will cause tenderness and sensitivity in the surrounding tissue. Inflammation and burning can also occur. The patient may have general malaise (uneasy ill feeling).
In cases of severe pain, your physician may prescribe I short-term course of analgesics (pain killers). This is usually only done in primary episodes, if at all. Taking prescription analgesics such as codeine or Demerol is not a good idea. These drugs often cause side effects such as constipation, urinary retention or drowsiness. Drug dependency is yet another complication that could develop. With the exception of severe cases, strong prescription drugs may work against you. In some cases they are no more effective than aspirin in dealing with the pain. Aspirin is a far more powerful drug than many people realize. If a painkiller is necessary, two aspirins every three hours should be the drug of choice. If they are taken every three hours instead of every four or six hours, you will have fewer peaks and valleys and the drug will maintain a more even level in the blood stream. Use Tylenol if you are unable to tolerate aspirin, and consult with your physician before trying anything different.
If you are reading this during a primary outbreak of herpes, you may scoff at the idea of using strong prescription drugs only in unusual cases. You are no doubt thinking you are the unusual case and you just wasted your money buying a book which is recommending a drug that can be purchased at any food store. Perhaps over-the-counter drugs coupled with some of the soothing remedies below may be your best bet. This combination will not cause constipation, drowsiness, nausea or drug dependency. You will be able to keep in closer touch with your body if you are not cycling through periods of numbness every four to six hours as with strong pain medication.
Burning on Urination
If urinating is painful because of close proximity of a sore and not general tenderness or swelling in the area, try covering up the rash gently during urination. Be creative when thinking of what to use. A small flat spatula or some other article from the kitchen may work for some women. If this is not effective and the pain during urination is such that you may have excessive retention, try a topical anesthetic available at drug stores. It is not a good idea to use this except in severe cases. As a general rule you want to keep the sores dry and exposed the air. Some topical anesthetics come in a petroleum-type form and will tend to keep the area moist and reuse air circulation around it. It is difficult to apply the anesthetic with the thought of removing it after urinating to its petroleum jelly-base. Wiping the material off will be painful and possibly serve to spread the virus.
There are three other techniques that may be helpful in avoiding pain while urinating. Some people find pouring hydrogen peroxide or water over the critical area while lilting to be helpful. You might also try to urinate in a bathtub, thereby instantly diluting the urine. Some patients report that drinking more fluids will dilute the acidity of the urine somewhat.
Dabbing the sores with plain rubbing alcohol may help control the pain and itching, provided the sore is external. It should not be applied if the sores are on the vaginal opening or on any sensitive skin. The virus dies when it becomes dried out; unfortunately the drying effect may aggravate sensitive skin. If the tissue around the sores seems to burn upon the application of the alcohol, discontinue its use.
Holding a hot compress on the sore several times a day for a few minutes each time may help. These should not be hot to the point that they damage the skin. Very warm would perhaps be more appropriate.
It may seem strange to follow up hot presses with a suggestion for ice packs. What works for some people may not work for others and what works for one of the body will not necessarily work for another. Many patients find an ice pack to be palliative. Ice should applied directly to the sores or skin. A technique for use e home consists of taking a clean towel and placing I’ll ice cubes in the center of it. Make a ball around the ice as though the towel was a pouch. If the cubes are large, strike the contents with a hard object or simply grab the loose ends of towel and swing it against the kitchen counter. This will break the ice into small pieces and make it more comfortable to apply to the sores.
Leaving an ice pack on the skin for too long can be harmful to tissue. Use good judgment.
This treatment is controversial with some physicians. Some feel it increases the possibility of spreading the disease. Currently, more physicians will recommend bathing than will recommend against it, providing it is not overdone.
The patient should sit in a tub for 15 minutes. To the warm water add Epsom salts or Burows solution. After the bath, carefully towel-dry the area. A hair dryer set at low temperature can be used to complete the drying.
Male patients with sores only on the penis may feel an extra measure of safety by substituting a glass for the tub.
Only minimal use of petroleum jelly-based topical anesthetics is recommended. The lesions will heal more rapidly if kept dry with as much air circulation as possible. Applying a petroleum jelly-like substance violates this principle.
Spray anesthetics are available. You might give these a try, but most patients find them only marginally useful.
Creams and Ointments
The same principle applies here. Lesions cannot be kept dry and clean with creams or ointments. These will delay healing and put you at risk of spreading the virus. One exception to the ointment rule will be discussed in Chapter Nine.
Tampons and Minipads
These can be worn in case of excess discharge from the cervix. However, wearing either of them compounds the problem of keeping the area dry and clean. Change them frequently and have your physician check any abnormal discharge. Wash your hands after changing to avoid inoculation of other areas on yourself or other people.
Wear loose clothing during a bout with herpes. Tight pants irritate the sores and do not allow the air to circulate. Friction from tight fitting clothes will be an irritant. Women will find long skirts more comfortable than pants. Cotton underpants should be the rule. Nylon underpants or pantyhose will be uncomfortable and will not allow for proper air circulation. If your job requires you to wear hose, garter belts are available. Men should wear cotton boxer shorts for the same reasons.
Large Doses of Common Sense
Masturbation and sex will slow healing, and the friction from these activities will greatly contribute to the overall pain. In addition, they may spread the disease.
Anxiety and worry over your viral infection may increase the physical discomfort and will surely change your perception of that discomfort. Reducing anxiety and worry by projecting a mere two weeks ahead, with some positive thoughts, will probably do more for your pain than analgesics. Most patients will acknowledge that the emotional and psychological stresses involved with herpes are perhaps the most undesirable side effects. Stresses will act to impede your healing and may actually cause more frequent recurrences. This article will help dispel some of the myths propagated by the media and uninformed persons. Correct information should help you deal with some of the frustration and helplessness.
There is no simple way to prevent recurrent herpes attacks. There are things that can be done to help reduce the factors that influence recurrences. Eating well, exercising well, and sleeping well may be the most important aspects in recurrent outbreak prevention. This advice cannot be followed consistently, but the more consideration we give our body, the more it will be considerate of us. We all have stress in our lives and we all deal with it differently. A person in excellent physical condition has a much better chance of dealing effectively with a stressful situation than someone who is run down.
Do not get caught up with the lunatic diets cropping up in the bookstores today. It is best to stick with a sensible diet that is low in fat and low in sugar. Read labels. If your doctor advises that you have a vitamin deficiency, he will also advise you on what to take to cure it. Short of this, do not overdo any one type of vitamin or vitamins. A good multivitamin is more than adequate for most of us.
A drastic change in dietary habits involves a shift in daily routine, and that will necessitate a shift as well in psychological patterns. Shifting psychological patterns could cause stress at a time when you least need it.
The single most healthy act you can perform for your body might be to give up smoking. Some people can drop the habit with little or no trauma. They are advised to do so immediately. However, if just the thought of abstinence sends shivers down your spine, the stress involved with such a move may be too great. In such a case, consider quitting after your recurrences have subsided. The object here is to avoid stress while staying as fit as possible. Only you know if draining your body’s resources by smoking is less traumatic for you than to quit smoking.
A practical view of the disease of herpes and a positive view of yourself are of tremendous value in dealing with herpes. A positive image of yourself and some common sense caution will enable you to overcome many of the difficulties that plague patients. If you acknowledge the physical damage that chronic stress and anxiety can inflict on your body, you will better be able to deal with the concept of the herpes disease. Thus your body will be better able to deal with the disease.
Most people who experience recurrences on a regular basis become adept at recognizing the prodrome. The following sensations may be experienced:
- Tingling sensation
- Burning in the area
- Pinprick feeling an itching sensation
- Twitching feeling
- Sick feeling like coming down with the flu
- Pain or tenderness in the groin area
- Throbbing dull ache
- Feeling of pressure
- Feeling like novocaine wearing off
We should be concerned with the prodrome, not only because it is the first warning sign that herpes is about to recur, but also because it marks the beginning of the contagious state. The prodrome may occur several hours or several days before the first visible sore emerges. The sores that do appear may be somewhat painful when left alone and very painful when touched.
There are many different factors that may trigger or contribute to a recurrence. Science has not yet pinpointed the exact cause of a recurrence of facial or genital herpes. Several factors crop up more often than others.
Sunlight – Sunlight has long been regarded as the number one trigger for Herpes labialis. Protection from the sun’s rays is critical not only for herpes patients but also for the prevention of skin cancer.
High-quality, effective sunscreens and lip balms are now widely available. The products bearing a rating of “15” provide the most protection and should be used as a preventive measure. This is of utmost importance while skiing or participating in water sports due to the amount of reflected sunlight.
Herpes is sometimes associated with debilitating diseases. Conditions such as cancer, leukemia, and organ transplants weaken a person’s immune system, leaving him highly susceptible to herpes. It can be severe in such cases.
Menstrual Periods – Menstrual periods are often associated with recurrent genital herpes. Many female patients report a history of a relationship between the outbreak of lesions and their menstrual periods. The enormous hormonal changes a woman undergoes during the cycle, it is felt, are a major factor.
Seasonal Trigger – Herpes occurs more in the summer months than in the winter. This may be due to temperature. No one is certain. Ultraviolet radiation from the sun is highest during the summer and is the most logical factor. Both cold and hot weather require care by persons with facial herpes. Avoid getting chapped lips in cold and/or windy weather. Lips that crack or peel are subject to infection because the surface of the skin has been broken. This will make recurrence more likely.
Traumatic Injury – Injury such as biting your lip or other trauma to the lip and face can trigger labial herpes. Patients who nibble on their lips with their teeth are advised not to do so. Extremely hot food will be sufficient trauma for some patients to trigger a recurrence.
Sex – Sex itself can be a trigger. Environmental trauma will not normally affect genital herpes sufferers, although sex is one that will. Direct inoculation and emotional stress of a new or strained relationship can trigger a recurrence. Friction during sex can be a contributing factor as well. If adequate lubrication is a problem, K-Y jelly may be used to prevent abrasion and friction during intercourse.
Recurrent herpes, as you can see, can be triggered by all manner of different factors. The good news here is that of the millions of Americans infected with the disease, about 30% will never have a recurrence. They will not even be aware that they have the disease without establishing the presence of antibodies in their blood.
The majority of persons with herpes who do have recurrences do not have the horrible problems that the media has led us to fear. We hear only about the severe and grim aspects, never about how herpes can be quite benign. It would not be exciting news to report that millions of people consider herpes as nothing more serious than a common cold. Despite the sometimes painful experience of the primary attack, the clinical symptoms of a recurrence are usually less severe and of shorter duration.
Episodes of recurrent disease are associated with fewer lesions, and these lesions will give off virus for a shorter period of time. The lesions also will heal faster than in the primary episode.
To limit the reactivation of the HSV, we must concentrate on two important factors: general fitness and stress. You should strive to increase fitness and decrease stress. This will help the body do much on its own with natural defenses.