Herpes Type 1

Good Afternoon, i was diagnose with Genital Herpes Type 1 about 4 months ago,
Well i havent got any outbreak, but im in daily suppresive therapy.

Well about 4-5 days ago, i saw like a rash with bumps in my thumb knuckle, i rapidly though it was herpes whitlow, right now dont hurt, they are very small, but they are like water type blister, well ive been in therapy and i dont know if this whitlow dont react to antivirals.

I wanted to know, how many recurrence does herpes whitlow could i get a year??? Does this gets better with time? Meaning less outbreaks? What to do to prevent outbreaks on hands, im a mechanic, work with hands and in sun??

What is the treatment, and what do i have to do to prevent infecting me again in other parts and not infect my kids..??

Im very sad and deppresed about this, if it wasnt enough to get Herpes on genital, to now get it on my hand.
And to think i will have this lots of times a year is more hurtful!!

Hope someone could help me here.
Thank You

[Terri Warren, RN, Adult Nurse Practitioner]

Sorry, we are traveling and are often without internet.  I'm doing this as quickly as I can.  

The only way to know is for you to have a swab test for HSV from your finger.  

The thing on your finger could be HSV, particularly if the cortisone made it worse.  The function of steroids is to take away an immune response that might be overdoing it, but with herpes, you need that immune response, so if you take it away, herpes gets worse.  

My best suggestion is for someone to swab test the lesions.  Otherwise, you will not know if this is herpes.  I think it is unlikely that you have HSV 1 on your hand, but I can't say for certain.

Is there a reason you are not being swab tested?

terri

[Ramish1]

Hi,
I don’t know if doctors don’t know much details about my situation and that’s why i haven’t get any response, but let me say that its been a complete week and they are the same, this morning, they looked worse.

Tuesday night i applied hydrocortisone and the next morning, they seem better, i don’t now if i was trying to convince myself that it was another thing (Not related to H). I continued with the Hydrocortisone and Well this morning i saw them worse, there like maybe 10 or 11 blisters, some are smaller than a mm, Right now im taking double dose, of valacyclovir, as if was an H outbreak, doctor told to do it, its my 2nd day taking 1000mg morning and 1000mg night.

Blisters don’t hurt, sometimes kind of hurt the complete thumb, but again maybe my mind. Sometimes an itch, but maybe it’s the ripping the bandaid a couple of times a day, I’m traveling that makes it difficult to go get tested, yes i did see a doctor and told me it looked like it. Bigger are like 2mm or smaller and rest smaller than that.. And I think this morning they were more of them. This morning I started again with zovirax ointment and I put a bandaid to protect other and being very honest to NOT affect me emotionally as I see it.

I just want to know your thought, about this how to not be a freak out there on the world, like wearing gloves and not shaking hands with work buddies etc. And most important not pass this to my kids. As I told you im taking suppressive therapy daily for this whole time since I was diagnose, not Outbreak on Gen, just the first one.

On the internet, not much people talk about this on fingers and hands, about recurrence, treatment and prevention of transmitting this. Feel like a monster with the Genital one, now its worse I cannot even shake hands, and I don’t know if recurrence are rare or they are lots.

If I need other medicine I could find on the pharmacy over the counter, let me know, if some of the doctors think it might be other thing.

Yes I know the best is to test, but right now its hard for me to get tested, I just need advice and your suggestions.

Hope this helps little bit more for you to give response, sorry if its some venting from my part.
Thank You

[Terri Warren, RN, Adult Nurse Practitioner]

Is the herpes medicine making the hand lesions better yet?  If this comes back, you really do need to figure out a way to get these swab tested.  And definitely don't apply any steroid creams (like cortisone) to this area.  If it is herpes, you will make it worse.

Terri

[Ramish1]

Hi,
Well the oinment is not doing much, yesterday i thought it be good to just keep it clean without the oinment and this morning i think there where more, maybe 1-2, just they are very small..

I applied again the zovirax oinment, at least it was good that i brought this oinment to this trip.

Im going to be 2 weeks out here, so im not going to be able to test..
I have HSV1 gen, diagnosed maybe 4 months ago, just wanted to know whats the recurrence of this on hand a year an average???

Im not applying more hydrocortisone, just that oinment zovirax and 1 pill morning 1000mg and night 1000mg valacyclovir.

I was in suppresive therapy daily and this happend dont know why :(
God only knows.

They are not BIG and in the 9 full days its been there i havent seen any scabbing, like on genitals.

I really appreciate your time, even though you are traveling.

I know i need to test, but its impossible to do it here, just wanted your opinion, advice and suggestions about this recurrence, treatment and prevention to transmitt this to kids.

Yesterday about 12pm i let it without bandaid, and still without it and did not applyed ointment just think maybe it needs oxygen, i have ointment since this morning but no bandaid.

Ived applyed lots of times this oinment and still nothing..
Read this last weeks, how sad.

Well i hope i can get your input.
Thank You

[Ramish1]

Just to update, its been the same like i told before; there more than before..
I know it could be Hsv, cause theres a couple like together, like crumbled together, just like what happend on genitals..

Im applying zovirax oinment wait a couple of hrs, like 4-5 hrs then wash hand blisters with alcohol and let it 15 mins without oinment and then apply it again..

When you have time let me know advice of recurrence, treatments and transmission, as i bath my kids, put their cloths, give the dinner etc.

Hope To hear from you soon
Thank You

[Ramish1]

Hi,
Just wanted to update, i think this is starting to dry.. The part where i said its crumbled, i dont see like the liquid. Its like hard, not like a bubble of liquid.
There havent been like scab, there just like drying.
I put apple cider vinegar saturday and it started to heal, ive been without the zovirax oinment since. Just cleaning with alcohol.
They are still there but definietly drying.
Yes they seem like its small water blister, but they are little hard to the touch.. Maybe its because the skin on hand its soo rough that you cant see the liquid that the HSV produce.
I havent had a hard time with the stigma, cause its almost noy visible cause its mainly the skin color, maybe some pinkish in the bigger one.
Verymild pain that comes and goes on thumb, but i never had pain when touching the blisters.
Im just having it on warm water about 10 mins before bath and alcohol..
Still on daily meds though!
If you can help me with the other questions and advice i will really appreciate it..
Sorry if i wrote much, i just want you to have all the informations as possible.
Thank You

[Terri Warren, RN, Adult Nurse Practitioner]

I don't know that we have good statistics on how frequently herpetic whitlow (herpes on the hand) recurs.  
I don't think you need any topical treatment for this, if it is herpes, you are taking adequate oral medicines.
Since it could be herpes, we just don't know, I would keep it covered around the kids.
I also would stop with the vinegar and the soaking and the alcohol on it.  If it is herpes, these are not helping.
Even if it is herpes, it is highly unlikely that you will pass this to your children because it does not shed virus except when there is a lesion, and you can cover it at that time.
It would be treated in the same way that genital or oral herpes it treated - oral medicines, like you are taking now.
Are there other questions that I have missed?
Can you please tell me why you can't go to get this tested?

Terri

[Ramish1]

Thank You for the time on answering me, well its almost dryed up, bumps are still some visible, but its healing very well now, i havent applyed the oinment, just keep it clean and the alcohol when cleaning.
Ok i will stop the alcohol, even if that dryed it up and have healed it, but again maybe was my meds. and not the vinegar and alcohol.
Either way ive been with this for about 11-12 days, and how things are going, maybe 3-4 days more to completely heal.

I cant go get tested cause im between travel and cruise.
I get home in 12 days or so. Just wanted your expert advice and knowledge about this average recurrence rate, and how to not get this to kids. Its very possible of this being H, cause of the apperance, and ive never experienced this ever, and im in a constant rutine, so nothing different to get allergies etc.
Its been 4 months since my last Outbreak (First One), had a mild one on the 3th month maybe 2-3 blisters, very mild, size of small pen point.
Why i got Whitlow after 4 months dont know, but this virus seems tricky.
Even if mine is H1, and its in the wrong place.

At least this was something not hurtful, and it did not scabbed and opened up like on internet pictures are; maybe the skin on had its touch and thats why its like this.

Let me know your last recommendations, other than going to get tested, that i trully know is the best. But right now its impossible.
Thank You

[Terri Warren, RN, Adult Nurse Practitioner]

I don't have any new recommendations for you, I believe I answered all your previous questions.

Terri

[Ramish1]

I wanted to post here again, cause its an update, about 2 weeks ago, the same blisters reocurr, after healing completly..
After healing the first time, it took maybe 1-2 weeks to recurr!!
Its lots of blisters maybe 50 small blisters, in a area maybe smaller than a quarter..
The dont form one big Blisters..
Dont hurt either!!
I was in Panama, on business trip, in the Hotel they found a doctor and said it could be H cause of my status, but it was like in a round patern and said maybe fungus, plus it dont hurt.

He advice lotrimin, and ive been with lotrimin butenafine hydrochloride cream 1%, since saturday and its almost completly healed!!
It worked wonders!! But maybe its H and it was time to heal..
Just wanted to ask you what do you think!!

This is day 14th of the second recurance in the exact exact exact spot!!

Read about ringworm, but read that it less active in the center when is ringworm, mine is blisters all on the area.. They dont open they just go..

I travel a lot, and this has happend when traveling, ill be home for 3 months now and if i get this i should be able to test..

Just wanted you expert advice on what do you think. At least sunday ill se my
Kids and i wont have this cause its almost cleared completely!

I appreciate your Advice!

[Terri Warren, RN, Adult Nurse Practitioner]

I think the next time this happens you should immediately seek medical testing with culture or PCR for herpes, so you can get an accurate lab test result.

Terri

[Ramish1]

Thanks for everything Terri!

I hope this dont recurr again, just want to hope this
Was only a fungus or ringworm!! But dont know!

Thats why i asked if lotrimin helps; maybe helps
Ringworm and Herpes.

Thing is that it dont hurt like many said it does!

And lotrimin help alot, but dont know if ringworm can dissapear
And then come back!!

Regars

[Terri Warren, RN, Adult Nurse Practitioner]

Lortimin does not help herpes, but remember that as time passes herpes lesions resolve on their own too.   If these show up again, please go in to see a professional to be evaluated.

Terri

[Ramish1]

Hi,
Well after healing for the second time, one blister again appeared.

First time took 3 weeks to heal and 1.5 weeks later it reocurred again,
Then it took 2.5 weeks to heal almost completely and its reocurring again.
Went to clinic 2 days ago they swab and came positive for herpes.

Im on suppresive cause of the genital H, and ive never had recurrance in this 5 months.
I eat healthy and do exercise; why having so much recurrencrs??
Is this gping to be for life? Every month with this recurrences?

Even with meds? I got this 4 months after initial diagnosis on genital,
Why took so long to appear??

Scared to touch my kids and give them
Food, bath them etc.

Im screwed for life, family will be broken down for this.
I cannot even be normal with kids without
Gloves.

How sad Terri!
Dont know what to do.

[Terri Warren, RN, Adult Nurse Practitioner]

I think you have overreacted to this diagnosis of herpetic whitlow.  
I have many many patients with herpetic whitlow who live completely normal family lives.  Yes, this is bothersome and you need to be thinking about what you do when the whitlow is present.  

First, let's talk about the medication regimen that you are one.  What are you taking and how often do you take it?  Write me back and let me know

Terri

[Ramish1]

Hi,
Im taking valtrex (valacyclovir), daily 500mg.
Right now clinic told me to go on 10 days of 1000mg,
Cause of this recurring whitlow.

Ive been whithout Outbreak on genitals so far.
So in that part its working.

Read so many things that could work but i dont trust nothing.
Tea bags, something called dynamiclear, baking soda etc.

Well Terri, thing is that i do everything for kids and recurring
So much its hard for me to take care of them :(

Thanks for helping.

[Terri Warren, RN, Adult Nurse Practitioner]

I understand that it might be a little more difficult to care for the children, but you definitely can.  Asymptomatic shedding does not apply to fingers.  You are infectious when you have sores on your hand, from the beginning of an outbreak to the end of it.  Cover the lesions when you are around the kids, and live as normally as you can.

You know, if you were my patient, I would consider also upping your dose to 1000 mg per day, but I would divide the dose between morning and evening, to keep your drug levels nice and high all day.  Just a thought to ask your health care provider about.

Terri

[Ramish1]

Thank You Terri,
Just dont know why i got this 4-5 months after initial diagnosis..
And did not had any OB in those months, so how can i
Self infected without OB, or if i got it when first outbreak,
Why it bursted 4-5 months later?

Can my body start like getting used to that dose of 500mg
And now i need more?

Well now i have those blisters! They never open or make a scab,
Just dissapear in 3 weeks.

Im using glove while bathing kids and making food.
Its hard for me and when i hear kids ask why i have glove or bandaid.

Ill try to do my best, its not gonna be easy, but i promise ill try!

Thanks for your help!

[Terri Warren, RN, Adult Nurse Practitioner]

I can't answer your question about the timing, but when people do get herpetic whitlow, it is usually within 4 months of a new diagnosis of herpes, before a good immune response has been established.    My guess, and it is just a guess, is that you infected yourself at some point during your first outbreak.  

I think using a glove at all times, when you don't have an outbreak, is over the top and not necessary.  It would be good to cover the blisters when they are present.

This is my last post on this thread.

Terri

[heartfluttersflyawayplz]

put gloves on when out break, throw away change them often