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HSV 1 Recurrent Outbreak
Dr. H:
I posted this in the free forum, but decided I wanted an answer from a professional:
2 months ago I went to planned parenthood after I noticed two tiny bumps on my vagina that were a little painful. At first I thought it was a small tear or that I got them from waxing. After a curlture was taken my results came back positive for HSV 1. I am now having my first recurrent outbreak and it is much more painful and many more tiny blisters are present. My question is if its possible for recurrent outbreaks to be much worse than primary outbreaks? Everything Ive read online says that with Genital HSV 1 recurrent outbreaks are rare and if they do occur they are much more mild than primary outbreak. Could this be something else?
Also, by partner who Ive been with for 2 years suggest he starts wearing a condom because he believes he is somehow re-infecting me. I tried telling him he can re-infect me once Ive been infected with HSV 1 so the condom wont help. He insists that not wearing a condom triggers my outbreaks. Is this possible?
Thanks, Doctor.
I posted this in the free forum, but decided I wanted an answer from a professional:
2 months ago I went to planned parenthood after I noticed two tiny bumps on my vagina that were a little painful. At first I thought it was a small tear or that I got them from waxing. After a curlture was taken my results came back positive for HSV 1. I am now having my first recurrent outbreak and it is much more painful and many more tiny blisters are present. My question is if its possible for recurrent outbreaks to be much worse than primary outbreaks? Everything Ive read online says that with Genital HSV 1 recurrent outbreaks are rare and if they do occur they are much more mild than primary outbreak. Could this be something else?
Also, by partner who Ive been with for 2 years suggest he starts wearing a condom because he believes he is somehow re-infecting me. I tried telling him he can re-infect me once Ive been infected with HSV 1 so the condom wont help. He insists that not wearing a condom triggers my outbreaks. Is this possible?
Thanks, Doctor.
MEDICAL PROFESSIONAL
Disregard my comment about Saturday. I forgot what day it is! Try to return to the PP clinic today. The sooner a herpes outbreak is examined, the easier it is to confirm the diagnosis -- and a single day can make a difference.
The HIV test was from blood taken from my finger at PP. I had already been with my partner for almost a year at that point.
I am on acyclovir. I called and requested it since the outbreak turned out to be worse than the initial one. Today will be the third day Im on it and to be honest with you I am feeling worse. Dizzy, nauseated, and headache. Im guessing its due to the pill.
Also, I should a add that my partner has never shown any symptoms but he has had cold sores on his lips in his past. I believe thats what the HSV 1 came from. Im hoping this recurrent outbreak isnt from HSV2. I will try my best to be seen today.
I am on acyclovir. I called and requested it since the outbreak turned out to be worse than the initial one. Today will be the third day Im on it and to be honest with you I am feeling worse. Dizzy, nauseated, and headache. Im guessing its due to the pill.
Also, I should a add that my partner has never shown any symptoms but he has had cold sores on his lips in his past. I believe thats what the HSV 1 came from. Im hoping this recurrent outbreak isnt from HSV2. I will try my best to be seen today.
MEDICAL PROFESSIONAL
The HPV has no effect on herpes, or vice versa. It is possible to have both genital HSV-1 and HSV-2; not very common, but it happens.
Was your negative 2009 HSV-1 test a blood test or a swab test from a lesion?
Call the clinic back and try to be seen today. If you can talk a clinician, preferably the same one who examined you last time, s/he will understand why it is important not to wait. If your outbreak is healing come Monday, it likely will be impossible to test accurately for virus type. Please give it a try -- insist if you must (but diplomatically); or even walk in, being prepared to wait.
Was your negative 2009 HSV-1 test a blood test or a swab test from a lesion?
Call the clinic back and try to be seen today. If you can talk a clinician, preferably the same one who examined you last time, s/he will understand why it is important not to wait. If your outbreak is healing come Monday, it likely will be impossible to test accurately for virus type. Please give it a try -- insist if you must (but diplomatically); or even walk in, being prepared to wait.
Thanks for your prompt response. I made an appt. with PP. The earliest I could get is for Monday.
I should have added that I found out about the HSV 1 from a culture taken at PP. Around the same time I found out through a normal pap test that I have high risk HPV. Dont know if this affects the HSV 1 outbreaks. As for HIV, I was tested September 2009 and it came negative.
One last question..Is it possible to have both HSV 1 and 2 genitally? And wouldnt that have shown up on the culture done 2 months ago?
I should have added that I found out about the HSV 1 from a culture taken at PP. Around the same time I found out through a normal pap test that I have high risk HPV. Dont know if this affects the HSV 1 outbreaks. As for HIV, I was tested September 2009 and it came negative.
One last question..Is it possible to have both HSV 1 and 2 genitally? And wouldnt that have shown up on the culture done 2 months ago?
MEDICAL PROFESSIONAL
Welccome the the STD forum. I'll try to help.
Since your herpes is newly diagnosed, you should return to the PP clinic and let them evaluate this recurrence. Probably it is another herpes episode, just as you suspect. But since it is different in severity, it would be good be be absolutely certain. Also, it is conceivable that you now have a new HSV-2 infection, on top of the previously documented HSV-1. Herpes due to HSV-1 doesn't usually recur so soon. Having a new HSV-2 infection is unlikely, but it still is worth checking out to be certain. Return to the clinic as fast as possible -- today if they are open on Saturdays, or for sure on Monday.
Having said all that, herpes outbreaks often vary in severity. And although your current recurrence is more severe than the initial outbreak, it actually doesn't sound very bad. Truly severe herpes outbreaks have sores all over the genital area, swollen/tender lymph nodes in the groin, fever, and often vaginal discharge -- none of which you mention.
As for HIV, there is nothing in this that suggests a significant chance you have it, and HIV remains rare in heterosexual men and women in the US and other industrialized countries. But since you are worried, have an HIV test. PP can do it when you return. You can expect a negative test result.
Your partner is wrong about reinfection. Sex does not trigger herpes outbreaks, and HSV infections cannot be transferred back and forth between sex partners. Once someone is infected with either virus type, HSV-1 or HSV-2, s/he is immune (or at least highly resistant) to new infection with the same type. There is no need for condoms; it would make no difference in your recurrence frequency.
However, I recommend your partner have a blood test, to confirm whether he is infected with HSV-1 and/or HSV-2. He could accompany you to the PP clinic when you return.
Finally, if you continue to have herpes outbreaks, whether due to HSV-1 or HSV-2, you could take suppressive treatment with one of the anti-herpes drugs, such as valacyclovir or acyclovir. Discuss it with your PP provider.
I hope this helps. Best wishes-- HHH, MD
Since your herpes is newly diagnosed, you should return to the PP clinic and let them evaluate this recurrence. Probably it is another herpes episode, just as you suspect. But since it is different in severity, it would be good be be absolutely certain. Also, it is conceivable that you now have a new HSV-2 infection, on top of the previously documented HSV-1. Herpes due to HSV-1 doesn't usually recur so soon. Having a new HSV-2 infection is unlikely, but it still is worth checking out to be certain. Return to the clinic as fast as possible -- today if they are open on Saturdays, or for sure on Monday.
Having said all that, herpes outbreaks often vary in severity. And although your current recurrence is more severe than the initial outbreak, it actually doesn't sound very bad. Truly severe herpes outbreaks have sores all over the genital area, swollen/tender lymph nodes in the groin, fever, and often vaginal discharge -- none of which you mention.
As for HIV, there is nothing in this that suggests a significant chance you have it, and HIV remains rare in heterosexual men and women in the US and other industrialized countries. But since you are worried, have an HIV test. PP can do it when you return. You can expect a negative test result.
Your partner is wrong about reinfection. Sex does not trigger herpes outbreaks, and HSV infections cannot be transferred back and forth between sex partners. Once someone is infected with either virus type, HSV-1 or HSV-2, s/he is immune (or at least highly resistant) to new infection with the same type. There is no need for condoms; it would make no difference in your recurrence frequency.
However, I recommend your partner have a blood test, to confirm whether he is infected with HSV-1 and/or HSV-2. He could accompany you to the PP clinic when you return.
Finally, if you continue to have herpes outbreaks, whether due to HSV-1 or HSV-2, you could take suppressive treatment with one of the anti-herpes drugs, such as valacyclovir or acyclovir. Discuss it with your PP provider.
I hope this helps. Best wishes-- HHH, MD
You are reading content posted in the STDs Forum
Herpes spreads by oral, vaginal and anal sex.
Herpes sores blister, then burst, scab and heal.
STIs are the most common cause of genital sores.
Millions of people are diagnosed with STDs in the U.S. each year.
STDs can't be transmitted by casual contact, like hugging or touching.
Syphilis is an STD that is transmitted by oral, genital and anal sex.
