How do I know if I am having an outbreak and others

[mystupidex]

On Valtrex 1 mg per day.  How can you tell aside from lesion if you have an outbreak or shedding?  Aside from lesion?  Is there anyway to know if there is one internally?  Is shedding less powerful if on Valtrex and how long does it last? As far as I know I haven't had any outbreaks except maybe one last year.  I do get some tingling and I've been putting denavir on areas that I know can turn into an outbreak. My ex passed to me from a large lesion on his bottom lip. My dr. did a culture 6 yrs ago (1st pregnancy) when the first real lesion appeared on my pubic bone right above my lips.  I’ve also developed a large area on my upper lip that has turned into an outbreak maybe three times.  And there are a few little blisters that sometimes form around my mouth. I’ve never had a blood test to confirm what kind of HSV this is.  What are the chances are that it could be HSV1 only? If on suppressive therapy what are the chances that the partner could have get it?  What would their outbreak be like? Does Valtrex or Lysine cause yeast? Can too much Lysine cause an outbreak?  If 500 mg of Valtrex reduces transmission by 50%, then does 1 mg per day suppressive reduce it more? For 2 or 3 weeks I've felt occasional tingling on my upper lip and in the one spot that is right above my pubic bone.  And the past 1 1/2 to 2 weeks I feel like my lymph node on pelvis occasionally flares up. Changed Valtrex to more of an outbreak dosage.  1 mg for 2/day yesterday and the same for today.  Do you know if too much Valtrex or Lysine can cause any of these symptoms I'm feeling? Do antibiotics cause Valtrex to be ineffective? Can you get herpes on your ear and/or head? On the bottom of my right ear at the part where my ear joins my head I'll get an occasional hard bump like it swells.  Popped it and it formed a flaky scab.  Do symptoms cause back and neck to feels like they are burning?  I'll sometimes get little pimples on scalp that result in a yellow scab.  

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A related discussion, L-Lysine and Acyclovir was started.

[Terri Warren, RN, Adult Nurse Practitioner]

Do you know if the swab test that was taken from the genital area was positive for herpes or not?  And if it was, please find out the type.

It would be unusual to get the same type of herpes in two locations on your body unless you acquired them at the same time.

Yes, it would be good if you good start with a new post to this board,

Terri

[mystupidex]

I did have a swab done one time which is actually the only time I ever noticed an obvious lesion in my pubic area.  It occurred while I was pregant and it got to be about the size of a quarter.  Ever since I get occassional tingling at that spot.  Apparently it wasn't typed but I'm going to check with my dr.  My annual gyn check is on June 11 and at that time I plan to have a number of questions for her as well as ask for a lab slip to get the blood work done.  When I was married my ex-husband had frequent outbreaks in the same spot on his lower lip.  It always turned into a very large white blister.  It's the only spot I've ever known him to get it.  I do get small cold sores or pimples on my mouth and do have one area above my lip that can get pretty big.  I've had 2 or 3 different episodes with that and sometimes tingling.  The tingling seems to happen the same time on both spots.  I've a little tingling in a different area above my mouth yesterday and now noticed a pimple.  I also found a pimple on butt yesterday and another small area that looked like a rash or pimples it didn't hurt or itch on the other side.  Today it is gone.  Like I said I do take Valtrex 1 mg per day for suppression.  Should I operate under the assumption that every pimple especially on my butt could be an outbreak?  Can you tell me the difference between recognizing a pimple and a herpe bump.  What if you pop it?  Last question I hope.  I can post another payment if you would like.  I do remember my first fever blisters when I was about 17 with a boyfriend at the time.  I do not remember a primary outbreak in my genital area except for the time when I was pregnant.  I do know that it would occassionaly tingle.  Ok, sorry if someone has HSV would they be less likely to have a serious primary outbreak?

[Terri Warren, RN, Adult Nurse Practitioner]

Sneezing has nothing to do with herpes at all.  I doubt that zinc oxide would be an irritant as we often use it to protect skin, but who knows about your personal sensitivities?  

So did you actually have a positive swab test from a genital lesion, is that right?  And it wasn't typed?  And you've never had an antibody test?  But you believe it is HSV 1, is that right?  HSV 1 recurs infrequently in the genital area, maybe once a year or less for most people.

Terri

[mystupidex]

Hello again.  My partner says he is having the following symptoms.  He said he feels like **** and has been sneezing a whole lot.  He stayed home yesterday and said he was sneezing as many as five times at once.  He hasn't complained of any irritation or blisters.  Do you know if sneezing came sometimes be considered an early indication of contracting the virus?  While we gone last weekend I took Valtrex 1mg twice per day and we only slept together 3 times.  I did not notice that one side of my vulva was very tender and red.  I never saw any blisters and it never itched.  Could that have been an outbreak?  The whole week before we left for out of town I used zinc oxide to help prevent any tearing or to strengthen my skin down there.  Could the zinc oxide have caused it to be irritated?

[Terri Warren, RN, Adult Nurse Practitioner]

I can't tell you if a specific symptom is herpes because herpes can have many presentations, subtle and not so subtle.  You would have to have the area swab tested to determine if a specific presentation is herpes.  Lesions in the vagina are uncommon, but they can be tender, red and don't crust over, they just fill in

I think you are on too many things, only one of which has been statistically shown to help herpes, Valtrex.

Terri

[mystupidex]

Thanks Terri. I'm back in town now.  I seem to be having more and more feelings in my lymph nodes on my legs over the past 3 or 4 weeks.  They are not swelled, but I seem to be having flare ups that last for a few minutes and then subside.  Can this be related to herpes.  With tingling I only get in on my upper lip and the one spot in my pubic hair.  It never lasts long so should I be concerned that I am shedding at that time.  Also I have noticed that I seem to be tearing at the top of my vagina.  It is in the area that is closer to my lips rather than my opening.  It makes having intercourse kind of painful.  Is this related.  I seem to think that my ob told me a couple years ago that my bladder may be slipping a bit.  I'm only 37 and have had 2 little girls.   Now can you please describe what an outbreak would be like on the inside.  Do you get blisters, do they itch, are they painful and do they crust over.  I ask because last week I had a sore, red area on the inside of my vulva.  I do not recall it being itchy at all or painful it all.  I would say it was more inflamed looking.  I'd like to also know if combining Valtrex and Lysine can counter act each other or cause some sort of outbreak or shedding.  Right now I'm on Valtrex 1 mg, Lysine 600 or 1200mg/day that has licorice root, prunella vulgaris, zinc and vitamin C in it; also vitamin E, C, green tea, echinacea and a homeopathic yeast pill to stop yeast.  Is it bad to take so many things.  Should I add anything?

[Terri Warren, RN, Adult Nurse Practitioner]

My, so many questions!  I'll do my best.  First of all, it would be very useful to know which type of herpes you have.  Let's assume for a moment, since there was a cold sore involved, that you have HSV 1.  Just for now.  
You cannot know when you are shedding virus.  You can assume that that you are shedding when you have an outbreak, but you could be giving off virus when you don't have an outbreak.  HSV 1 genitally sheds infrequently, much less than type 2 genitally.  So was the culture positive?  And it wasn't typed, are you sure?  If you are on daily therapy, the change of transmission is reduced.  How much, I can't say, since I don't know if you have HSV 1 or HSV 2.  1 mg may offer some benefit over 500 mg, but not much, our studies have shown.  Too much Valtrex or Lysine cannot cause yeast infections, no.  Antibiotics have no influence on the effectiveness of Valtrex.  It is highly unlikely, now that you have established infection, that you would move your herpes to a new location on your body.  Herpes should not cause your back and neck to feel like they are burning.  

It would be good to know what type of virus you have so a more accurate risk assessment can be made about your transmission risks.

Terri