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TWICE MONTHLY RECURRENCE OF ORAL HSV1
Hello Dr's. You have helped me in the past with questions of transmission of oral HSV especially to my young son... I test positive for HSV1 in blood testing. My problem is I am having monthly to twice monthly breakouts of hsv sores on the margin of my lip. I have taken 1000mg Valtrex daily for a few months now and I am still getting very frequent outbreaks. This is becoming mentally and physically taxing. Anxiety levels never get a chance to subside which creates a viscous cycle I am sure. Do you have any thoughts for me? Do I bump up to 2000mg Valtrex daily to get this under control? IS this normal? Is there any hope of this subsiding with time? The outbreaks are never really bad, just very very frequent. Any help would be greatly appreciated.
Swab PCR test done today on day one of outbreak. Visual diagnosis by Dr. is an uncertain "appears to be herpetic". Not extremely painful to the touch but slightly painful, no tingle, no "blistering" I have thick facial hair and it appears that a less than 1/2" area is reddened at the corner of my mouth and the hair follicles seem to be irritated. Skin looks like I held an electric razor in one spot too long. Slight swelling and tightness of skin. I do not feel it all all unless I touch it. Should have results by mid next week. Thank you again for some peace of mind.
MEDICAL PROFESSIONAL
PCR is a swab test.
I'm aware your diagnosis of oral HSV-1 is solid. But I'm still not convinced that all of the "outbreaks" you describe are herpes -- even more so since "The appearance doesn't seem to be the same every time". In other words, the purpose of another exam and a repeat swab test (preferably PCR) is to check the cause of the current "outbreaks", not to confirm the diagnosis itself. I'll be interested to hear what your doctor thinks after you've been examined, and the result of a test (if done) in a few days.
I'm aware your diagnosis of oral HSV-1 is solid. But I'm still not convinced that all of the "outbreaks" you describe are herpes -- even more so since "The appearance doesn't seem to be the same every time". In other words, the purpose of another exam and a repeat swab test (preferably PCR) is to check the cause of the current "outbreaks", not to confirm the diagnosis itself. I'll be interested to hear what your doctor thinks after you've been examined, and the result of a test (if done) in a few days.
IS the PCR a blood test or swab test? Which should I request? I have a Dr I can see today and I noticed my outbreak this morning
Yes sir I realized I should have posted to herpes forum after I posted the question to the STD forum. I have had a swab test done a few months ago that came back positive. The appearance doesn't seem to be the same every time. I have had an IGG test and am positive hsv1. Is that different from a PCR test?
MEDICAL PROFESSIONAL
Welcome back to the forum.
The first issue is to be certain your recurrent oral sores really are herpes. Such frequent outbreaks are rare, even without valacyclovir, and I suspect something else is going on. You should see a doctor, preferably one experienced in herpes, such as a dermatologist. Set it up so you can be seen promptly (within a day or two) when the next oubreak starts so you can be examined and have an HSV PCR test from the outbreak (or culture, but PCR is preferred).
Rather than bumping your valacyclovir dose, I would recommend you stop the drug entirely until you have been examined and tested and the diagnosis is certain. Deal with proper dosing at that time.
I see you have asked the same question on the herpes forum; I imagine Terri Warren's advice will be similar to mine.
Regards-- HHH, MD
The first issue is to be certain your recurrent oral sores really are herpes. Such frequent outbreaks are rare, even without valacyclovir, and I suspect something else is going on. You should see a doctor, preferably one experienced in herpes, such as a dermatologist. Set it up so you can be seen promptly (within a day or two) when the next oubreak starts so you can be examined and have an HSV PCR test from the outbreak (or culture, but PCR is preferred).
Rather than bumping your valacyclovir dose, I would recommend you stop the drug entirely until you have been examined and tested and the diagnosis is certain. Deal with proper dosing at that time.
I see you have asked the same question on the herpes forum; I imagine Terri Warren's advice will be similar to mine.
Regards-- 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.
