Dr. M.J. Bazos, Patient Handout

About Your Diagnosis
Herpes simplex is a virus in the family of viruses that cause chickenpox, shingles, cold sores, and mononucleosis. The principal cause is the herpes simplex virus type 1. This particular virus type is the primary cause of fever blisters and cold sores. The initial infection usually occurs in childhood. It is estimated that about 80% of all adults have had exposure to the virus, but only a few can recall a specific first infection. Herpes simplex is mainly transmitted by nonsexual intimate contact with saliva of an infected individual; for example, a child kissed by an adult relative who is shedding the virus but has no evidence of an infection. The virus from an infected individual can enter your body by passing through a break in your skin or through the tender skin of your mouth. It is extremely difficult to trace the
transmission because a current outbreak may be the result of an infection acquired months or years in the past. Herpes simplex is usually detected by inspection of the infected site. You may know when a recurrence is about to happen because you may feel itching, tingling, or pain in the places where you were first infected. The typical appearance is heralded by a tingling or discomfort at the site of the outbreak; then small blisters emerge and proceed to form ulcers and crusts. Healing occurs over 10–14 days. In special circumstances, specific laboratory tests can be used to verify the identity of the virus, but are not usually necessary in typical cases. Herpes virus infections are not curable and may recur throughout life.

Living With Your Diagnosis
The typical appearance is heralded by a tingling or discomfort at the site of the outbreak; then small blisters emerge and proceed to ulceration and crusting. Healing occurs over 10–14 days. This is a chronic infection that is impossible to eradicate, but millions of individuals are living a normal life with the disease.

Although there is no cure, the drugs acyclovir, valacyclovir, and famciclovir can be very helpful. The recommended treatment for primary episodes is 200 mg of acyclovir taken orally five times daily for 10 days, or 400 mg of acyclovir taken orally three times daily for 10 days. Treatment can significantly shorten the course. Acyclovir speeds up healing and can lessen the pain of herpes simplex infection for many individuals. It is used to treat infections and can also be used to lessen the number of recurrences. To soothe pain, take aspirin, acetaminophen, or ibuprofen. Penciclovir (Denavir) is an effective topical cream for treatment of recurrent herpes on the lips and face. Other topical antiviral agents have been popular but have not been shown to abort recurrent episodes. Many popular remedies are available including moisturizing or anesthetic lip balms, but there is no evidence that they are effective. Common side effects of the antiviral medications include nausea, vomiting, and itching. Allergic reactions and side effects of the medication are possible.

The DOs
• Take medication as prescribed by your doctor.
• Avoid stress. Reactivation of the virus can occur with emotional or physical stress and menstruation. Therefore, stress reduction measures such as avoiding stressful situations or learning how to deal with them effectively are important.
• Apply sunscreen to susceptible areas. Sunlight is also a precipitating cause, and application of sunscreen may decrease recurrences.
• Learn to recognize the early symptoms of tingling or itching; then avoid kissing anyone until the sores have completely healed.
• Keep hands well washed.
• Keep the lesion clean and dry.
• Avoid shaving the affected area.
• Avoid sharing individual hygiene items.

The DON’Ts
• Do not scratch. Scratching can lead to a secondary infection.

When to Call Your Doctor
• For infections that recur more than four to six times per year.
• For infections that involve a sensitive organ or tissue such as the eye.