Herpes recurrences explained

  1. What are herpes recurrences and how likely are they?

    Recurrences (also called outbreaks, episodes, flare-ups) are repeat symptoms (sores, blisters, patches of red skin or tiny splits) which appear at or close to the place where the infection was first noticed. These are often fairly minor and may be no more than a small spot that heals in a few days. They may be accompanied by sensations – itches or nerve twinges. They are unlikely to be as severe as first symptoms and may be almost unnoticed.

    1. Why does genital herpes come back?

      There are many different things that may trigger herpes recurrences. Sometimes, a person can learn to recognise why outbreaks appear – but for other people there does not seem to be any particular reason for it.

      Between recurrences the virus travels from the skin along the nerve to the nerve ganglion (a junction for several nerves supplying the same area) where it remains. Once you have been infected, the virus remains in the body, just as chickenpox and some other viruses do. Recurrent symptoms occur when the virus is reactivated or ‘triggered.’ The symptoms normally appear in the same area as the first time. For some people they may move a short distance, e.g. from genitals to buttocks, but always within the same dermatome (nerve region).

      Some people feel aching, tingling, burning or sharp pains in the area affected (leg, genitals or buttock) preceding a recurrence. These are called prodromal symptoms or prodromes. They are a sign that the virus is trying to reactivate and there may be virus on the skin surface. Sometimes they last for a few days then disappear without any symptoms appearing on the skin.

      1. How many genital herpes recurrences will I have?

        Researchers know the average number of outbreaks – but you are not average! Does knowing how many children a woman has ‘on average’ tell you how many you will have? 

        However, we know that outbreaks are about 6 times more frequesnt whith a type 2 genital infection than when it is caused by type 1. So a person who is having a lot of genital herpes recurrences is more likley to have herpes simplex type 2. (And a person with type 1 on the genitals is not expected to have many recurrences at all.)

      2. How often can genital herpes come back?

        Some people get no further episodes, while a few get frequent recurrences. If you do, you could ask your doctor for antiviral pills to prevent outbreaks – see antiviral treatment, or you can try self-help treatments. There are two pages of suggestions on our “Tips to prevent recurrences” leaflet. It is available to members. Outbreaks normally decline in frequency and severity over time.

      3. Why do some get more outbreaks than others?

        Research has found a gene which helps some people control the virus so they get no further episodes. So if you get a lot of outbreaks, you can blame a parent! However, good or bad genes, you can still help your body to prevent outbreaks – see antiviral treatment, or you can try self-help treatments. There are two pages of suggestions on our “Tips to prevent recurrences” leaflet. It is available to members. Outbreaks normally decline in frequency and severity over time.

      There are websites with headings like ‘Living with oral herpes’, ‘Living with herpes simplex type 2’ or just ‘Coping with herpes’

      We don’t use these phrases. Would anyone expect to read ‘Living with cold sores’? Or ‘Living with shingles’? Or ‘Coping with thrush?’ These phrases seem to be created to dramatise the condition. Granted some people are unlucky with their outbreaks – see here for treatment. Most of us (and our partners) soon realise what a small issue it really is.  See a sample of a ‘happy ever after’ personal report in a copy of our quarterly magazine, sent to subscribers.

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