WHAT IS HERPES?
Herpes is a skin condition caused by the virus HSV-1 or HSV-2 ("herpes simplex virus"), which can appear on the mouth or the genitals. In the past, HSV-1 was commonly diagnosed on the mouth and HSV-2 on the genitals, but the two can appear in both places if an infected partner gives or receives oral sex. Herpes appears on the skin as blisters that resemble pimples and may occur in clusters. A person can transmit herpes when these blisters are present but also when they are not, called asymptomatic shedding. Asymptomatic shedding occurs about 10.2% of the time--this means a person who is herpes positive can still transmit the virus with no signs or symptoms. This is why it's important to always use protection, even if you do not believe you are contagious. See the CDC website for more information.
WHO HAS HERPES?
A Lot of Us
According to the CDC (2017), 15.7 % of people aged 14 to 49 years have an HSV-2 infection. If you consider those that carry genital herpes as HSV-1, the virus that causes cold sores around the mouth, then the number is much higher. More women than men carry herpes (20.3% versus 10.6% in 14 to 49 year olds) as it's easier for men to give herpes to women. That's because the vagina, in all its warm and moist glory, is more susceptible to harboring the virus--this is the environment it prefers. And, get this, 87.4% of 14–49 year olds infected with HSV-2 don't even know they have herpes.
HOW CAN I PROTECT MY PARTNER?
Doing What’s Needed
Talk to your doctor about the best methods to protect your partner from contracting herpes from you. Most will tell you to use condoms (read this post about the type), take suppressive therapy (such as valacyclovir), and abstain from sexual intercourse while having an outbreak. It's also important to stay stress free, eat well, and exercise--all things you should be doing to maintain a healthy lifestyle.
HERPES & PREGNANCY
Can I Have a Baby?
Yes, ladies, you can still have a baby. It's vital you are not having an outbreak during the last month of your pregnancy, though. My doctor suggested I take suppressive therapy during that time to ensure the virus stays deep inside my body. During the days/week leading up to delivery, you may consider getting a swab test of the area to see if the virus is present but invisible on the surface of your skin, in the areas you typically get an outbreak. If positive or if you are having an outbreak, you can have a C-section. The risk with having a vaginal delivery during an outbreak is that the virus can be passed onto the skin of your baby, anywhere its skin touches your infection. This can cause some pretty serious complications. Stay diligent in preventing an outbreak during the last month and communicate your concerns with your doctor.
BATTLING AN OUTBREAK
By and large, your first outbreak will be the worst. Your body is going to work on a new foreign invader and pulling out all the stops to kill it off. You'll experience inflammation first, then, as the virus multiplies on the surface of your skin, blisters or bumps form, sometimes in clusters. They'll eventually burst, ripping open your skin. When urine touches this area, you'll also experience a stinging pain. How can you alleviate all of this discomfort? Start with suppressive therapy (valacyclovir or acyclovir), prescribed by your doctor (obgyn or internist). This will slow down the reproduction of the virus. A cream like Vagisil with benzocaine (or off-brand) can be applied directly on the blisters and surrounding inflamed areas to numb the pain. Use a cup or bottle of water to pour on your genitals as you urinate to help wash away the urine from the inflamed skin. I have also found Australian tea tree oil to speed up the recovery process: swab a small amount on the infected area. Ibuprofen may also reduce inflammation and help with general pain relief. So, make your list and hit the pharmacy as soon as possible.