There are a number of testing procedures to determine a Herpes infection. Proper diagnostic procedures include a physical examination of infected areas by a qualified health care professional. Most experienced practitioners are competent in identifying HSV by its visible characteristics. Cell cultures are the standard test for confirmation, and must be taken by sampling or swabbing an active lesion. Many experts recommend that a culture be taken even in the case of a "classic herpes" visual diagnosis, to confirm the diagnosis and viral type.
Cultures are best when taken on a fresh lesion. Even then, the amount of virus present may not be enough to get an accurate result. The amount of virus present is usually less in recurrent Herpes outbreaks than on a first outbreak, and cultures of recurrent lesions have a very high (50%) false negative rate. Suspected Herpes infections that show negative in culture may require additional testing. However, a positive result by culture is a definite determinant of infection. Be sure to obtain the viral type (HSV-1 or HSV-2) from your health care provider.
Most commercially available blood tests and titer tests are not accurate for determining HSV type, the only exception being the Western Blot serology, which must be specially ordered and processed through the lab at the University of Washington. It usually takes about 6 to 8 weeks after initial infection for antibodies to develop in the blood. HerpeSite recommends that no other blood test be considered other than the Western Blot for Herpes. Consult with your local medical labs and health care provider as to availability, costs, and applicability of these procedures. Detailed information on the Western Blot blood test for Herpes can be found at the Viridae Clinical Sciences website (a link can be found on the Resources page of HerpeSite).
According to a survey conducted by the American Social Health Association in 1991, most
patients with Herpes had tried between two and five different therapies. These included
prescription drugs, OTC "cold sore" treatments, herbal remedies, vitamins, nutritional
changes, psychotherapy, etc.
While there is no cure yet for HSV, there are 3 anti-viral drugs that have been proven to have a high efficacy in suppressing the Herpes Simplex Virus. These drugs also have been proven to significantly reduce the severity, duration, and frequency of occurrences. The 3 drugs are: Acyclovir, manufactured by Glaxo Wellcome under the trade name of Zovirax, now also available in generic; Valacyclovir, a "prodrug" of acyclovir, by Glaxo Wellcome under the name of Valtrex; and Famciclovir by Smithkline Beecham under the brand of Famvir. Valacyclovir and Famciclovir in clinical trials have proven to be more effective in their "uptake" or absorption by the body than acyclovir.
Acyclovir has been widely available for over 13 years, yet has recently been denied approval for over the counter sales (OTC) by the FDA. There is now also a generic version of acyclovir available. All three drugs must be prescribed by a licensed physician. Famvir and Valtrex are now available for both intermittent “acute” and daily “suppressive” therapy.
There are basically two types of drug intervention. "Acute therapy" and "suppressive therapy."
Acute therapy means taking the drug to reduce or prevent a specific, individual outbreak. It involves taking regular doses of the medication for a period of usually 5 days, starting with the first signs of impending outbreak. Since these medications work on new viruses as they are replicating and coming out of latency, the best results are obtained by starting treatment at the very first indication of symptoms - tingling, itching, or burning, before a lesion shows. If treatment is started after a blister or lesion has formed, it may lessen or prevent any subsequent lesions, but it will not shorten the duration of the current lesion by very much if at all.
Suppressive therapy, which is sometimes called prophylactic therapy, involves a daily regimen of medication to "suppress" the activation of the HSV virus. Suppressive therapy can be very useful for those patients who have a high frequency of recurrence, or who experience severe physically and/or psychologically troublesome outbreaks. Also, some people who want to reduce the risk of transmission to their sexual partners take suppressive doses of antiviral medication to reduce both the rate of outbreaks and asymptomatic shedding. The anti-viral medications can be quite expensive, and buying them in larger quantities can help reduce the long-term costs. Some people may wish to consult with their doctor about a program, and see if she/he can arrange for a renewable refill in conjunction with their insurance company for ease and economy.
There are other drugs for the treatment of HSV in special situations, including Foscarnet
(phosphonoformic acid), which is given by injection to severely immunosuppressed patients;
idoxuridine, for external use in ocular herpes infections only; and vidarabine, also used for
eye infections.
There are a variety of topical products on the market labeled for "cold sores," "fever blisters." There are no OTC products specifically labeled for genital herpes. Except for the prescription drug Zovirax, which acts on the virus itself, the predominant action of these products is to relieve symptoms by softening the sores or scabs, drying the infection site, and/or reducing pain. The topical ointment form of Zovirax (by prescription in the US, OTC in Australia) has been shown to have some effectiveness during a primary episode, but very limited effectiveness in recurrent episodes, due to the action of the drug on emerging viral DNA, and as it is not well-absorbed into the skin. It does help to reduce viral shedding, and may decrease the length of outbreak by a day or two. There are several new topical products being tested and seeking approval from the FDA for sale in the US. We’ll keep you posted as they become marketed and more available.
Many of the available OTC products contain ingredients, such as alcohol, which can cause stinging and further irritation and chafing of the infected area. Topical creams and ointments may even slow the healing of HSV outbreaks by over-drying or irritating the site. Many also contain lidocaine or benzocaine as a temporary numbing agent, only partially effective, which can lead to allergic reactions in some people. Some OTC topical medications labeled for treatment of cuts, wounds, or infections also contain corticosteroids, which are not effective against HSV, and can initiate and prolong outbreaks. Experts strongly advise against using any kind of topical cortisone-type cream on herpes, as they supress the local immunity, and may worsen outbreaks significantly.
Medical experts generally recommend keeping cold sores or hot spots clean, dry, and
uncovered. Many women, who may experience extreme burning and pain during urination,
find covering the lesions with petroleum jelly or an antibiotic ointment prior to urination to
be very helpful. Occasional use of antibiotic ointments, while having no effect on the virus or
outbreak itself, may also help to prevent secondary bacterial infection in some cases, and
may soothe areas subject to friction. Some people have found Aloe to be effective as a
soothing agent for areas subject to chafing.
There are a number of alternative treatments that have been anecdotally reported to be effective in treating or suppressing HSV. HerpeSite friends and others have reported the most success with lysine and dietary adjustments.
L-Lysine is a naturally occurring amino acid that can be found in a number of foods. Lysine supplementation has been anecdotally reported to be effective in ranges of 200 - 1000 mg a day. Scientific studies have shown conflicting results with lysine, but many people with herpes believe that it works well for them.
Garlic is reported to have anti-viral properties. Increasing intake of anti-oxidant vitamins, zinc, or iron seems also to help many. Numerous herbs and essential oils, inluding melissa, echinacea, ti tree, goldenseal, licorice, and others, have been tried as internal or external treatments, with varying results.
Reduction of foods high in the amino acid arginine, particularly chocolate and nuts, seems to help many, although recent studies have indicated that arginine is an immune-enhancer.
Restriction of caffeine, sugar, alcohol, and processed foods have been widely reported as helping to curb outbreaks. Coffee has been demonstrated to be a nerve stimulant, and may have the effect of irritating the nerves and increasing outbreaks.
There are many other non-traditional "treatments" or "remedies" such as various homeopathic products, algae, colloidal silver, hydrogen peroxide, etc. HerpeSite has not yet read of any conclusive benefits to these products. Many of these products may be beneficial in some ways, many may be ineffective yet harmless, and some may be ineffective and unhealthful or even dangerous to certain people. Please research any treatment, even so-called "natural" ones, very carefully before attempting them.
Currently, there is no documented evidence of any treatment or product that can cure Herpes. In their quest for relief, people with Herpes can become vulnerable to false claims, scams, and purported cures for HSV. Be aware that organizations and individuals exist that prey on the emotional hopes or fears of the infected. There are many radical alternative procedures and concoctions being promoted as a "cure" for Herpes. HerpeSite advises all they should proceed very cautiously when investigating or exploring alternative therapies of any sort. We also suggest you consult with your health care provider before proceeding with implementing any radical regimen.
Buyer Beware
HerpeSite knows that there are many dedicated people and organizations working diligently to find new treatments and even a cure for herpes. It is our belief that when a legitimate possible or definite CURE has been discovered, there will be much fanfare and celebration. Indeed, the people who discover a cure for herpes will become historical figures like Thomas Edison, Jonas Salk, Madame Curie, and Albert Einstein, and they will no doubt win the Nobel Prize for Medicine. There have been, and are, many miracles in this world, and a cure may not necessarily be discovered through or by an established medical or pharmaceutical company, and may come from a small or surprizing "alternative" source. Even so, beware of any treatments touted as "cures," and remember the adage, "If it sounds too good to be true, it probably is!"
One of the most effective ways to care for HSV is to pay attention to "environmental" considerations to the body and particularly to areas of infection. Everyone has a different experience with HSV, and different factors may or may not affect certain people, so each person should pay attention to the factors that affect them.
It can be very helpful to avoid and manage stress, sickness, and fatigue, and unhealthful dietary and lifestyle practices. All these things can effect the host environment - i.e. the body. Many HerpeSite members and friends find it especially beneficial to maintain healthy sleep and rest patterns, to eat a diet rich in fresh, whole, live fruits and vegetables, and to avoid caffeine, alcohol, and tobacco products.
UVA/UVB, PABA-free sun screen can be effective in protecting infected areas and body in general from sunburn which can aggravate and initiate HSV recurrences.
When a having a particularly painful outbreak, some people find bathing several times a day in cool water to provide temporary relief.
Many women who experience extreme pain while urinating find pouring body-temperature water over the area, or urinating while immersing the area in lukewarm water, alleviates the pain. Also, drinking plenty of liquids helps to dilute the urine.
Experts recommend to keep actively infected lesions clean, dry, and exposed as much as possible to air, but not direct sunlight.
Participation in a support group, either "live" or online, can help by increasing social contact, providing access to information and encouragement from others who've "been there." Talking about it may seem difficult at first, but it really does help... and it's a surprise to discover how many others will say, "hey, I've got it too!"
Relaxation techniques, deep breathing, yoga, exercise programs, meditation, and/or self-hypnosis have helped many to successfully control pain, strengthen the immune system, and gain a sense of well-being that may lead to fewer, less severe outbreaks.
For additional sources of mind/body health and nutrition information, please go to the Reading page of HerpeSite.