Primary Care Physician
Dr. Orrange received her BA in Biology at the University of California, San Diego, and a Masters Degree in Health Sciences at the Johns Hopkins University School of Public Health. She received her MD from the USC Keck School of…
What is the treatment for herpes? Can herpes go into remission?
Posted in Oral Herpes by Dr. Sharon Orrange on Jun 30, 2010
"I have always thought that the bumps I got on my lips were pimples since I get black heads above my upper lip. Recently though, I've had a red bump forming on my lip that doesn't feel "pimple-like" and am now terrified. My mom says I probably kissed a guy who has herpes and now I have it for life. I haven't been tested by a doctor yet but I feel like she is right since I had heard a rumor that one of my ex's found out he has oral herpes. I'm 18 years old and feel horrible about myself and wonder if I should even continue dating. I know a large number of the population has it (my aunt has it from giving mouth to mouth to a woman who had been drowning) but I still feel dirty and don't know what to do. Is it possible for the virus to go into remission or a treatment to help?"

Yes, there are options for suppressive therapy to prevent recurrences of oral or genital lesions from Herpes Simplex Virus (HSV type I and II). First you need to have a diagnosis. See your doctor when you have an active sore and have him or her culture it to see if this is Herpes. The gold standard for diagnosis is a culture of a new, active sore.

If Herpes Simplex Virus (HSV) is the cause of your recurrent lip sores you do have an option of treatment with an antiviral for prevention of outbreaks.

Chronic suppression with a daily antiviral medication has proven helpful in preventing HSV lesions in individuals with frequently recurrent lesions. Controlled trials show a decrease in occurrence of new lesions from 50 to 78 percent in people on a regimen of oral acyclovir (600 to 1000 mg daily). A daily suppressive regimen (200 mg three to five times daily) has been shown to be safe and effective when used continuously for up to one year.

What I usually prescribe is Valtrex (Valacyclovir) which is now generic and works well to suppress recurrences of mouth sores from herpes. Valacyclovir 500 mg a day is easier to take then Acyclovir which requires three times a day dosing. You can discuss with your Doctor taking chronic suppression of Valacyclovir 500 mg a day if your recurrences are very frequent, more than two every four months of if recurrences interrupt job performance or present increased risk of infection for others e.g. medical and dental personnel.

Most importantly, herpes in the mouth and genital region is very very common yet not trivial as you have experienced. Yes, you will deal with this your whole life but there is no reason for shame and please reach out to others on this site in the same boat.

Dr O.

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This is all great advice, it can go into hiding for decades, especially if you have an early strain pre mid 1970s.
By dailyfooddiaryuser  Jul 02, 2010
Read comment 2, then 3, as I ran out of space!
By blondegal55  Jun 30, 2010
Tips to avoid outbreaks are: avoid extended hours in the sun, avoid too much smoking or drinking, late hours and lack of sleep, and of course stress. Yes, L-lysine helps alot!
Buy the over the counter, Abbreva cream, apply as soon as you feel a bump, or itchiness. Don't use the same lipstick or tooth brush and don't let it spread! Don't feel embarassed, and if you have the coldsore, avoid the sun,touching it,and don't kiss a soul, or have sex it you have it.Research states, that you can pass it anytime without an outbreak, so be extremely considerate when you have an outbreak, cuz the likelihood of spreading it to your partner increases dramatically!
By blondegal55  Jun 30, 2010
Once you have herpes simplex one(mouth)or two(genitals),you will always have it.
The meds help in alleviating or decreasing outbreaks, but the virus, gets embedded in your spinal fluid, and can come out any time. The problem with meds is there are side effects, which can affect your liver,and kidney which filters your blood and cleans it.
Herpes can later affect your life,by turning into shingles,which is the cousin of the chicken pox. Shingles (reddish inflammation)often affects the groin area, making it sore. Some have milder versions of shingles, and others, quite painful.
By blondegal55  Jun 30, 2010
One thing the Dr. doesn't mention - vitamin supplements. Oral herpes (which is VERY common) can be kept in check with lysine supplements. My husband passed it on to me, and by taking lysine, neither one of us has outbreak for years. It's worth considering before you put an stress on your system by taking lifetime medication!
By drdim  Jun 30, 2010
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