[Question #12127] Genital Herpes Outbreak Healing
10 months ago
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(Female) I tested positive for hsv2 about 2yrs ago by swab and have been taking 1g valcyclovir everyday since. My outbreaks typically heal within a week, but sometimes they leave a little, barely noticeable scar that lasts another week or 2. I started an outbreak (1 sore) 12 days ago. The outbreak has been fully closed with no scabs for about a week, and I have had a tiny, barely noticeable pink scar ever since. Does this mean the outbreak is still active, or is it healed and could be a result of me pulling at the outbreak to look at it frequently? I would like to have sex again (protected) but don’t want to if the outbreak is still “active.”
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Terri Warren, RN, Nurse Practitioner
10 months ago
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The problem here is that we know that people can give off virus, even with zero symptoms. So to tell you when it is safe to safe sex again is elusive for sure. Probably pulling at the outbreak isn't a great idea - try to visualize it without pulling. And how often are you breaking through suppressive therapy with an outbreak? You might want to consider taking 500 mg about 12 hours apart to get a bit more even coverage during the course of a day. Another option would be to have the scar swab tested, either by you at home with a PCR kit or by a clinician, at least once. That might give you a better idea of whether scarring represents a time when virus is present or not.
Terri
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10 months ago
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I get outbreaks about every 2 months, sometimes more frequently if I’m stressed or sick. The scar is so little I don’t know if the doctor would really be able to find it, I have to pull the skin taught to even see it, which is probably not a good idea.
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Terri Warren, RN, Nurse Practitioner
10 months ago
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There doesn't have to be anything visible to have a positive swab result. We are able to get virus off of completely normal looking skin. Outbreaks every two months while on one gram of Valtrex daily is highly unusual. When you say an "outbreak" tell me exactly what they means to you, please.
Terri
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10 months ago
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Yes I know, I just know that’s the chances are higher if there is an active outbreak. I went to a doctor she didn’t swab it but said it didn’t look like an active outbreak because new skin had formed. My outbreaks usually are not usually severe - just one sore that itches and hurts a little for about 3 days and then it starts to heal, though it seems that they can scar a little as the little pink area is still there 2 weeks later.
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Terri Warren, RN, Nurse Practitioner
10 months ago
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I think you probably need a small adjustment in your dosing. If you were my patient, I would recommend that you take 500 mg twice a day rather than 1 gram once a day. This would keep the drug levels very even over the course of the day, rather than having a good high peak but a lower level 20 hours later. I'm not promising better results but it certainly is worth a try.
Terri
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