[Question #3194] HSV-2 First OB

38 months ago
I tested positive for HSV-2 last year.  Having my first OB anal area, space between anus and scrotum, behind scrotum and in my inner thighs. Combination of small pimples and raw skin at this point.  There is weeping of clear liquid. 

On day 6 of 500mg Valacyclovir 2x a day. I Been using A&D to coat the area after warm shower. Inflammation does not seem to be getting better. Kept my diet clear of the high Arginine foods. 

Plan for today was to get some Caladryl lotion and echinacea supplements. Help!
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
38 months ago
You tested positive by antibody test, is that right? Do you have the number associated with that positive result so that I can know that you don't need confirmatory testing?  Did you get this raw area swab tested to be sure this is a herpes outbreak?  Is the area improving, do you think?  The best thing to do with outbreaks is to keep them clean and dry.  I like 2 grams once and 2 grams 12 hours later for one day for outbreaks myself.  A big wallop really helps to bring things under control more quickly.  You can continue the medicine if you aren't improving but you could also get it checked out if you have not already to be sure that's what you are dealing with - an exam can be so helpful that way.

Terri
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38 months ago
The test was an antibody test of >8. I just had it redone with the same result. I haven’t had it swabbed because I didn’t go to my PCP to have it checked for confidentiality reasons. 

I have a feeling it hasn’t improved because of the A&D since it doesn’t allow it to dry out.  It’s also in an area that is hard to keep dry and airy since I’m pretty physical at work. I do however keep it clean. 

2 grams of what exactly? Not sure what you are referring to. 

I have picked up caladryl with anti itch as well as hydrogen peroxide (another home remedy I read about). Also picked up Lysine 1000mg. 

Looking for a path you can recommend. 

Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
38 months ago
That score does not need confirmation.
It is best to keep it cool and dry but the location definitely makes that challenging, I know. 
Sorry, 2 grams of Valacyclovir.  These topical may help the symptoms but as you suspect, they may be extending the healing time.  It's a trade off for sure.  Don't do too much, you could really irritate the area and won't know which thing is causing the irritation.

Terri
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38 months ago
Thank you...It makes sense now to not try too many diffent remedies. 

Going on my 7th day of 500mg x 2 a day has not decreased the outbreak should I step up to another course at higher dosing?

This all started with a clear watery oderless discharge from my anus which has been consistent since the start a week ago. It can soak a pair of shorts in just a few hours. Is this also a symptom?  This presents an additional challenge to keeping things dry. 


Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
38 months ago
That is not normal for herpes.  Your symptoms could be an exception but if you called my office with this complaint, I would ask to see you right away.  And you should be seen right away.  This could be something other than herpes and you need to rule that out.  Especially since the medicine is not improving your symptoms.   Please go be seen to be very certain what is going on here.

Terri
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