OOH for herpes outbreak?

[MadamMooMoo]

Was diagnosed with herpes type 1 on genitals six weeks ago. Looks like I'm having an outbreak just starting. Should I go to OOH GP or can it wait for a regular GP appt?

[NoCapes]

I don't think you need to go anywhere? They can't treat it, you just wait it out

[MadamMooMoo]

Thank you nocapes. I wasn't sure and didn't want to call just in case.

[cudbywestrangers]

Recurrences are usually less severe than the first episode so you may not need treatment... but treatment works best if started quickly. Unless it's really uncomfortable then seeing someone tomorrow is fine- but I'd recommend your local sexual health clinic

[DoctorBeat]

Get to gp first thing. Get an emergency apt if necessary. If not, go to walk-in at a gum clinic asap. It can wait til tomorrow, but needs treating quickly as the sooner you take antivirals, the best chance of lessening the severity of the outbreak (I am a dr who has worked in sexual health). If you keep getting regular out breaks, you may meet the criteria for preventative antivirals. So you are best getting under the care of a gum clinic earlier on, as they will be more knowledgeable about the up to date guidelines on management. Meantime take care of the area. Loose fitting cotton clothes and underwear. If it hurts to pee, either pee in the bath or pour a jug of water over the area as you go. Wash with water only. If you can't pee at all (urinary retention can sometimes occur with herpes) then you need to go to ooh or a&e more urgently. Also goes without saying to avoid sex as you will be shedding virus. Hth, and hope you are not too uncomfortable... 😕

[NoCapes]

I have always been told after the first outbreak there's nothing that can be done or prescribed?!

[DoctorBeat]

No they can. Especially early on. It may make no difference, but sometimes antiviral s can help. As time goes on outbreaks will become less severe and less frequent and may not need it.

[NoCapes]

Well that's rather annoying
I haven't had an outbreak in about 12 years, but fuck me the first few were painful
Ignore me then OP, my GP then was clearly a knob

[DoctorBeat]

www.evidence.nhs.uk/document?ci=http%3a%2f%2fcks.nice.org.uk%2fherpes-simplex-genital&returnUrl=Search%3fom%3d%5b%7b%22srn%22%3a%5b%22Clinical+Knowledge+Summaries+-+CKS%22%5d%7d%5d%26ps%3d30%26q%3dherpes%2bsimplex%2bsuppression%2bguidelines&q=herpes+simplex+suppression+guidelines

Management will be based on individuals, so I think getting under the care of a gum clinic is best as they can monitor severity and frequency of attacks and manage accordingly. The fact you have had a secondary recurrence fairly early on (some people only get the primary attack and never get it again) makes me lean towards going for more than supportive therapy. But best to be examined and assessed properly at a gum clinic and follow their advice.

[DoctorBeat]

No capes - hopefully you will never get an outbreak again! It doesn't make any difference to the long term prognosis to treat, so it will have done you no harm to ride it out, but as the first few attacks will be the worst and they will gradually improve and lessen with time (as you have experienced) earlier attacks may benefit from early treatment just to hopefully make them less horrid! Generally looking after yourself will help too - plenty of sleep and eating well, minimise stress. Help your immune system to fight it itself (which it will) and keep it suppressed! (Hopefully) 💐

[DoctorBeat]

Evidence is flimsy though either way about treatment, and guidance may have changed since your day. I worked I gum in late 2016.

[Justtrying]

DrBeat, so glad people like you are around, I had a horrendous time with type 2, but on my genitals 20+ years ago. Made to feel so horrible by hcps, at the time, I've been lucky only one recoccurance down below, typically whilst pregnant.

Still suffer orally, occasionally but so happy to hear barriers are being broken down.

Madam moo, if all else fails salt water baths are a god send and really speed up healing.

[MadamMooMoo]

Thanks everyone for the help and thanks DrBeat for your experience.

I have a GP appt on Thurs for an unrelated issue so might see what happens then and ask about it?

I also have a white spot on the inside of my lip so think I have HSV 1 orally too :(

[DoctorBeat]

I wouldn't wait til Thursday. If you are going to treat, it is better to treat sooner. Also, as a go trainee, it is easier to deal with one thing at a time in 10 mins! So go asap to gp or gum about herpes tomorrow about the herpes issue, then go again about the unrelated issue on Thursday.

[SeaShores]

Can I ask about herpes as I feel a bit out of touch. Sorry for hijack OP.

I understand that infection occurs when one person is shedding the virus. I also understand they may be symptomless during this time. Is this true? Or would they have to have active blisters for it to shed?

How then, does anyone know if their new partner is carrying HSV? Would they have had an outbreak at some time in the past?

Presumably condoms don't protect as the virus is shed from skin and not just directly from the penis (in PIV sex.)

Can a man carry HSV and not know, and pass it on? Minefield!

[MadamMooMoo]

Happy for others to use thread for help seashores :)

[SeaShores]

I have since read up on this and there is 'asymptomatic shedding'. This seems to be saying that someone can be infected and pass it on without having symptoms, BUT does it also mean they have never had any signs of the virus, ever? Or just that it's inactive when they are shedding?
If the former, how the heck does anyone know if they are at risk?

[yikesanotherbooboo]

Lots on this on recent thread. You cannot be sure. The thing to remember is that herpes is usually a fairly minor illness... albeit the first attack can be very painful and it is a nuisance in childbirth. Lots of us are asymptomatic carriers , take sensible precautions for the sake of other more pernicious stis until you are commmitted