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Treatment of sore pain and spreading mechanism

Doctors, my female friend is enduring an initial outbreak of genital Hsv1 I am certain I am the cause via a cold sore and oral sex. She started showing symptoms  a week ago. 1 sore that blistered. Two days later 2 more sores.  She saw a her gyn this Tuesday at that time still 3 sores total.  1 was almost healed ( the original one) . She started on 1 gram twice a day Of valacyclovir Tuesday evening . Today the sores have multiplied like mad  and she is in a great deal of pain.

Questions.
1 is it possible the drug made it temporally worse. ?
2 what is the best topical pain med or procedure to alleviate some of the pain  ?( opiates make her I'll)
3 are the sores being spread from sore to sore if so it best to cover them?
4. Beside hygiene is there anything else that can stop them from spreading?
5. should she return to see her gyn ?
11 Responses
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239123 tn?1267647614
MEDICAL PROFESSIONAL
Welcome back to the forum.  This question could have been asked in your previous thread with Dr. Hook, without a new posting fee.

Your partner apparently has a doctor who understands herpes well, and she is being treated with the right drug in the correct dose -- exactly what I would have recommended.  As your partner is learning, initial herpes can be extensive and painful.  New lesions normally continue to appear for 2 days after starting valacyclvir treatment, and it can take another 2-3 days for significantly reduced pain.

The valacyclovir hasn't made it worse and there is no spread "from sore to sore".  Covering the lesions or improved hygiene won't help this, but of course she should keep the area clean with light washing a couple times a day.  An anesthetic ointment may help, especially one with lidocaine as the active ingredient; a pharmacist can help her select an over-the-counter product, or her gyn can recommend or perhaps prescribe one.  Corticosteroid creams (hydrocortisone and related products) sometimes help as well, but should not be used unless directed by her doctor.

With the weekend coming, I recommend she call her doctor if things are no better by tomorrow.  Most likely this can be handled by phone, but perhaps the doc will want to see her in person.  In the meantime, she should continue valacyclovir as prescribed.  And tell her to do her best not to worry.  With or without additional treatments, the valcyclovir will kick in soon -- she won't be in serious pain for very long.

Also, make sure she understands that even though herpes can recur later, repeat outbreaks are uncommon with genital HSV-1; almost half of all persons have no recurrent outbreaks at all.  And recurrent outbreaks are typically much milder -- pretty much the same as your recurrent cold sores, not the multiple painful lesions she has now.

I hope this has helped.  Best wishes--  HHH, MD
Helpful - 1
Avatar universal
Hate to be a bother but new thoughts keep popping up. She is complaining about a sore in the back of her throat . Is it possible , since she has no immunity she has it there as well and is it possible that it can spread to her eyes. I know I am probably being paranoid but this is all scary as hell . Thanks again
Helpful - 0
239123 tn?1267647614
MEDICAL PROFESSIONAL
I'm not familiar with liquid bandaids and have not used them in herpes patients.  Sorry.
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Avatar universal
Thanks for all yur help. You have made this a little easier
Helpful - 0
239123 tn?1267647614
MEDICAL PROFESSIONAL
Thanks for the thanks.  I'm glad to have helped.
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Avatar universal
Thank you . One more question . We heard liquid band aides help . Any validity to that ?
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Avatar universal
You may have missed this response please reply

mrpatnpend  
19 hours
To: H. Hunter Handsfield, M.D.
Hate to be a bother but new thoughts keep popping up. She is complaining about a sore in the back of her throat . Is it possible , since she has no immunity she has it there as well and is it possible that it can spread to her eyes. I know I am probably being paranoid but this is all scary as hell . Thanks again
Helpful - 0
239123 tn?1267647614
MEDICAL PROFESSIONAL
Patience, patience.  You did not need to re-post the same comment.  The moderators are not on call 24/7, and it often takes a day or two before follow-up questions can be accommodated.  

Assuming the sexual exposure when the virus was transmitted included kissing, your partner may well have acquired genital and oral HSV-1 simultaneously, explaining the ulcer in her throat.  However, even in this situation, eye infection is rare -- and extremely unlikely once she is taking anti-HSV treatment.  If she develops an irritated or sore eye, of course it should be checked out right away.  But even then, no worries; ocular herpes is easily and effectively treated if diagnosed and treated promptly.

How are her genital symptoms doing?
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Avatar universal
Thanks . Genital area seems to be getting slightly better . Now how ever , she may be getting something on her lip in addition to the sore she has in the back of her throat.  Throat sore is fairly recent

Thanks again
Helpful - 0
239123 tn?1267647614
MEDICAL PROFESSIONAL
Once symptoms start to get better, they tend to improve rapidly.  She'll probably be a lot better by Monday.
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Avatar universal
Thanks again be well . she is still getting new sores though not as pronounced  . We are hoping the new sores stop completely In a  day or so. Thanks again I will post when she is on the mend.
Helpful - 0

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