How to recognise an outbreak / Is medication a must?

[Maximo]

I got diagnosed HSV2 recently and, besides the difficulties I have coping with the fact that this virus won’t go away, I’m getting lots of anxiety.

I keep checking my butt to see if it has come back every day, I’ve seen small pimples near the area where I had my first outbreak but they feel different and have disappeared quickly. Is there any way to be sure I’m getting an outbreak? I try telling myself it’s something else.

I find this quite difficult to understand: When I got diagnosed the doctor said he will only prescribe more Valtrex if I feel unwell, is this how it works for everyone? I find it quite complicated as I need to take 1 hour to go see the doctor and maybe he can say it’s not an outbreak? I also understand that maybe my immune system can deal with the outbreak without medication but I will only discover this by seeing how my body reacts to the virus over time  is this correct?

When I searched online apparently Valtrex is not sold over the counter, how do others deal with this? I’ve found one pharmacy that sells without prescription, I do feel spending 40USD for 10 tablets is a lot, specially considering I might not need it. On the other hand I think “no harm taking extra precaution”, would this be ok?

When I was diagnosed I was quite confused as my rash didn’t look like the average picture you see online when you search for HSV2 or cold sores. The doctors only answer was that he has seen many cases and not all rashes look the same. Is there a straightforward way to know I’m having an outbreak? Given my usual anxiety (even before diagnose) I tend to overthink and tell myself, for example, “yes I’m getting tingling feeling” but it might be nothing.

[AnnieO]

I think our symptoms of an outbreak can vary. Sometimes mine will feel like a yeast infection might be coming on, or I just have a sore spot because I wore the wrong pants on a bike ride. The glands in my groan area get sore. I've been dealing with this virus for over 30 years now. I went a long time between outbreaks, so when I did have one it took me by complete surprise. The Doc put me on meds but I never took the maintenance meds that they talk about here. I hardly will take an ibuprophen, only when my body REALLY hurts. I'd like to say that your best defense is a good diet and exercise, fresh air and sun. Positive attitude couldn't hurt either. Anxiety doesn't help your state of mind in general. Take it day by day and try not to stress. I feel your pain.. literally. 

Hang in there. stay connected to the group, they all have great advise. 

Message me if you'd like to discuss further about this "issue"

[mr_hopp]

Hey @Maximo,

I'm really sorry to hear about your anxiety. @AnnieO's advice is spot-on. Herpes outbreaks can vary widely in appearance, so it's tricky to be 100% sure just by looking. It's fine to wait it out to see if you get outbreaks, but your doctor should be open to giving you medication if you want to suppress it (and even if you don't get outbreaks, it still cuts down on asymptomatic shedding, which will keep partners safe.) FYI, there are only 2 reasons to take herpes medication: https://www.herpesopportunity.com/post/herpes-medication

As for saving money on meds, this is the place I use for my Acyclovir (works the same as Valtrex, but you just take it twice a day instead of once, but discuss with your doc to see if it's right for you):
https://costplusdrugs.com/medications/acyclovir-200mg-capsule-zovirax/

Don't stress too much over every bump. If you're unsure, keep a list of symptoms and chat with your doctor about them. And stay connected with us here—you've got a supportive community to lean on.

Take care!

[Maximo]

Thanks @AnnieO and @mr_hopp

I’ll try to ask the doctor next time I book an appointment, he didn’t seem to interested into listen to my stress, I’ll see how that goes. 
Is acyclovir as good as Valcyclovir?

I read the docs you sent to me, is it fair to say that if it’s not too uncomfortable I shouldn’t take herpes medication? Some online websites says medication will only reduce the recovery period of HSV2 by 1 day, makes me wonder if it’s worth taking it.

I also wanted to ask, when I started on Valtrex I got headaches after 3 days of having it, is it likely to be a reaction to medication? I might be overthinking this one as well!

[mr_hopp]

Hey @Maximo,

It's good you're reaching out to your doctor. And it sucks that he didn't have time to comfort you. This is unfortunately a common occurrence. Try to emphasize your concerns when you see him next time. You'll want to have some medication on-hand anyway so you can at least treat your symptoms episodically if you notice an outbreak coming on in the future. And yes, Acyclovir is very similar to Valacyclovir, but instead of once-daily (Valtrex), it's taken twice (one in morning, other eve). Both help reduce outbreak severity and frequency, but you pay more for the convenience of just needing to take one pill per day instead of two. 

As for whether to take the medication, if your symptoms aren't too uncomfortable, it's often fine to go without them. Medication mainly helps reduce symptoms and speed up recovery. And of course, if you're having sex with a partner who doesn't have herpes, it lessens viral shedding and therefore reduces transmission rates by about 50%, so it's a necessity in sero-discordant relationships. 

Headaches can be a side effect of Valtrex, but if you're unsure, keep track of your symptoms and discuss them with your doctor. Might just be a random coincidence with one occurrence. 

Take care!

[Maximo]

I have another tricky question:

Two days ago I noticed I have very tiny lesions that look the size of a hair follicle and like some kind of lump, which I scratched by mistake and it felt like burning. I thought the worse as ordered some Valtrex 500 home. Even though I’m not sure if this is an outbreak, I have an upcoming trip and loads of work, can’t really afford to take 2 hours to go to the doctor. 

On Google I had found in several places that the average doses are:

2 tables twice a day for initial outbreak for 10 days

1 tablet twice a day for recurrences for 3 days 

So I’ve been taking 1 tablet twice a day, it does feel better but it’s still not gone. 

Should I continue until it’s gone or just stop tonight?

From what I gather on info online and several personal experiences I’ve found, I see there’s no straight answer. It feels like medication will help my immune system attack the virus and recover so maybe that’s why 3 days is suggested?

As I mentioned in my previous post, I’m thinking to get more options from the doctor next time I go (last time insurance covered for Valtrex). The doctor seems really good at what he does (I spent 2 months with another doctor that misdiagnosed) but he doesn’t seem to have a heart. It really kills me when I remember he said he’ll prescribe more if it comes back. 

[mr_hopp]

Hey @Maximo,

It sounds like you're preparing for a busy time and don't want to lose that momentum! Valtrex (Valacyclovir) typically works best when taken at the right dose for the right duration. And the dose depends on the tablet. For a recurrent outbreak, the common recommendation is 500 mg twice daily for three days. If it's still lingering, consult your doctor about continuing. It's smart to get your doctor's input on when to stop or adjust the dose.

Make sure you also stay hydrated and try not to stress too much about it. Take care and stay well!

[Maximo]

Thanks!

That’s exactly the problem, not much time right now. 

I’ll try to set an appointment soon with him once I’m back. 

[mr_hopp]

Yeah, that's the bind I'm in, too. I can't be giving you direct medical advice since I'm not a doctor. Sorry I can't be of more help!