Prodrome,ActiveLesion, or something else?

[30plusyears]

Hi Terry,

I’ve had HSV2 confirmed by westernblot for over 30 years. My initial outbreak was one of the worst the dr had seen. I used to have 6-7 obs per year but have had it very under control for the past 20 years either due to the passage of time or because I take Valtrex 500mgs daily or both. My husband (of 20+ years) does not have hsv2 or if he does, he has no symptoms so I worry often about transmission to him. I am approaching menopause and am starting to experience some hormonal changes. This week, right after my period ended, I started with what seems like prodromal symptoms – a red itchy spot on one labia minora near the top. On examination it does appear to be small lesion, although it’s difficult to tell. I have no other symptoms but a dull headache.It feels exactly like a herpes ob is starting, no pain just itching. I immediately took 3 X 500 mgs of valtrex and 12 hours later another 3X 500 mgs. It’s now 72 hours later and nothing has changed – the small spot is still there and the itch remains. It’s like an elongated prodrome but perhaps it’s something else. I had symptoms like this several years ago that lasted for many months and the dr’s were unable to explain it. It was swabbed and came back negative but this may be because I take valtrex daily.Eventually, one dr gave me a cortisone cream to put on it in case it was a herpetic neuralgia. That did seem to help but it seems to me cortisone is the wrong thing for herpes! Does cortisone help with herpetic neuralgia? I am wondering how to proceed – ie if I should assume I am symptomatic. Can Valtrex actually cause the prodrome to last longer than it otherwise would? At a certain point, I’d rather just have the full sore emerge so it can crust over and heal. Are you aware of any other conditions/hormonal issues that can cause symptoms like this? Due to the discomfort not diminishing, I find I am quite anxious about it and my head space is preoccupied wondering whether I am having an ob. Thanks

[Terri Warren]

I think if the medicine made no impact on the symptoms, it is very unlikely that this is a herpes outbreak though I cannot be certain about that. Do you use antiviral therapy daily to reduce transmission to your husband? With the antiviral therapy, it is going to be difficult to know for sure if this is an outbreak. Sorry I cannot be more certain here!

Terri

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