1. This recurrence has been worse than my initial outbreak which consisted of 2-3 small ulcer type lesions. I note what you said in your previous answer about this still being early days (3 months in from first outbreak) but I’m nonetheless concerned about its severity. Is this normal to have such a serious recurrence? Is it possible to provoke or worsen an outbreak through trauma such as knocking the scab?
No, I don’t believe so and this is extremely atypical for a recurrence. Are you taking any other meds, like steroids for anything?
2. The first sore of the recurrence was similar to my initial outbreak, appearing as an ulcer. The ‘second wave’ of the recurrence, however, appeared as lots of small clusters of fluid filled blisters. I have had ulcer type lesions swabbed by PCR both times and returned positive for HSV-1. I note that blisters are more consistent with HSV-2. Can recurrences manifest differently (ie ulcer or fluid filled blisters) or is it possible that I have HSV-2 as well as HSV-1? Perhaps the HSV-2 did not appear on the PCR swab as those lesions weren’t present at the time the sample was taken?
Have you had a recent encounter that would put you at risk for HSV 2? The blisters of HSV 1 and HSV 2 look identical – no different at all. I believe that HSV 2 would have shown up on the swab had it been there
3. My doctor prescribed 500mg of Valtrex 2x / day for three days which I started on day 3 or so. I understand this is the recommended dose for recurrences but it doesn’t seem to have made a difference in my case. Should I continue taking Valtrex again given this has been quite a long recurrence or would it make no difference now that I’m some 8-9 days in.
So very odd. Are you applying anything to the sores at all? You could try the cold sore dosing since this is HSV 1 (albeit genital). That’s 2 grams, the 12 hours later 2 grams of Valtrex again, see if you get any benefit.
Terri