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Dr. Andrew Rynne

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Hi, I woke up with a horrible herpes out break

Answered by
Dr.
Dr. Antoneta Zotaj

General & Family Physician

Practicing since :2004

Answered : 1789 Questions

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Posted on Thu, 3 Jan 2019 in General Health
Question: Hi,

I woke up with a horrible herpes out break the worse I have ever dealt with, I also woke up with a very bad sore throat, headache , congestion and lower back pain. This is all after having oral and normal sex. I have herpes but I have never gotten this sick from an out break. What can it be and what can I do?
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Follow up: Dr. Antoneta Zotaj 0 minute later
Hi,

I woke up with a horrible herpes out break the worse I have ever dealt with, I also woke up with a very bad sore throat, headache , congestion and lower back pain. This is all after having oral and normal sex. I have herpes but I have never gotten this sick from an out break. What can it be and what can I do?
doctor
Answered by Dr. Antoneta Zotaj 50 minutes later
Brief Answer:
Few more questions asked and kindly asked for the answers

Detailed Answer:
Hello,

Thank you for the information you already provided. I would kindly ask for a few more things:
Is this herpes in the oral mucosa or genital mucosa? Is it rash with vesicles (small fluid filled transparent lesions)?
Do you have fever or any other complaints?

If you would like to have treatment for herpes the sooner it is started the better effect and you are on time so please let me know asap on the above issues. If it is genital herpes is the one that we generally treat with acyclovir orally for a week or so to help the infection heal sooner.

Waiting to hear from you soon.

Kind regards,

Antoneta Zotaj
General and Family Physician
Above answer was peer-reviewed by : Dr. Yogesh D
doctor
doctor
Answered by Dr. Antoneta Zotaj 0 minute later
Brief Answer:
Few more questions asked and kindly asked for the answers

Detailed Answer:
Hello,

Thank you for the information you already provided. I would kindly ask for a few more things:
Is this herpes in the oral mucosa or genital mucosa? Is it rash with vesicles (small fluid filled transparent lesions)?
Do you have fever or any other complaints?

If you would like to have treatment for herpes the sooner it is started the better effect and you are on time so please let me know asap on the above issues. If it is genital herpes is the one that we generally treat with acyclovir orally for a week or so to help the infection heal sooner.

Waiting to hear from you soon.

Kind regards,

Antoneta Zotaj
General and Family Physician
Above answer was peer-reviewed by : Dr. Yogesh D
doctor
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Follow up: Dr. Antoneta Zotaj 6 minutes later
It is genital mucosa I also have a swollen bump inside on the right side where my out break is in my vagina. Is this normal to be having flu like symptoms? And also why does my back hurt so bad ?
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Follow up: Dr. Antoneta Zotaj 0 minute later
It is genital mucosa I also have a swollen bump inside on the right side where my out break is in my vagina. Is this normal to be having flu like symptoms? And also why does my back hurt so bad ?
doctor
Answered by Dr. Antoneta Zotaj 36 minutes later
Brief Answer:
Detailed answer below- oral acyclovir is the most important treatment

Detailed Answer:
Hello,

The best treatment that will affect the length and severity of the genital herpes infection is Acyclovir which is an antiviral and you need prescription for it. But starting it as soon as possible (within the first day is the best, after day 3 has not much effect) will prevent spread of the lesions and quick healing of the lesions that have already developed.
The dose for the acyclovir can be different:
- acyclovir 400 mg orally 3 times daily for 5 days
- acyclovir 800 mg orally twice daily for 5 days or 3 times daily for 2 days

During the treatment you will need to drink plenty of water so to make it easier for the kidneys to clear it and do not get damaged.

Other things that might help with pain otherwise is Ibuprofen in high doses: 600 mg 4 times a day or 800 mg 3 times a day after food and be cautious for stomach problems as it might hurt the stomach. You may add Omeprazole 20 mg 1-2 pills a day to help protect the stomach. Combined with paracetamol 500 each time you take it might help with the pain.

Sits bath (putting your genital and buttock area in warm water, not hot, and some baking powder and salt mixed with it and staying there 20 minutes) can help with the pain as well.

Alternative treatments with aloea, zinc, echinacea, bee products or L-lysine are not found to be effective in genital herpes in studies.

As for the flu symptoms, they may happen with herpes infection, not very common with genital herpes but still can happen. Your back pain might be part of the flu symptoms you are having, I don't think it is related directly to the herpes infection or lesions. The pain medications should help with it.

Genital herpes is a sexually transmitted disease (STD) and as a routine check all patients with one STD should be checked for other ones so it is recommended for you to have a routine check for: HIV, Syphilis, Hep B and C, chlamydia and gonorrhea, trichomonas and have regular pap tests and HPV testing.

To conlcude:
-Please see your doctor as soon as possible and take the prescription for acyclovir as soon as possible as it is the only treatment that effectively reduces the symptoms and the duration of the infection if started on time.
- talk with the doctor on the need for tests to rule out other STD if you have not had this done recently

I hope I have answered to your question and I wish you quick healing. Please let me know if I can assist you further.

Kind regards,

Antoneta Zotaj
General and Family Physician
Above answer was peer-reviewed by : Dr. Remy Koshy
doctor
doctor
Answered by Dr. Antoneta Zotaj 0 minute later
Brief Answer:
Detailed answer below- oral acyclovir is the most important treatment

Detailed Answer:
Hello,

The best treatment that will affect the length and severity of the genital herpes infection is Acyclovir which is an antiviral and you need prescription for it. But starting it as soon as possible (within the first day is the best, after day 3 has not much effect) will prevent spread of the lesions and quick healing of the lesions that have already developed.
The dose for the acyclovir can be different:
- acyclovir 400 mg orally 3 times daily for 5 days
- acyclovir 800 mg orally twice daily for 5 days or 3 times daily for 2 days

During the treatment you will need to drink plenty of water so to make it easier for the kidneys to clear it and do not get damaged.

Other things that might help with pain otherwise is Ibuprofen in high doses: 600 mg 4 times a day or 800 mg 3 times a day after food and be cautious for stomach problems as it might hurt the stomach. You may add Omeprazole 20 mg 1-2 pills a day to help protect the stomach. Combined with paracetamol 500 each time you take it might help with the pain.

Sits bath (putting your genital and buttock area in warm water, not hot, and some baking powder and salt mixed with it and staying there 20 minutes) can help with the pain as well.

Alternative treatments with aloea, zinc, echinacea, bee products or L-lysine are not found to be effective in genital herpes in studies.

As for the flu symptoms, they may happen with herpes infection, not very common with genital herpes but still can happen. Your back pain might be part of the flu symptoms you are having, I don't think it is related directly to the herpes infection or lesions. The pain medications should help with it.

Genital herpes is a sexually transmitted disease (STD) and as a routine check all patients with one STD should be checked for other ones so it is recommended for you to have a routine check for: HIV, Syphilis, Hep B and C, chlamydia and gonorrhea, trichomonas and have regular pap tests and HPV testing.

To conlcude:
-Please see your doctor as soon as possible and take the prescription for acyclovir as soon as possible as it is the only treatment that effectively reduces the symptoms and the duration of the infection if started on time.
- talk with the doctor on the need for tests to rule out other STD if you have not had this done recently

I hope I have answered to your question and I wish you quick healing. Please let me know if I can assist you further.

Kind regards,

Antoneta Zotaj
General and Family Physician
Above answer was peer-reviewed by : Dr. Remy Koshy
doctor
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Follow up: Dr. Antoneta Zotaj 30 minutes later
But what about my sore throat?
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Follow up: Dr. Antoneta Zotaj 0 minute later
But what about my sore throat?
doctor
Answered by Dr. Antoneta Zotaj 10 minutes later
Brief Answer:
Detailed answer below

Detailed Answer:
Hello,

Acyclovir and the pain medications (paracetamol and ibuprofen) will help with it as well.
Sometimes it is a flu like viral infection that might reduce your immune response and reactivate the herpes virus sleeping in your body (paracetamol and ibuprofen are the main treatment for the sore throat in this case) or the herpes virus itself can cause flu like symptoms (even though rare in genital herpes, it still can happen) and the sore throat can be from that as well (acyclovir and paracetamol with ibuprofen will help in this case).
No matter which is the cause of the sore throat (another virus or the herpes virus) the treatment in this case is the same due to the need to treat the genital herpes with acyclovir and paracetamol and ibuprofen which will help with the sore throat as well.

Make sure you don't drink hot drinks or soups as hot fluids or food can burn the inflamed mucosa and worsen the pain in the throat extending the time of healing.
Local lozenges might help with the pain.

I hope I have answered to your query. Let me know if I can assist you further.

Take care.

Kind regards,
Antoneta Zotaj,General & Family Physician
Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
doctor
Answered by Dr. Antoneta Zotaj 0 minute later
Brief Answer:
Detailed answer below

Detailed Answer:
Hello,

Acyclovir and the pain medications (paracetamol and ibuprofen) will help with it as well.
Sometimes it is a flu like viral infection that might reduce your immune response and reactivate the herpes virus sleeping in your body (paracetamol and ibuprofen are the main treatment for the sore throat in this case) or the herpes virus itself can cause flu like symptoms (even though rare in genital herpes, it still can happen) and the sore throat can be from that as well (acyclovir and paracetamol with ibuprofen will help in this case).
No matter which is the cause of the sore throat (another virus or the herpes virus) the treatment in this case is the same due to the need to treat the genital herpes with acyclovir and paracetamol and ibuprofen which will help with the sore throat as well.

Make sure you don't drink hot drinks or soups as hot fluids or food can burn the inflamed mucosa and worsen the pain in the throat extending the time of healing.
Local lozenges might help with the pain.

I hope I have answered to your query. Let me know if I can assist you further.

Take care.

Kind regards,
Antoneta Zotaj,General & Family Physician
Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
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