From the Guidelines
If you're experiencing an increase in herpes outbreaks despite having a long-established infection, you should consider suppressive therapy with antiviral medications like acyclovir (400mg twice daily), valacyclovir (500-1000mg daily), or famciclovir (250mg twice daily) to reduce outbreak frequency by 70-80%. Several underlying factors can contribute to the increasing frequency of herpes simplex outbreaks, including:
- Increased stress levels, as psychological stress is a common trigger for herpes recurrences 1
- Immune system changes, such as recent illnesses, new medications (particularly immunosuppressants), or conditions like HIV that can compromise immunity 1
- Hormonal fluctuations, particularly during menstruation, pregnancy, or menopause, which can trigger outbreaks
- Poor physical health, including inadequate sleep, poor nutrition, and excessive alcohol consumption, may contribute to increased frequency
- Sun exposure, particularly UV radiation, can trigger oral herpes outbreaks It's essential to investigate these potential underlying causes and consult a healthcare provider to determine the best course of treatment. According to the most recent guidelines, routine prophylaxis to suppress virus replication should be considered for patients with frequent recurrent attacks 1. Lifestyle modifications like stress management techniques, adequate rest, balanced nutrition, and sun protection can complement medical treatment. Increased outbreaks often reflect changes in your body's ability to suppress the virus, which remains dormant in nerve cells between outbreaks.
From the Research
Potential Underlying Causes of Increasing Frequency of Herpes Simplex Outbreaks
The provided studies do not directly address the potential underlying causes of increasing frequency of herpes simplex outbreaks in the absence of a recent infection. However, they do discuss the treatment and management of herpes simplex virus infections.
Treatment and Management of Herpes Simplex
- The studies suggest that antiviral medications such as valacyclovir, famciclovir, and acyclovir are effective in treating and managing herpes simplex virus infections 2, 3, 4, 5, 6.
- These medications can help alleviate symptoms, suppress recurrences, and reduce transmission 2, 3, 4, 5, 6.
- The choice of therapy may depend on factors such as cost, ease of dosing, and acyclovir resistance 3.
Comparison of Antiviral Medications
- A study comparing famciclovir and valacyclovir found that valacyclovir may be somewhat better than famciclovir for suppression of genital herpes and associated shedding 5.
- Another study found that valacyclovir is more effective than acyclovir and equally effective as famciclovir in hastening the healing of zoster-associated pain and postherpetic neuralgia 6.
Limitations of the Studies
- The provided studies do not address the potential underlying causes of increasing frequency of herpes simplex outbreaks in the absence of a recent infection.
- Further research is needed to understand the factors that contribute to the increasing frequency of herpes simplex outbreaks.