Treatment of the first attack
If you think you may have a first attack of herpes, see your doctor or go to a sexual health clinic straight away. Antiviral drugs will stop the herpes lesions from spreading further and will make you feel much better within 24 hours. They also help the first attack to clear up more quickly. The sooner you start this treatment, the better it works.
You should rest in bed until your temperature goes back to normal and you feel well again. To keep the area clean and ease the pain, bathe the sore every few hours with a mild salt-water solution. Make up a supply in a clean 2-litre bottle, putting in two level teaspoons of salt and filling the bottle with water – it need not be boiling or hot. Moisten a wad of cotton wool or old rag with the solution and gently dab the sore and the genital skin around it. Throw the cotton wool away. If the area is too painful to touch, simply pouring the salt water over the lesions or sitting in a tepid salt-water bath may bring relief. There’s generally no need to use any antiseptic.
If passing urine is a problem, it helps to apply local anaesthetic jelly (Xylocaine Jelly, which can be bought without a script) to the lesion. If you can’t empty your bladder, contact your doctor at once.
You should of course avoid any genital sexual contact until the attack has completely cleared up and the scab has dropped off. Otherwise, don’t feel too ‘poxy’. HSV can only be spread from the infected area: you can still hug and kiss people without fear of infecting them. HSV can’t be spread from the toilet seat or from cakes of soap. Always wash your hands and dry them well after touching the lesion so that you won’t risk infecting other parts of your body or others, and don’t share your bath towel with anyone. It is wise to use a separate small towel for drying your genitals.
How is herpes diagnosed?
Often the history and the appearance of the lesion is suggestive enough for treatment to be started. However, it is very important to know for sure whether HSV is the cause of genital ulcers. Many people worry themselves sick thinking they have herpes when they haven’t.
Your doctor can do tests to confirm whether or not you’ve been infected with HSV. Some fluid from a blister or the surface of the ulcer is used to try to grow and identify the virus in the laboratory. Results usually take about two weeks. A negative test for HSV doesn’t prove for certain that you haven’t been infected. If you get a negative result and the symptoms have been very suspicious, your doctor might suggest another attempt to grow the virus if you ever get similar symptoms again.
Many people are very upset to know that they have been infected with HSV, thinking that it will keep coming back and blight their sex life forever. However, while men average about four (typically much milder) recurrences per year, women generally suffer fewer recurrences than this, and these tend to become less frequent as the years pass. The occasional person with very frequent attacks is generally offered treatment with antiviral drugs.