The H Word...

Your plumber might have it....your roommate might have it....your former fuck buddy might have it...even the dick doctor might have it!

You might have guessed that I'm talking about herpes--the H Word that doesn't get talked about enough (in my opinion). People shy away from the H Word, when it's actually super common. Did you know that an estimated 90% of Americans have been exposed to Herpes Simplex Virus Type 1 (HSV-1)? That's a butt-load of people!

I got diagnosed with genital herpes when I was in my teens, and I remember being confused and super embarrassed. But over the years, I've learned a lot about it, treated lots of patients, and learned how to live with the virus. Herpes can't be cured, but it can be managed with a little TLC.

Here's a little herpes self-care 101...

WHAT CAUSES OUTBREAKS?
Outbreaks can happen at any time, but they may be more likely to happen when:
• You first get the herpes virus from a partner (outbreaks generally get less common after you've had the infection for more years).
• You have a compromised immune system, from HIV infection or from taking medications that suppress the immune system, like chemotherapy.
• You have an infection with HSV-2 compared to HSV-1.

Some people notice situations that seem to bring on outbreaks. These can include:
• Fatigue (tired/exhausted/too much P & P).
• Stress (emotional, mental, or physical).
• Getting too much sun.
• Irritating your penis or vagina (longer, rougher, crystal sex. ouch!).
• Menstrual periods (our female-bodied friends).

OH SHIT! I'M HAVING AN OUTBREAK!...
An outbreak of herpes blisters can be painful. Try the following:

Medical Treatments:
• Take medication for herpes. This is especially important if you are having your first outbreak. Many people with herpes either take medication every day to avoid having outbreaks or have medication on hand to start as soon as they think they are beginning to have an outbreak.
• An over-the-counter pain reliever like acetaminophen (Tylenol), can reduce pain. Use only as directed!

Caring for Herpes Sores:
• Dip a washcloth in cool water, wring it out, and place it on the sores. Do this several times per day, to reduce pain and itching (keep this washcloth to yourself, so you don't spread the virus).
• Wash sores gently with soap and water, then pat dry. Put on loose-fitting cotton underwear, and loose-fitting pants. Leave the sores uncovered--bandages may slow the healing process!
o Wash your hands with soap and water before and after touching sores; touching your eyes or genitals; and touching a contact lens.
• Leave the sores alone. Touching or picking at them will slow the healing process. Don't put a lotion or ointment on sores unless your medical provider has prescribed it.
• Sex can irritate the sores, and expose your partner(s) to infection. Give your genitals, anus, or mouth a rest when you have blisters. If you do have sex, use a barrier like a condom to reduce the chance of spreading herpes. Use water-based lube to reduce friction that can irritate the skin, leading to an outbreak.

Care For Yourself:
• Treat yourself to a nap, a warm bath, or a movie (porn optional). Your self-care is important!
• Try to eat balanced, healthy meals. Your body will thank you!
• Try to get a good night of sleep every night.
• Try a meditation or relaxation exercise. Some people experience additional emotional stress when they have an outbreak.
• Use sunscreen to reduce stress to your skin.
• Have a heart-to-heart with a friend/loved one who can offer you emotional support.
• Did you know there are in-person and online support groups for individuals who have herpes infection?
• Think about couples counseling. You can talk about sex and intimacy, and learn about reducing the risk of transmission to your partner.

KEEP COVERAGE ON-HAND:
• Condoms and oral barriers like dams provide the most coverage and protection against skin-to-skin contact that can spread herpes. Check out my article Mouthing Off, for more oral sex safety tips.
• Use water-based lube to reduce friction during sex. Friction can irritate the skin in the genital area, which can lead to an outbreak.
• People who have HSV-2 can also reduce the likelihood of transmitting HSV-2 to a partner by taking antiviral medications. Antivirals can also make outbreaks less painful and happen less often. Medications can reduce outbreaks by up to 80%. Some of these medications are meant to be taken every day, others are meant to be taken at the first sign of a herpes outbreak. Talk with your medical provider to see if antivirals are right for you.
• Having herpes can make it easier to spread or get HIV. That's because herpes sores can bleed or create tiny breaks in the skin or mucous membranes--making it easier for HIV to get in/out.

SAFER USE:
• You may feel camaraderie passing the pipe around, but sharing can spread herpes. Consider getting your own pipe, or if you are going to share, discreetly wiping it off with your sleeve or an alcohol wipe.
• If you're using, you may get run-down from lack of sleep, poor nutrition, and dehydration. Try to plan out your use. Seattle Counseling Service offers FREE one-on-one assessments for guys who want to cut back or quit crystal, or just talk about options.

Be kind to yourself and each other. In good health,

Dr. Dick