This disease is a manifestation of reactivation. A primary outbreak is typically the most severe and most painful outbreak but can vary in severity. Patients complaining of a primary infection may present with burning, itching, painful ulcerations in the genital region along with headaches, malaise, fever, and inguinal lymph node enlargement. As the earliest signs of recurrent episodesm prodromal symptoms may occur presenting as paresthesia and pains in the areas of lumbosacral dermatomes (Sauerbrei, 2016). Patients who have not developed antibodies to either HSV-1 or HSV-2 tend to have the more severe symptoms than those exposed. Subsequent outbreaks tend to diminish in severity and occurrence as the virus ages within the person. Patients with recurrent outbreaks may complain of a prodromal burning sensation 24 to 48 hours prior to an outbreak. Lesions will crust over 7-10 days without subsequent therapies. Stress, menstruation, and sun exposure are some the known factors that appear to initiate an outbreak. However, a third of infected individuals do not experience the lessening of symptoms over time (Cernik et. al., …show more content…
Patients may feel distressed, confused as to how it happened, sad, and disappointed that they contracted the disease (Merin & Panchankis, 2011). The main psychological stressor is the stigma that comes with the diagnosis. Genital herpes jokes are mainstreamed in Hollywood today from movies such as Pitch Perfect and The Hangover to name a few. Dr. Anna Wald states that “Herpes has a stigma attached to it that even H.I.V. doesn’t have anymore” (Sabo, 2010). It is important to understand as a clinician the implications of an STD diagnosis on a patient, especially if they were not expecting the diagnosis. Understanding the patient’s feelings can aid in creating a treatment plan. Given a diagnosis of HSV-2, what are the best treatment options for different patient needs? Though HSV-2 is incurable, there different approaches to reduce outbreak during and frequency of recurrent outbreaks. One approach is pharmaceuticals. A second approach to those who have adverse effects to oral drug therapy is topical drug therapy. Another approach to those who are adverse to pharmaceuticals for fear of stigma or other reasons is a more natural approach with supplements. o Subtopic 1 – the common three (acyclovir, famciclover, valacyclovir) Acyclovir, valacyclovir, and famciclovir are available for standard antiviral treatment of genital herpes (Sauerbrei, 2016). These drugs