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How Long Does a Herpes Outbreak Last?

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When first seeing herpes lesions, you may worry about their duration. First, I want to assure you that, after the initial episode, subsequent outbreaks are less intense. In the meantime, for initial infection, I’ve outlined a timetable for what to expect.

I also share how to guard against future outbreaks. Don’t fear that the virus is uncontrollable. You can moderate its effects. Here’s how to manage flares of oral and genital herpes.

1. Comforting Numbers

Helpful is knowing you’re not alone. Oral herpes is very common, affecting 50 percent of Americans. Regarding genital herpes, one in eight Americans has it, roughly 12 percent of the US population.

Of women infected with herpes, 60 percent have no symptoms. In those who do, the average number of yearly outbreaks is four or five. Still, some people report that, after one or two episodes, they’ve remained symptom-free.

Lesions are traced to the herpes simplex virus, abbreviated HSV. Two types of HSV exist. HSV-1 produces oral sores. Most frequently, genital herpes is caused by HSV-2.

2. Symptoms and Duration

On average, here’s the symptom sequence:

  • tingling – signaling the virus is active
  • blistering – fluid-filled sacs appear, red and itchy
  • ulceration – blisters open, oozing a yellowish or clear liquid, revealing shallow sores
  • scabbing – lesions develop crusts
  • healing – sores disappear and skin dries, flaking off

How long does a herpes outbreak last?

Generally, blisters form within two to 20 days of infection. Other symptoms that may arise include headache, muscle pain, loss of appetite, fever, joint aches, fatigue, and swollen lymph nodes, pea-sized filtering organs present in the groin, underarms, and neck.

Since a fever or cold can reactivate oral herpes, the lesions are called fever blisters and cold sores. Common sites are along the edges of the lips and inside the mouth, sometimes with pain during swallowing. Touching fever blisters can transmit HSV to the hands and face.

Genital herpes brings sores around the penis, scrotum, and vagina, and possibly the anus, thighs, and backside. Lesions begin as small, red bumps, evolving into blisters and open sores that tingle, burn, and itch. Burning may also accompany urination.

Gradually, the blisters scab and fall off, usually without scarring. During the first herpes episode, lesions can take two to three weeks to resolve. On average, subsequent flares last three to 14 days, with milder symptoms.

3. Treating Lesions

For retail sources of products mentioned below, click on the highlighted links.

CAUTION – When doctoring sores, first wash your hands, followed by donning disposable gloves. After treating lesions, rewash your hands. Discard supplies that contacted sores during handling, such as gloves and cotton balls.

1. Aloe Vera Gel

The sap of the aloe plant relieves swelling, redness, and pain. Polysaccharides in aloe rouse white blood cells, T-helper cells, and antibodies, your immune defenders. Aloe components that help repair skin are amino acids, zinc, and Vitamins C and E. Like aspirin, aloe vera gel contains salicylates, easing soreness.

A 2016 study in the Journal of Dentistry showed that aloe vera speeds healing of oral herpes by hindering HSV-1 growth. A 1997 study cited by the Journal of Dermatological Treatment found that aloe shortens the healing time of genital blisters. Additionally, many study subjects reported they were outbreak-free for 15 months after using aloe on lesions.

Store aloe vera in your fridge. Apply the cooled gel to lesions, and allow to dry, repeating as needed.

2. Apple Cider Vinegar

With anti-inflammatory, disinfectant, and astringent properties, apple cider vinegar (ACV) soothes lesion swelling, pain, and redness, promoting faster healing. Taken internally, ACV builds immunity.

For topical use, mix one teaspoon organic apple cider vinegar with three teaspoons water. Saturate a cotton ball with the mixture, and hold against sores for a minute. Perform this treatment three times daily, until lesions have healed. You may be able to halt an outbreak by applying ACV at the onset of tingling.

Also, consider starting your days with an ACV beverage, drinking two teaspoons ACV mixed with one cup water. Or you may try this detox tea:

How to Use Apple Cider Vinegar for Herpes ?

3. Topical Black Tea

Tannins are compounds in tea with antiviral effects. Applying a black tea bag to herpes lesions quells pain and inflammation while curbing viral growth.

Brew a cup of black tea, and let it cool until lukewarm. Place the tea bag directly on lesions, keeping it there for five minutes. Or, soak a paper towel in black tea, and apply to sores. Repeat three times daily.

4. Lemon Balm

Botanically termed Melissa officinalis, this herb wields antiviral power. A 2008 study reported in Phytomedicine found that melissa essential oil virtually slays HSV on contact.

Topically, lemon balm cools the swelling, redness, and burn of herpes lesions. It also prevents outbreaks. To apply melissa essential oil, blend two drops melissa essential oil with one teaspoon coconut oil, and massage into lesions. Lemon balm remedies are also available as salve and lip balm.

Dress lesions with essential oil, salve, or lip balm three times daily, until the sores clear.

You can also drink lemon balm tea to ease other herpes related symptoms, such as anxiety, depression, and insomnia. WARNING – Do not drink lemon balm tea if you take thyroid medication, as the herb can interfere with drug effectiveness.

5. Propolis Ointment

Propolis, a resin produced by honeybees and poplar trees, has antiviral clout. Additionally, propolis confers healing via flavonoids, plant pigments that aid immunity and tame inflammation.

A 2000 study featured in Phytomedicine found that propolis worked better than the drug acyclovir at suppressing HSV. The research involved 30 men and women with genital herpes, treated with propolis salve four times daily. Women with cervical and vaginal lesions used propolis-treated tampons.

At day 10 of the study, the propolis subjects were compared with 30 participants who were taking acyclovir. In the propolis group, 24 of 30 subjects had healed, compared with 14 of 30 in the acyclovir group.

Additionally, a 2016 study reported in Medical Science Monitor showed that propolis hindered viral replication in both cold sores and genital lesions, expediting healing.

Apply propolis ointment to lesions four times daily until resolution.

WARNING – Do not use propolis if you’re allergic to bee byproducts and bee stings. Pregnant and nursing mothers should obtain physician consent before applying propolis.

6. Zinc Cream

A 2013 Indian study revealed that a 4 percent formulation of topical zinc sulfate helps genital lesions heal 40 percent faster. Zinc cream relieves skin tingling, itching, burning, and redness. It also dries up herpes blisters.

For cold sores, a 2001 study showed that cream formulated with zinc oxide and glycine reduced both symptom severity and duration.

Apply zinc cream at symptom onset, up to three times daily, until skin clears.

For more natural cold sore treatments, read this Optiderma blog. Additional home remedies for genital sores are covered in this post.

4. Infection Routes

HSV-1 lives in saliva, so you can acquire cold sores from sharing straws, cups, food, eating utensils, lipstick, lip balm, toothpaste, and kisses. HSV also resides on broken skin, so you can get it by touching contaminated objects, such as towels.

Typically, genital herpes is caused by the HSV-2 virus. However, HSV-1 can transmit to the genitals through oral sex. Otherwise, HSV-2 spreads through unprotected intercourse, when condoms aren’t used.

5. Shedding Period

Even if lesions aren’t present, HSV can spread during a “shedding period.” This is when the active virus is released through the skin.

Viral shedding is most frequent during the first three months of getting HSV. Genital herpes sheds more often than the oral type. Shedding is also most likely for one week after lesions have apparently healed. Despite such skin clarity, a high risk remains for transmitting herpes during the seven-day shedding window.

6. Virus Transmission

A large majority of people with herpes don’t know they’re carriers, showing no signs. Or, they mistake fungal infections for herpes symptoms. Being well-informed on HSV reduces transmission risk.

If you have kids, warn them not to share food, cups, eating utensils, toothbrushes, toothpaste, lip balm, lipstick, makeup, towels, and mouth-to-mouth kisses. For teens, drive home the necessity of either sexual abstention or protected sex. If your teen is sexually active, they should use latex condoms, offering more protection than the natural membrane type.

Still, latex condoms are only 50 percent effective in preventing herpes infection. Therefore, it’s best to abstain from sex during outbreaks and at least one week after symptoms resolve. Also, be alert for “prodromal symptoms,” warnings of a pending flare, such as tingling, headache, fever, joint aches, muscle pain, loss of appetite, and fatigue.

7. Dormancy

After cold sores heal, the virus enters facial nerve cells. Once genital lesions resolve, the virus migrates to nerve cells near the spinal cord. In both instances, the virus then becomes inactive or “dormant.”

However, HSV can spontaneously reactivate. Then, it moves from nerve cells back to the original site of infection, and lesions recur.

HSV can stay “asleep” for long periods. Some people have one or two flares, and then they’re symptom-free. Unfortunately, the immune system can’t destroy HSV, so it remains inside the body throughout a person’s lifetime, even without signs of infection.

8. Averting Recurrence

1. Maximize lysine.

This essential amino acid reduces the severity, duration, and recurrence of herpes symptoms. Lysine also strengthens immunity. Our bodies can’t produce lysine, so we must obtain it from food. Potent sources are apricots, papaya, figs, mango, apples, pears, beets, eggs, yogurt, and white beans.

Also helpful is taking lysine supplements. For a severe outbreak, take 1,000 mg three times daily, with food. This is the dose recommended by a 1987 study published in Dermatologica. Study participants on this regimen had milder symptoms, faster healing time, and fewer outbreaks. As a preventive measure, take 500 mg of lysine daily.

Lysine also counteracts the effects of arginine, an amino acid that revs the speed at which HSV replicates.

WARNING – High doses of supplemental lysine can cause diarrhea, nausea, and stomach cramps. Since lysine supplementation hasn’t been studied in pregnant and nursing mothers, they shouldn’t take concentrated lysine. The same precaution exists for people with kidney and liver disease. However, lysine-rich foods can be safely eaten.

2. Avoid arginine foods.

To hamper HSV activity, reduce your consumption of chocolate, orange juice, cola, beer, peas, wheat products, oats, grain cereals, coconut meat, carob, gelatin, pecans, almonds, peanuts, cashews, walnuts, and sesame seeds.

Also consider eliminating foods that raise arginine levels, such as coffee, caffeinated tea, cantaloupe, watermelon, and cucumber. Here are additional dietary tips for staving off flares.

3. Curb stress.

Take time to relax daily, as the virus is sparked by emotional stress, which suppresses your immune defenses. Diffuse tension with fun types of exercise, such as dancing, gardening, biking, hiking, skating, and tai chi. Other stellar stress relievers are guided imagery, creative visualization, and meditation.

4. Beware other outbreak triggers.

Since UV rays kindle herpes flares, when outside, wear SPF 30 sunscreen and lip balm. Also, skip tanning beds. Another herpes instigator is fatigue, so aim for seven to eight hours of nightly sleep.

As mentioned, fever blisters can recur with the onset of a cold and fever. Herpes can also reactivate during menstruation, pregnancy, infections, tooth extractions, and physical injuries.

5. Replace oral products.

After a fever blister breaks, prevent reinfection by obtaining a new toothbrush. Then, once the sore heals completely, replace that toothbrush with a new one. Since HSV can remain on a moist toothbrush for one week, keeping new ones handy deters ongoing cold sore episodes.

Likewise, replace your toothpaste after a cold sore heals. For this purpose, buy small toothpaste tubes, to save money. Store your toothbrush in a dry location, such as a sunny windowsill. Otherwise, brush moisture will perpetuate the virus. Here’s a tip for you women – swap infected lip balm and lipstick with fresh products.

WARNING – After six days, if blisters aren’t healing, consult your doctor. Also, promptly see your doctor for these symptoms:

  • blisters near the eyes
  • pus-filled sores
  • unmanageable pain
  • difficulty swallowing and eating
  • frequent flares

A physician can help identify episode triggers and advise if there’s a risk of complications. Severe symptoms may require medication. Antiviral drugs can speed healing and lower the risk of herpes transmission.

If you do opt for medication, inform your doctor of the herbal remedies and supplements you take, as these can interact with drugs, with adverse side effects.

9. Stay Strong!

How long does a herpes outbreak last?

The first herpes episode is the most challenging, healing in two to three weeks. Subsequent outbreaks clear up faster, in three to 14 days, with milder symptoms.

How to relieve symptoms of herpes?

Promote comfort and healing by treating lesions with aloe vera gel, apple cider vinegar, black tea bags, lemon balm, propolis ointment, and zinc cream.

How to reduce the recurrence and severity of herpes symptoms?

Fuel your immunity by supplementing with lysine, avoiding arginine foods, getting daily relaxation, and enjoying regular exercise. Practice prevention by wearing SPF 30 lip balm and sunscreen and skirting other known triggers. By day six of an outbreak, if blisters show no signs of healing, see your doctor for more aggressive care.

When you’re armed with awareness and strong defenses, HSV may sleep indefinitely!

Below, please share your tips for treating herpes lesions, and spread the relief!

The Best Essential Oils for Fever Blisters

J. Beck, Holistic Nutritionist, CNC & Natural Health Writer

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