Here is a cold sore on the lip.  There can be one cold sore or many cold sores during an outbreak.  They can be located on any mucus membrane (lip, inside lip, tongue, nose, eyes…) but usually cold sores are mostly found on outside of lip. 

Below is genital herpes.  Genital herpes can often look like the picture above but located in the genital area.  Quite often people describe genital herpes and cold sores as a “pimple” like sore that turns more into a “blister” like sore.

Lastly, we have genital warts.  Genital warts often will show up in crowded multiples (like the pic below) but you can have just a couple. 

 Hope this helps!  Contact me if you have any questions or comments about living your life with herpes or genital warts.

Herpes simplex virus –there are two different strains.  The first one is HSV-1 which typically causes cold sores and then HSV-2 which causes genital herpes.  It is possible to transfer a cold sore to the genital area and transfer genital herpes to the lip area. 

Genital herpes is a sexually transmitted disease.  Over 22% of Americans have HSV-2.  It is one of those STDs that can be spread through sexual touching (even without penetration).  Condoms can help but do not protect 100%.  Very important to know is that a person with HSV-2 can be contagious even without any obvious breakout. 

Just a short point here…I was on a Q&A site on the internet and found a ton of questions about STDs.  They would talk about HSV2 as though it is the plague but HSV1 as “just a cold sore.”  The truth is HSV1 and 2 are not that different –except one is “caught” during sex.  As a society, we do not talk about sex and STDs openly.  Currently, for schools to get federal funding they need to teach an abstinence only program!  Maybe if we spoke openly (instead of ignoring them) about these taboo subjects we could make a real difference in STD transmission.  Alright, I am off my soap box, let’s go on… J

After becoming infected, symptoms usually start in 2-14 days.  The first infection is usually the worse and can last for 2 to 3 weeks.  There are usually pimple-like bumps that turn into blister-like vesicles that 90% of people say are painful.  Flu-like symptoms may also occur (like fever, headache, body aches).  Viral shedding (which is when it is contagious) goes on for about 12 days.  Like most STDs, symptoms are often worse for women!

Once infected with the virus –it is there for life.  The first year is usually the worse –averaging about 10 outbreaks.  After that, the average person has 4 outbreaks in a year.  However, some people get very few outbreaks throughout their lifetime.  Some people have a “natural immunity” that can keep the virus under control.  Stress, other sickness and some drugs can increase risk of recurrence.

The following outbreaks are usually less painful, less serious and shorter.  They last an average of 7 to 10 days and viral shedding (when it is most contagious) is about 2 to 5 days.

Treatment for an outbreak:

·        All treatments are antiviral prescription medications.

·        It is best to start treatment with 72 hours of start of symptoms.

·        Treatment within 72 hours has been proven to lessen length and severity of symptoms.

·        All of the following drugs work equally as well…decision on which one to use is based on price and frequency of dosing.

First outbreak:

·        Valtrex (valacyclovir) 1000mg twice daily for 7-10 days

o       Available only in brand (generic is suppose to be released soon)

o       This is exactly the same as acyclovir except it has easier dosing (twice a day versus three to five times)

·        Famvir (famciclovir) 250mg three times daily for 7 -10 days

o       Available in a generic

·        Zovirax (acyclovir) 400mg three times a day or 200mg five times a day for 7 -10 days

o       Comes in a generic and the 200 mg is currently on discount lists at a few retail pharmacies

Following outbreaks:

·        Zovirax (acyclovir) 800mg three times a day for 2 days or 400mg three times a day for 3 to 5 days

·        Famvir (famciclovir) 125mg twice daily for 3 to 5 days

·        Valtrex (valacyclovir) 500mg twice daily for 3 days

Prevention of outbreaks:

·        If a patient has regular outbreaks and they want to avoid them, antiviral medication can be taken on a daily basis.

·        Zovirax (acyclovir) 400mg twice daily

·        Famvir (famciclovir) 250mg twice daily

·        Valtrex (valacyclovir) 500 mg or 1000mg once daily

Some studies have shown that OTC lysine daily can be helpful.

This is quite detailed info on the drugs but I thought it important –I have patients taking Valtrex and paying a lot of money when they could take acyclovir and pay 1/10 of the price.   So, talk with your physician about it! 

Do you know any herbal/home remedies to treat genital herpes?  Please share –leave a comment or send an email at nova@getpharmacyadvice.com

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Then, a few weeks ago, I attended a class to be trained and certified to give vaccines.  That is when I started to really look into HPV, the link to cervical cancer and the vaccine.

I became even more interested when I was on the health section of Yahoo Answers and found a ton (literally) of questions about HPV, genital warts, common warts and cervical cancer.

As we covered before in HPV and Genital Warts and Thwart the Wart, there are a lot of different strains of HPV (i.e. HPV-1, HPV-2, etc).  Some HPV strains cause common warts on feet, hands, etc.  Other HPV strains cause genital and anal warts.  Then other HPV strains have been linked to cervical cancer (these are called high risk strains).  The HPVs that cause genital/anal warts and cervical cancers are sexually transmitted diseases (STDs).

Studies show that 99% of women with cervical cancer also have HPV.   However, not everyone with high risk HPV will get cervical cancer.  Most cases of HPV are cleared naturally by the body within 2 years. 

Sometimes HPV will stick around longer –for these women their risk for cervical cancer goes up.   However, they still may not get cervical cancer because high risk HPV plus some other things (which have not been figured out yet) together cause cervical cancer.   It is like an equation:  

high risk HPV + X + Y à cervical cancer. 

So, the idea is if we can vaccinate for high risk HPV –we can take the HPV out of the equation and hopefully decrease the risk of getting cervical cancer.

In the States we now have Gardisil –the HPV vaccine that covers:

1.     Two high risk HPV strains that are responsible for 70% of all cervical cancer cases and   

2.     Two HPV strains that cause 90% of genital wart cases.

The vaccine is relatively new –it was released in the States in 2006.  Currently it is approved girls and women 9 to 26 years old and is given at a 3 shot series (given at 0, 2 month and 6 months).

Because it is new, there are a few issues that are still being worked out.  The main question is how long it provides protection.  As of now, studies show that it will protect for at least 5 years…as time goes on, there may be a need to have a booster shot.

Common side effects include pain and swelling at injection site, headache, fever, fainting.  More serious side effects include seizures, Guillain-Barre syndrome, severe allergic reaction and 17 deaths (although they were ruled as not related).

So…does it work? 

Well, for now the studies show that it works very well to prevent genital warts and abnormal pap smears. 

However, it is not possible to see how well it protects against cervical cancer because cervical cancer usually takes at least 10 years to show up after being infected with high risk HPV and the studies have not been going on that long.  It is assumed that because it decreased abnormal pap smears that it will decrease cases of cervical cancer too.  

I know this stuff can be confusing so please contact at nova@getpharmacyadvice.com or leave a comment if you have questions or anything to add.

And of course if you would like to become a member of our humble group –you are more than welcome to subscribe (all the cool kids are doing it J)

Human papillomavirus (HPV) can cause warts, genital warts and cervical cancer. 

Genital HPV is the most common viral STD (sexually transmitted disease) in the United States.  There are over 40 different types of HPV that can infect the genital areas of women and men. 

HPV is a viral infection and currently there is no cure.  However, over 88% of the time, the person’s body will naturally clear the infection.  Most people who are infected with HPV do not have symptoms.  Quite often they don’t even know that they have the infection. 

Certain strains of HPV can cause genital warts.   The warts can appear on the thigh, anal area, penis, scrotum, vagina and cervix.  Less than 1% of patients infected with HPV will have visible genital warts.  There are treatments to get rid of the wart but often they will reappear because the virus is still active.    

So you are ready to discuss options with your physician, treatments for genital warts include:

ü     Waiting for the body to clear them naturally (usually take less than 2 years)

ü     Aldara (imiquimod) –prescription drug that is usually applied to warts at bedtime three times a week for up to 16 weeks.

ü     Surgical or cryotherapy administered by physician

ü     Condylox (podofilox) –prescription drug applied to warts twice daily for 3 days then 4 days with no application (usually repeated 4 times)

ü     Trichlor (trichloroacetic acid) –prescription drug applied to warts, cover for 5 days then repeat if needed

Other strains of HPV (high risk HPV) can lead to development of cervical cancer, as well as other forms of cancer.  These strains of HPV can be healed by the body’s defense system.  However, if the body does not heal itself, the HPV hangs around and increases the risk of developing cervical cancer.

Pap smears are the best way to test and monitor for HPV infections that can lead to cancer. 

Gardasil and Cervarix are vaccines for HPV that can cause cervical cancer.  Gardasil can be given to girls and women from 9 to 26 years old.  Cervarix is not yet available in the States but it is used in Australia for females 10 to 45 years old and males 9 to 15 years old. 

The vaccines do not guarantee 100% protection and are still being researched. 

A person can get genital HPV from penetrative sex (vaginal and anal) and oral sex.  It can also be spread through touching, like naked genitals touching or hand to genital touching.  This means that using a condom decreases the likelihood of passing on HPV but even with a condom, you are still at risk. 

So, think about getting the vaccine and always remember…no glove, no love! 

I would love to hear what you thought of this topic -send me an email at nova@getpharmacyadvice.com

STDs can be spread through oral sex, vaginal sex and anal sex.  They can also be spread through skin-to-skin contact of the genital area.  This means that some STDs can be spread even if correctly using a condom. 

Over 19 million people will get an STD this year in the States.  Men have higher rates of STDs but women with STDs have worse symptoms.  The greatest risk factor for getting STDs is the number of sexual partners.  The more partners –the more opportunities to get infected.

Many people still associate STDs with men that have sex with men (MSM).  MSM are at higher risk for STDs because they are more likely to have more sexual partners and anal sex.  However, we are all at risk for STDs –no matter your gender, nationality or sexual preference. 

Some STDs are easily treatable; other STDs can not be healed but symptoms can be treated.

The most common sexually transmitted diseases: 

1.     Chlamydia

2.     Gonorrhea

3.     Syphilis

4.     Mycoplasma Genitalium

5.     Trichomoniasis

6.     Crabs/Pubic lice

7.     Human Papillomavirus (HPV)/genital warts

8.     HIV/AIDS

9.     Herpes/HSV

The only way to absolutely avoid the risk of getting an STD is complete abstinence.  The second best is having a mutually monogamous sexual relationship between two uninfected people.  Then there are female and male condoms (rubbers, jimmies, hoody, lid, rain coat…).

Little side note: Currently, in the States, for schools to receive federal funding for sexual education, they must teach an abstinence only program.    

Latex male condoms are put on an erect penis to act as a physical barrier.  They are not a 100% guarantee but when used correctly and consistently they are highly effective in stopping STD transmission.  Natural or lamb skin condoms do not protect you from STDs.

Latex male condoms can be used with nonoxnol-9 (a spermicide).  Addition of the spermicide has been proven to decrease the risk of getting gonorrhea and chlamydia.

Lubricant can also be used with condoms too.  It is important to get a water-based lubricant because use of oil-based (like Vaseline, lotions, baby oil) can eat away at the condom so that the condom will tear easily.    

Female condoms are a sheath that is put into the vagina that acts as a protective border.  They also do not offer 100% protection.  However, they provide an option for women to be completely in charge of STD protection.   DO NOT use male and female condoms together…it will cause tearing and no protection will be provided!

There are dental dams too –to use when having oral sex.

Condoms should be used each time you have sex. So, once the man ejaculates (cums), a new condom needs to be used if you have sex again.  They have expiration dates -so check them and please guys- do not keep them in your wallet!  Heat and friction from the wallet pocket can cause the condom to break down before its expiration date. 

There are lots of different kinds of condoms –flavored, colored, glow in the dark, vibrating, ribbed and lubricated…the list goes on.  So have fun with it and  Don’t be a loner, cover that boner!

Anyone that knows me will tell you, I can talk about condoms and STDs all day long! Leave me a comment or email me at nova@getpharmacyadvice.com