Long-term patterns in the cycle of active and inactive phases also raise the question:
What triggers HSV to break out of its dormant phase and causes it to become active again?
Can outbreaks be avoided simply by avoiding these triggers?
Over the years, people with herpes have put forth many suggestions as to what triggers recurrent herpes. These include
· Psychological stress
· Caffeine and Chocolate
· And poor nutrition
Sun exposure – even the mildest sunburn – can be a trigger for HSV, as can irritation or friction at the site of infection. And some say that vigorous sex can cause this kind of irritation.
Few of these possible triggers have been studied at length by researchers, but some work has been done. Scientists have noted several types of outbreak stimulants in lab animals, among them:
· Skin irritation at the site of infection
· Surgical trauma to the nerve or ganglion where the latent virus resides
· And radiation
However, very detailed studies have looked at the role of intense ultraviolet light on facial cold sores caused by HSV-1.
In these studies, 70% of the subjects exposed to about two hours of midday sun developed herpes symptoms within a week. Subjects who used sunscreen were protected. The message for people who get cold sores is clear, particularly if they’re sensitive to the sun. On the basis of a few small research studies, it seems that ultraviolet light may well have a similar effect in triggering genital herpes in those who have prolonged and direct exposures of the buttocks or genital area.
Menstruation remains prominent as a trigger factor in anecdotal accounts, but researchers have found no evidence of this in research studies.
Psychological stress has received a great deal of attention as a possible trigger factor. Over two-thirds of the respondents in ASHA’s 1991 survey, for example, indicated that “stressful events contribute to herpes symptoms.” This issue also has been examined by a variety of researchers, with somewhat contradictory results. The latest study on stress, published in 1999, suggests that there is not a relationship between short-term stress – say, a deadline at the office – and genital herpes recurrence associated with stressors lasting more than 7 days – for example, a period of anxiety about prolonged unemployment.
Can you avoid triggers?
From a strictly scientific point of view, outbreaks cannot be predicted with accuracy. No one will be able to identify the certain cause of every flare-up, and some people won’t have a clue about any of them. At the same time, however, it appears that many people with herpes do begin to associate certain events or behaviors with reactivation.
Once identified, triggers can sometimes be avoided.
If sunburn gives you a bad case of cold sores, there is always sunscreen, lip balm, and a hat.
If outbreaks seem to be brought on by fatigue, maybe it’s time to get serious about a quality eight hours every night.
Stress is perhaps a more troublesome category. There is little point for most of us in trying to create “stress-free” lives. In fact, even if we did, there is no proof that we’d be free from HSV reactivations. Nonetheless, it’s widely accepted that managing stress through exercise or other activities can be beneficial to one’s overall physical and mental health. It’s possible, though not proven, that this may have some benefit in managing herpes as well.
Many triggers are not known or can’t be foreseen. Other you may have good reason to suspect but can’t do much about. The last thing you want to do is blame yourself for recurrences or try endless experimental strategies to avoid them. For some, this becomes another form of obsession.
If, on the other hand, you gain clear insight into your pattern of outbreaks, you may find practical ways of sometimes averting them. Over time your knowledge of your own triggers and your sensitivity to prodromal symptoms will likely increase. This information, in turn, is something you can use in a variety of ways, including taking preventive medications or taking precautions to lower the risk of transmitting herpes to a sexual partner.