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HomeAnswersVenereologyhsvWhy do I get sores on genitals during every HSV-1 outbreak?

Does diabetes or thyroid increase the recurrence of HSV-1?


The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.

Medically reviewed by

iCliniq medical review team

Published At April 23, 2017
Reviewed AtMay 10, 2024

Patient's Query

Hi doctor,

I was diagnosed with (herpes simplex virus) HSV-1, but all other tests like human immunodeficiency virus (HIV), HBsAg, hepatitis C virus (HCV), venereal disease research laboratory (VDRL), and treponema pallidum hemagglutination (TPHA) are normal. I got infected with HSV through oral sex. My first outbreak was about four months back, and I got sores in the genital area, mouth, head, and my waist. Recently, a sore has erupted in my mouth, but it healed without any medicine within four days. I am a healthy person. Is it compulsory to get a sore on my genitals during every outbreak? If I take Acyclovir at the time of symptoms, will I be able to restrict the infection? Does HSV-1 have complications like ocular herpes and encephalitis in a healthy individual? Does diabetes or thyroid increase the recurrence of HSV-1?


Welcome to icliniq.com. Repeated outbreak of HSV (herpes simplex virus) are common, but repeated outbreaks are usually shorter and less severe. Although the organism stays in the body for the rest of your life, the number of outbreaks tends to decrease over a period of years. At the time of the first episode, it should always be treated with Acyclovir. This is to prevent the prolongation of illness and to prevent the severity of the disease. Almost all people with symptomatic first episode subsequently experience the recurrent episodes of HSV. Antiviral medications like Acyclovir can be taken as suppressive therapy, so as to reduce the frequency of recurrences or shorten the duration of the illness. Studies have shown that suppressive therapy reduces the frequency of genital herpes recurrence by 70 to 80 percent. If you take Acyclovir only at the time of the episode, it requires initiation within one day of the lesion onset. This will not only shorten the severity of the disease but also shorten the duration of recurrent episodes. Ocular herpes and encephalitis due to HSV-1 occurs due to reactivation of the virus at the latent sites in the body, one of the possibility is the change in the status of the immune system or due to stress, in immunocompromised patients like in HIV or patients on cytotoxic drugs. Uncontrolled diabetes or thyroid disease can increase the chances of recurrent infection of HSV. I hope your queries have been answered. If you still need more clarification, please revert.

Patient's Query

Thank you doctor,

I am a healthy person now, will I be affected with encephalitis or ocular herpes? And what if I get any immunosuppressive disease, thyroid, or diabetes in the future, will I be at risk? Do I need any treatment now? I am not married yet, will herpes simplex virus (HSV) affect my life? I am worried about encephalitis and ocular herpes. Please guide me.


Welcome back to icliniq.com. Encephalitis or ocular herpes can occur in people of all ages. The most common cause is infection by a virus. But patients who are immune compromised or immune suppressed are more susceptible than healthy individuals. Your HIV (human immunodeficiency virus) test as you mentioned earlier is negative. Fasting blood sugar and TSH (thyroid stimulating hormone) will help you to know whether you have deranged blood sugar levels and thyroid function respectively, so I suggest you get these done. Suppressive therapy is preferred for immunocompromised or in an immunodeficient state. Use precautions in future likesafe protected sex, using condoms.

Patient's Query

Thank you doctor,

Is ocular herpes or encephalitis common in herpes simplex virus (HSV) IgG positive person? According to my report, IgG is positive and IgM is negative. During reactivation, do the sores appear only on the skin? What is the gap between consecutive outbreaks? Will HSV affect my marriage or life?


Welcome back to icliniq.com. As per world health organization (WHO) statistics, 67 % of people under the age of 50 years are infected by (herpes simplex virus)HSV-1, which means you are not alone or rare. As per WHO, ocular herpes and encephalitis is a rare disorder and occurs mostly in specific situations like disseminated HSV infection and patients with HIV. Nearly all of the HSV-infected people will have IgM antibody response followed by IgG antibodies. There is no fixed time period; generally, it reactivates when there is stress, psychological trauma, illness, fever, etc. The most common site of recurrences is skin and the mucosal areas. As far as your marriage or sexual life is concerned, in the case of recurrences in the oral or genital areas, you need to use precautions at the time of active infection.

Same symptoms don't mean you have the same problem. Consult a doctor now!

Dr. Ravinder K. Sachdeva
Dr. Ravinder K. Sachdeva

HIV/AIDS specialist

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