Genital Herpes

[TopBunk]

What do you do when you notice genital herpes on your masseur?

[Guest]

43 minutes ago, TopBunk said:

What do you do when you notice genital herpes on your masseur?

If you really want to go through with the massage, stop, insist that he put on his pants, and then wash his hands. Of course, what the Hell is he doing taking off his underpants when he has an active outbreak? Super creepy. 

[+ Charlie]

Let's hope that all you wanted was a massage.

[marylander1940]

On 4/23/2022 at 1:40 PM, Charlie said:

Let's hope that all you wanted was a massage.

that's NOT the case in 99% of massages... 

[GeoMitch]

On 4/23/2022 at 1:40 AM, TopBunk said:

What do you do when you notice genital herpes on your masseur?

Immediately let him know.  

[Guest]

6 hours ago, GeoMitch said:

Immediately let him know.  

Herpes outbreaks are usually painful. I'd be surprised if he didn't know. Even if one doesn't look, one can feel the outbreak.

[MikePDNA51]

Let masseur know immediately. I’ve almost hooked up with guys where they made excuses for genital worts. All STD and STI have mitigation medicine. A masseur should have STD/ STI testing at least once a month!! personal contact is guy’s business he should know to get tested. 

[Simon Suraci]

You can get tested for each type (1 or 2) of herpes simplex virus (HSV), but doctors do not routinely test for it with regular prep labs like they do for chlamydia, gonorrhea, HIV, syphilis, and to a lesser extent each type of hepatitis and other STIs.

A very large percentage of the population has herpes. Estimates vary, but here is a range. I can only reasonably believe the rates are much higher among men who have sex with men. And even higher for men who have sex with men for work:

In the U.S., 48% of the population have HSV-1, whereas 12% have HSV-2.

There is no cure once you have either type of herpes, so it’s highly likely anyone here is regularly coming into contact with people who have herpes, although only some will exhibit an active outbreak at any given time.

I agree nobody should be allowing touch with an active outbreak, and no it’s impossible to NOT notice you have an active outbreak. And yes almost everyone here will eventually get genital herpes at some point in their life. It’s unfortunately very common and normal especially in MSM communities. Herpes is a part of our world. Avoid coming into contact with, or spreading active outbreaks. Manage symptoms. That’s all you can do.

You can manage symptoms with antiretrovirals.

If you notice your masseur has sores, avoid contact.

[Guest]

18 hours ago, Simon Suraci said:

...In the U.S., 48% of the population have HSV-1, whereas 12% have HSV-2.

....

Your statistics are spot-on for the total age group 14-49. That being said, most adults in the US have been exposed to HSV-1 by their 30th birthday, and it keeps going up. I would guess that a very large majority percentage of escorts would test positive for this virus:

Products - Data Briefs - Number 304 - February 2018

WWW.CDC.GOV

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Prevalence of Herpes Simplex Virus Type 1 and Type 2 in Persons Aged 14–49: United States, 2015–2016

For HSV-1:

For HSV-2:

[+ BenjaminNicholas]

On 4/23/2022 at 1:40 AM, TopBunk said:

What do you do when you notice genital herpes on your masseur?

You keep your 'oh, fuck' face on the inside, look at your watch and immediately say you had an important meeting you forgot about.

Then you exit, stage right.

[marylander1940]

On 4/23/2022 at 1:40 AM, TopBunk said:

What do you do when you notice genital herpes on your masseur?

you ask him to give you a massage and after that hire an escort for sex.

 

Edited June 28, 2023 by marylander1940

[Guest]

2 hours ago, BenjaminNicholas said:

You keep your 'oh, fuck' face on the inside, look at your watch and immediately say you had an important meeting you forgot about.

Then you exit, stage right.

Or stage left... 😄

[Guest]

Did Snagglepuss make me and @BenjaminNicholas gay?

Edited June 29, 2023 by Unicorn

[Luv2play]

On 6/26/2023 at 9:24 PM, Simon Suraci said:

You can get tested for each type (1 or 2) of herpes simplex virus (HSV), but doctors do not routinely test for it with regular prep labs like they do for chlamydia, gonorrhea, HIV, syphilis, and to a lesser extent each type of hepatitis and other STIs.

A very large percentage of the population has herpes. Estimates vary, but here is a range. I can only reasonably believe the rates are much higher among men who have sex with men. And even higher for men who have sex with men for work:

In the U.S., 48% of the population have HSV-1, whereas 12% have HSV-2.

There is no cure once you have either type of herpes, so it’s highly likely anyone here is regularly coming into contact with people who have herpes, although only some will exhibit an active outbreak at any given time.

I agree nobody should be allowing touch with an active outbreak, and no it’s impossible to NOT notice you have an active outbreak. And yes almost everyone here will eventually get genital herpes at some point in their life. It’s unfortunately very common and normal especially in MSM communities. Herpes is a part of our world. Avoid coming into contact with, or spreading active outbreaks. Manage symptoms. That’s all you can do.

You can manage symptoms with antiretrovirals.

If you notice your masseur has sores, avoid contact.

One correction. You treat herpes with an antiviral medication, not an antiretroviral which is used for HIV infections.

[marylander1940]

On 6/26/2023 at 9:24 PM, Simon Suraci said:

You can get tested for each type (1 or 2) of herpes simplex virus (HSV), but doctors do not routinely test for it with regular prep labs like they do for chlamydia, gonorrhea, HIV, syphilis, and to a lesser extent each type of hepatitis and other STIs.

A very large percentage of the population has herpes. Estimates vary, but here is a range. I can only reasonably believe the rates are much higher among men who have sex with men. And even higher for men who have sex with men for work:

In the U.S., 48% of the population have HSV-1, whereas 12% have HSV-2.

There is no cure once you have either type of herpes, so it’s highly likely anyone here is regularly coming into contact with people who have herpes, although only some will exhibit an active outbreak at any given time.

I agree nobody should be allowing touch with an active outbreak, and no it’s impossible to NOT notice you have an active outbreak. And yes almost everyone here will eventually get genital herpes at some point in their life. It’s unfortunately very common and normal especially in MSM communities. Herpes is a part of our world. Avoid coming into contact with, or spreading active outbreaks. Manage symptoms. That’s all you can do.

You can manage symptoms with antiretrovirals.

If you notice your masseur has sores, avoid contact.

I have both, I've never had an outbreak in my genitals and it's been at least 5 years since the last time I had a cold sore in my upper lip. I used to get one every other year, avoid sex and it would be gone within less than a week. I occasionally take acyclovir or zovirax and I avoid spicy food. 

[marylander1940]

On 6/28/2023 at 8:27 PM, Unicorn said:

Did Snagglepuss make me and @BenjaminNicholas gay?

Taking this off subject... that cartoon would be called woke and groomer nowadays.

Edited July 1, 2023 by marylander1940

[Guest]

19 minutes ago, marylander1940 said:

Taking this off subject... that cartoon would be call woke and a groomer nowadays.

 

I wish I could put two comment emojis: laughing and clapping! 😄

[+ Charlie]

I got genital herpes in my early 20s and suffered occasional outbreaks for years, but I haven't had any outbreak for at least a dozen years. Any idea why?

[Rudynate]

A couple weeks ago, I came down with a scary looking rash called pytariasis rosea.  It's supposed to be caused by herpes 6/7.  I have itchy red blotches on my back, shoulders, chest, stomach. arms, legs.  I asked them to give me valacyclovir for it, but they said no - not enough evidence that it is effective.  Instead, they gave me an industrial strength itch cream compounded with a long-acting corticosteroid. 

Edited July 2, 2023 by Rudynate
spelling

[Guest]

4 hours ago, Rudynate said:

A couple weeks ago, I came down with a scary looking rash called pytariasis rosea.  It's supposed to be caused by herpes 6/7.  I have itchy red blotches on my back, shoulders, chest, stomach. arms, legs.  I asked them to give me valacyclovir for it, but they said no - not enough evidence that it is effective.  Instead, they gave me an industrial strength itch cream compounded with a long-acting corticosteroid. 

Wow. How old are you? It's pretty common, but usually a rash young adults or teenagers get. Never met anyone 40+ to get it. Why did you think valacylovir would help? The cream seems OK. If you were given an injection of a long-acting steroid, that's a bit risky and not recommended. That can result in avascular necrosis of the hip, which can result in permanent disability. A week of an oral steroid might have been reasonable if the itching was really bad. Early on, a bit of suntanning can be helpful.

[Rudynate]

12 hours ago, Unicorn said:

Wow. How old are you? It's pretty common, but usually a rash young adults or teenagers get. Never met anyone 40+ to get it. Why did you think valacylovir would help? The cream seems OK. If you were given an injection of a long-acting steroid, that's a bit risky and not recommended. That can result in avascular necrosis of the hip, which can result in permanent disability. A week of an oral steroid might have been reasonable if the itching was really bad. Early on, a bit of suntanning can be helpful.

Unusual in older adults but not rare either.  Two dermatologists and my PCP all agreed on the dx.  Unfortunately, since they weren't familiar with the literature WRT use of acyclovir to treat pytyriasis, I'm outside the window when it would have done any good. The cream is triamcinolone in Sarna - works well enough, but the acyclovir could have knocked this out in as little as a week. 

[Guest]

I think that the 2006 studies which suggested efficacy weren't double-blinded. Blinded studies haven't shown efficacy, to my knowledge, hence the lack of FDA approval or professional guidelines recommending this:

Acyclovir is not effective in pityriasis rosea: Results of a randomized, triple-blind, placebo-controlled trial - Indian Journal of Dermatology, Venereology and Leprology

IJDVL.COM

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Acyclovir is not effective in pityriasis rosea: Results of a randomized, triple-blind, placebo-controlled trial

The efficacy of macrolides and acyclovir in pityriasis rosea - Indian Journal of Dermatology, Venereology and Leprology

IJDVL.COM

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The efficacy of macrolides and acyclovir in pityriasis rosea

"...At the moment, no treatment can be recommended on the basis of evidence-based medicine and pityriasis rosea remains a self-limiting exanthematous disease that probably needs just reassurance and a little rest."...

This is the reason the FDA doesn't approve a medication for a condition unless there have been at least two double-blinded placebo-controlled RCT's. In my opinion, your doctors were correct regarding the antivirals. 

This is from May 2022:

Pityriasis Rosea Medication: Corticosteroids, Antihistamines, Antibiotics, Other, Antiviral Agents

EMEDICINE.MEDSCAPE.COM

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Pityriasis rosea (PR) is a benign rash first described by Gilbert in 1860; the name means “fine pink scale.” It is a common skin disorder observed in otherwise healthy...

"...Oral antihistamines and topical corticosteroids can be used as needed. For patients in whom superficial tinea infection is a concern or possibility, topical antifungal therapy can be used. There is no evidence-based medicine for pityriasis rosea, a self-limited disorder. .."

Note that only topical corticosteroids are recommended. An intramuscular injection of long-acting steroids is not recommended (though I wouldn't argue against a brief course of oral prednisone if the itching were unbearable).

Edited July 3, 2023 by Unicorn

[Guest]

Current guidelines from the American Academy of Dermatology do not include antivirals:

Pityriasis rosea: Diagnosis and treatment

WWW.AAD.ORG

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Learn about how dermatologists diagnose and treat pityriasis rosea.

Pityriasis Rosea | Adolescent Medicine | JAMA Dermatology | JAMA Network

JAMANETWORK.COM

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This Patient Page provides information on pityriasis rosea, a common cutaneous erruption that is more prevelent in older children and young adults.

 

Edited July 3, 2023 by Unicorn

[+ Charlie]

1 hour ago, Rudynate said:

Unusual in older adults but not rare either.  Two dermatologists and my PCP all agreed on the dx.  Unfortunately, since they weren't familiar with the literature WRT use of acyclovir to treat pytyriasis, I'm outside the window when it would have done any good. The cream is triamcinolone in Sarna - works well enough, but the acyclovir could have knocked this out in as little as a week. 

I had never heard of triamcinolone until my doctor recently prescribed triamcinolone cream for some very nasty spider bites, and within three days they were almost undetectable.

[Rudynate]

I don't think the 2006 study was double-blind.  It's unfortunate you gave up searching before you found any references that called what you "know" into question. 

According to this meta-analysis,  double-blind studies have shown a clear benefit from treatment with high-dose acyclovir. 

I haven't looked at the indications for acyclovir, but I don't imagine it is FDA approved for pytyriasis.   I don't doubt you are familiar with off-label uses of approved drugs.  

Effectiveness of acyclovir in the treatment of pityriasis rosea. A systematic review and meta-analysis - PubMed

PUBMED.NCBI.NLM.NIH.GOV

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Symptomatic treatment is a reasonable option for pityriasis rosea, and the addition of acyclovir is justified for the control of symptoms and pruritus.