Thank you for your query at DoctorSpring.com
The problem with herpes outbreaks is that no one can really predict the number of outbreaks per year. However patients on Valtrex ( Valacyclovir ) have fewer than 3-4 outbreaks per year. Such outbreaks also depend on the current nutritional or the stress the individual has, as stress or low immunity seems to make it more frequent.
How is her health overall? Does she have any diabetes/hypertension? Diabetes makes a patient more prone for recurrent infections.
There is no such specialisation on herpes because most herpes cases are handled by internal medicine specialists or the dermatologists.
In this situation we need to assess her overall health. So can you provide me a detailed medical history?
Patient replied :
Thank you for your response. My friend is generally in good health. She does smoke some. Only some low evel of hypertension. She does have a thyroid-related auto immunce disorder. However, she has no major healthy conditions or lifestyle issues which seem to be sufficiently serious enought to cause such lengthy continuous symtoms. Thank you.
The fact that she has thyroid related auto immune disorder shows that her immune system is slightly over active compared to other cases.
So whatever trivial herpes virus proliferation is there in the site, due to the immunity she will manifest the rash.
The rash or the sores are all body's way of fighting off or warding off the infection.
This could be one of the possibilities.
For example, for a lot of people in US ( almost 1/3 rd ) they have HSV-1 infection but they never manifested. That is because of good immunity. However if the immune system starts reacting to even one or two isolated viruses, then it will actually be detrimental. It is like acting against the normal flora.
So i guess in her case she has a predisposition for auto immunity. And hence she needs such high dose to maintain absolutely zero levels of HSV-2 viruses, the moment even a few multiplies, she gets the rash or sores.