RESEARCH FINDINGS USING GUIDED
IMAGERY FOR
HERPES
August, 2006
Definition
of the Problem
There are two separate and distinct contagious viruses that
make up the Herpes Simplex Virus. The viruses cause
shingles, chicken pox, mononucleosis, oral herpes, and
genital herpes. HVS-2 accounts for 90% of genital herpes;
HVS-1 causes the other 10%. Herpes is spread from person to
person through contact with bodily fluids.
An infected person can also cause it to spread to more than
one area of his own body. It can be spread whether or not
the infected person has an active outbreak, since the
active virus is continually being shed. Since shed virus
can live for a time in the air, a person can be also
infected by coming into contact with an infected towel or
clothing.
A herpes “episode” can have no symptoms, or it can start
with flu-like symptoms, including fever and swollen glands.
While the virus has no cure, the number of outbreaks tends
to decrease over the years.
Scope
and Cost of the Problem
At least one in five Americans – about 45 million people --
have herpes, and most are unaware that they are infected
(Genital Herpes CDC Fact Sheet, 2004). Since most people
with HSV-2 never get lesions or have only mild symptoms, it
is easily possible for them not to know they have been
infected (Genital Herpes CDC Fact Sheet).
There are approximately 1,000,000 new cases annually (The
Surgeon General's Call to Action, 2004). The number of
Americans with genital herpes increased 30% between the
late 1970s and the early 1990s (Genital Herpes CDC Fact
Sheet, 2004).
According to the National Institutes of Health, the annual
cost of genital herpes is more than $96 million (Sexually
Transmitted Disease Cooperative, 1994).
Medical Treatment
Antiviral therapies can be used during outbreaks or to
inhibit or reduce future outbreaks. Antirival medications
include acyclovir (Zovirax), famciclovir (Famvir), and
valaciclovir (Valtrex). Pain relief can usually be achieved
using over-the-counter remedies such as acetaminophen or
ibuprofen.
Lifestyle changes (stress reduction, healthy diet,
exercise, sleep, limiting sun exposure) can sometimes limit
the number or severity of outbreaks.
Mind-Body Approaches
Since stress has been linked to the frequency and severity
of outbreaks, stress reduction is always a goal (Cohen,
Kemeny, et al, 1999; Cruess, Antoni, et al, 2000;
Lutgendort, Antoni, et al, 1997). In one study, patients
using a program that included stress reduction, education,
and guided imagery were able to limit the number and
severity of herpes outbreaks (Longo, Clum, and Yaeger,
1988).
Relaxation has also proven beneficial (Kiecolt-Glaser,
Glaser, et al, 1985; Koehn, Burnette, and Stark, 1993), as
has hypnosis (Fox, Henderson, et al, 1994; Gould and
Tissler, 1984; Pfitzer, Clark, and Revenstorf, 2005;
Shenefelt, 2000).
Conclusion
Guided imagery can help to lower stress,
improve coping skills, improve compliance with lifestyle
changes, and possibly reduce the severity and frequency of
outbreaks.
References:
Cohen
F, Kemeny ME, Kearney KA, Zegans LS,
Neuhaus JM, Conant MA. Persistent stress as a
predictor of genital herpes recurrence. Arch Intern
Med. 1999
159:2430–6.
Cruess
S, Antoni M, Cruess D Fletcher MA, Ironson G, Kumar M,
Lutgendorf S, Hayes A, Klimas N, Schneiderman N. Reductions
in herpes simplex virus type 2 antibody titers after
cognitive behavioral stress management and relationships
with neuroendocrine function, relaxation skills, and social
support in HIV-positive men. Psychosom Med.
2000
Nov-Dec;62(6):828-37.
Fox PA, Henderson DC, Barton SE, Champion AJ, Rollin MS,
Catalan J, McCormack SM, Gruzelier J. Immunological markers
of frequently recurrent genital herpes simplex virus and
their response to hypnotherapy: a pilot study.
Int J STD
AIDS. 1994 Nov;10(11):730-4.
Genital
Herpes - CDC Fact Sheet. Centers for Disease Control and
Prevention. May, 2004.
http://www.cdc.gov/std/Herpes/STDFact-Herpes.htm#common
Accessed August, 2006.
Gould SS, Tissler DM. The use of hypnosis in the treatment
of herpes simplex II. Am J Clin Hypn.
1984 26:171–4.
Kiecolt-Glaser JK, Glaser R, Williger D, Stout J, Messick
G, Sheppard S, Ricker D, Romisher SC, Briner W, Bonnell G,
et al. Psychosocial enhancement of immunocompetence in a
geriatric population. Health Psychol.
1985 4(1):25-41.
Koehn KA, Burnette MM, Stark CJ. Applied relaxation
training in the treatment of genital herpes.
Behav Ther Exp
Psychiatr. 1993 Dec;24(4):331-41.
Longo DJ, Clum GA, Yaeger NJ. Psychosocial treatment for
recurrent genital herpes. J Consult Clin
Psychol. 1988 56:61–6.
Lutgendorf SK, Antoni MH, Ironson G, Klimas N, Kumar M,
Starr K, McCabe P, Cleven K, Fletcher MA, Schneiderman N.
Cognitive-behavioral stress management decreases dysphoric
mood and herpes simplex virus-type 2 antibody titers in
symptomatic HIV-seropositive gay men. J Consult Clin
Psychol. 1997 Feb;65(1):31-43.
Pfitzer BE, Clark K, Revenstorf D. [Medical hypnosis in
cases of herpes labialis improves resistance for
recurrence. A pilot study] [Article in German] Hautarzt.
2005 Jun;56(6):562-8.
[no authors listed] Sexually Transmitted Diseases
Cooperative Research Centers NIH Guide. 1994. Volume 23,
Number 18, May 13.
http://grants.nih.gov/grants/guide/rfa-files/RFA-AI-94-016.html
Accessed
August, 2006..
Shenefelt PD. Hypnosis in dermatology. Arch Dermatol.
2000
Mar;136(3):393-9.
[no authors listed] The Surgeon General's Call to Action to
Promote Sexual Health and Responsible Sexual
Behavior. U.S. Department of Health
& Human Services. July 7, 2004.
http://www.surgeongeneral.gov/library/sexualhealth/glancelist.htm
Accessed, August, 2006.