Various factors can trigger an outbreak. Some people, for example, believe that emotional or physical stress brings on oral and genital outbreaks. Others find that outbreaks are brought on by certain foods (nuts, chocolate), trauma to the skin, menstruation, fatigue, poor nutrition, illness, and exposure to sunlight. Keeping track of potential triggers, possibly in a diary, is a good idea; then the triggers can be avoided in the future. Sometimes, despite “doing everything right,” people still have outbreaks. Why the virus goes from inactive to active in some people but not in others is not understood, but researchers are actively investigating this question.
The virus does not usually spread to other areas of the skin in people infected with herpes who are otherwise healthy. An exception to this finding is a phenomenon called autoinoculation. Especially during the first few weeks of an initial infection, before the body has built up immunity to the virus, a person may spread the virus to other areas of the body by touching the area of infection and then immediately touching another area of the body. This is uncommon and generally can be prevented by washing the hands thoroughly after touching any infected area.
In people who are not healthy, such as those with compromised immune systems (people with acquired immunodeficiency syndrome [AIDS] or people undergoing chemotherapy), the virus can spread on its own to other areas of the body. This process, called dissemination of the virus, is uncommon. Herpes symptoms also tend to be more prolonged, and are usually more severe in general, in people with compromised immune systems.
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