Can outbreaks of Herpes simplex (cold sores) slow recovery?
For every single known outbreak in adults, there are 2-3 others that are asymptomatic (no skin lesion is present). These outbreaks can stimulate enough inflammatory stress to limit recovery when taken collectively. I’ve seen this many times in adults and several times in children. As a rule, I will place my patients on suppressive herpes medication, and if recovery improves over the next 2-3 months, I will continue the suppressive medication until autonomic recovery is complete.