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trompe de chasse

par alligator83
03/10/2018 à 17:20

Je débute la pratique de la trompe de chasse et souffre de douleurs sur la lèvre supérieure avec symptome d'herpès, problème récurrent même après u peu de repos. Que faire? Quel soin appliquer?
par Docteur Icarre
07/10/2018 à 13:11

Bonjour,

L'herpès communément appelé aussi "bouton de fièvre" est semble-t-il plus fréquent chez les instrumentistes à vent de la famille des cuivres. Le facteur traumatique est souvent invoqué comme facteur favorisant l'émergence de l'herpès labial chez les instrumentistes à vent.

Il s’agit au départ d’un virus (herpès simplex de type 1 en général), qui est un virus résurgent particulièrement fréquent dans la population générale (30 % de la population générale). Il est à noter qu’il est contagieux pour les personnes exemptent de ce virus, ce qui signifie de ne pas prêter son embouchure.

Vous pourriez dans un premier temps vous faire conseiller par un professeur de cet instrument, avec si possible un travail permettant de limiter la pression sur les lèvres.

Le plus généralement le traitement se fait que si l’herpès labial est gênant. Il existe des traitements antiviraux, peut-être pourriez-vous vous consulter un dermatologue afin d'avoir son avis.

Docteur A. Icarre

Voici par ailleurs une réponse à un FAQ sur ce sujet sur un forum américain

" Medical FAQs for Brass Players Cold Sores - Herpes Labialis Caused by HSV-1 Vurus"

" Cold sores are caused by reactivation of the HSV-1 virus (Herpes Simplex Virus). The virus is spread by close contact with oral secretions (saliva) or oral lesions, usually on the lips. In different studies up to 70 to 90% of adults show evidence of prior infection and as many as 10 to 15% of adults are shedding the virus in saliva at any given time. The virus remains dormant in the body after the primary infection and reactivates periodically, sometimes in response to triggers such as sunlight, minor trauma, surgery, other illness, or fatigue. It is not always just bad luck when a cold sore breaks out right when you are in the middle of strenuous woodshedding for an important gig.

Recurrences happen as often as once a month in up to 25% of people and 3 to 4 times a year in over 50% of people. Active lesions can make it difficult to play a brass instrument, and last on average 6 to 8 days. This can obviously take a big chunk away from playing time.

There are several options to deal with recurrences. One is to not treat with anything and wait them out. Another is to start treatment as soon as symptoms begin. Many players experience some burning or tingling hours before a lesion appears. Studies have shown that starting topical antiviral cream (acyclovir) within hours of the first symptom decreases the mean time to healing by a little less than a day.

Over the counter non prescription remedies do not have as strong evidence supporting their effectiveness, but could help. Abreva does seem to work well for some people. Two studies showed it decreased average healing time by about 18 hours. 40% of people using it within an hour of symptom onset were able to stop the progression of symptoms. It is interesting that in the same study 30% of people applying the placebo cream without the active ingredient had a similar effect. Acyclovir seems in clinical trials to do better, reducing healing times by 1.6 days.

If Abreva works for you stick with it. It can certainly help. If results are unsatisfactory the added expense of the prescription acyclovir might be worth it.Taking prescription antiviral pills for one to 5 days, depending on the drug, reduced healing time by about 2 days, from 6 to 4 days, in clinical trials. Pills seem to work better than creams in most studies.

Players who do not get warning signs or who have frequent episodes might consider suppressive therapy, consisting if taking a reduced dose of oral antiviral medication on a daily basis. This has been shown to decrease the number and frequency or recurrences by at least 50%. Taking antiviral medicine for a prolonged duration has been shown to be safe, but you will still require monitoring by your doctor. Daily treatments can also be expensive if you pay for your own medications, but perhaps not as expensive as missing gigs on a regular basis because you have cold sores. If you have frequent outbreaks a discussion with your physician might be worthwhile."