Herpes Simplex

Herpes simplex is a common viral infection. If you’ve ever had a cold sore or fever blister, you picked up the herpes simplex virus. The most common virus causing cold sores on the mouth is herpes simplex virus-1 (HSV-1). A closely related herpes simplex virus, HSV-2, causes most cases of genital herpes. However, either HSV-1 or HSV-2 can cause a herpes sore on the face or genitals. Most people get HSV-1 as an infant or child when an adult kisses them or pinches their cheeks. This virus is spread by skin-to-skin contact with someone who carries the virus. A person usually gets HSV-2 (herpes simplex type 2) through sexual contact with an infected person.

Risk factors for HSV-2:
◦ Female.
◦ Having had multiple sexual partners.
◦ Had sex for the first time at a young age.
◦ Have a history of another sexually transmitted infection.
◦ Have a weakened immune system due to a disease or medication.

Once a person becomes infected with a herpes virus, the virus never leaves the body. After the first outbreak, the virus moves from the skin cells to nerve cells. The virus stays in the nerve cells forever and it usually stays there. In this stage, the virus is said to be dormant, or asleep. But it can become active again.

Things that can trigger (wake up) the virus are:
◦ Stress.
◦ Illness or surgery.
◦ Fever.
◦ Sun exposure.
◦ Menstrual periods.

Common symptoms:
◦ Tingling, itching, or burning may develop before the blisters appear.
◦ One or more painful, fluid-filled blisters may appear.
◦ Blisters break open and often ooze fluid and form a crust, before healing.
◦ The first time sores appear, they may show up between 2 and 20 days being in contact with an infected person, and may last from 7 to 10 days.
◦ Oral herpes (HSV-1): Most blisters appear on the lips or around the mouth but may form on the face, tongue or anywhere on the skin, and can last for 1-3 weeks.
◦ Genital herpes (HSV-2): Sores typically occur on the penis, vagina, buttocks, or anus. Like oral herpes, these sores can appear anywhere on the skin, and can last 1-6 weeks.
◦ Fever, muscle aches, or swollen lymph nodes (glands) are possible.
◦ Genital herpes lesions may cause trouble urinating or a burning feeling while urinating.
◦ Herpes simplex virus can spread to one or both eyes. If this happens, you can have pain, light sensitivity, discharge, and a gritty feeling in the eye. Without prompt treatment, scarring of the eye may result, causing cloudy vision and even loss of vision.
◦ Some people who get the virus never see or feel anything.

Treatment:
◦ Over-the-counter or prescription topical antiviral creams can be applied up to 5x per day.
◦ Prescription oral antiviral medications can be taken when the symptoms first appear for 1 day to prevent the sores.
◦ Prescription oral medications can be taken for 1 week after the sores appear.
◦ If you develop many infections per year, you can take a daily prescription oral medicine to prevent the outbreaks.
◦ Intravenous antiviral medications can be given in the hospital in cases of herpes eye infections, or severe skin infections.
◦ There is no cure.
◦ A dermatologist can diagnose herpes by looking at the sores; the doctor may take a swab from a sore and send it to a laboratory.
◦ When sores are not present, a blood test can detect exposure to the virus.
◦ Herpes sores often clear without treatment, however treatment can relieve symptoms and shorten the outbreak.