Herpes simplex is a common viral infection. If you’ve ever had a cold sore, you’ve been infected with the herpes simplex virus. Most cold sores are caused by herpes simplex virus type 1 (HSV-1), which is why HSV-1 is also called “oral herpes.” A different yet closely related herpes simplex virus, HSV-2, causes most cases of genital herpes. Either virus, however, can cause a herpes sore, most commonly on the face or genitals.
ORAL HERPES: SIGNS AND SYMPTOMS
Many people who get the virus that causes oral herpes never have any signs or symptoms. If an outbreak occurs,
it can cause:
- Skin to tingle, itch, sting, or burn
Fluid-filled blisters called “cold sores” or “fever blisters.” These usually appear on the lips, around the mouth, on the tongue, or elsewhere on the face or even the
- After the blisters (or blister) form, they quickly break down, often oozing fluid. As the fluid dries, crust forms. Eventually the crust falls off, revealing new The skin rarely scars; however redness of the skin can persist.
- Flu-like symptoms: Fever, muscle aches, swollen lymph glands Signs and symptoms of an outbreak generally last for 7 to 10
GENITAL HERPES: SIGNS AND SYMPTOMS
Most people infected with the virus that causes genital herpes never get sores and may never know that they have the virus. If signs and symptoms occur, these can include:
- Minor rash or itching
Painful sores, usually on buttocks, penis, or vagina
- While most genital herpes sores appear in the genital region, the HSV-2 virus can cause sores elsewhere on the body, especially the buttocks or thighs. In women, sores can develop inside the body on the
- Burning sensation while urinating
- Flu-like symptoms: Fever, muscle aches, swollen lymph glands
Sores may develop between 2 to 20 days after sexual contact with an infected person. Alternatively, the virus may remain in the infected nerve indefinitely without causing an outbreak or may cause an outbreak months or years after infection. The sores typically heal within 2 to 6 weeks.
HOW DID I GET HERPES SIMPLEX?
The herpes simplex viruses are extremely contagious and easily spread.
In the United States, more than 57% of people are infected with HSV-1 and more than 16% are infected with HSV-2.
Most people get the virus that causes oral herpes during infancy or childhood. A kiss, even on the cheek, sharing eating utensils, or skin-to-skin contact from a person who carries the HSV-1 virus is often all that is needed to pass the HSV-1 virus to a child. The infected child may or may not develop herpes sores.
A person who has a herpes sore also can spread the HSV-1 virus by sharing objects such as lip balm or a razor.
Genital herpes generally spreads through sexual contact. Most people become infected during sexual intercourse. If a sexual partner has a cold sore or fever blister and performs oral sex, this can spread the HSV virus, causing herpes sores on the genitals.
Pregnant women should tell their doctor if she or her partner has genital herpes. A woman who has genital herpes at childbirth can give the virus to her baby as the baby passes through the birth canal. Precautions taken before birth can prevent this.
Newborn babies can develop serious complications if their skin is touched by a herpes sore.
Infected persons also can spread the virus to unaffected parts of their own bodies by touching a herpes sore and immediately touching unaffected skin.
CAN HERPES SPREAD WITHOUT SORES?
Yes. Most people get herpes simplex from an infected person who does not have sores.
WHY DO HERPES OUTBREAKS COME AND GO, OR NEVER APPEAR AT ALL?
Once you get the herpes simplex virus, it never leaves the body.
Your first outbreak is often the worst. The body does not have antibodies (defenses within the immune system) to fight the virus, and the signs and symptoms tend to be more severe. After the first outbreak, also called the “primary outbreak,” your signs and symptoms tend to be milder.
However, not all primary outbreaks are severe. Some are so mild that a person does not even notice.
After the first outbreak, the virus moves from the skin cells to nerve cells. There the virus remains dormant. Some people never have another outbreak. Others have recurrences, which are generally more common during the first year.
Over time, the outbreaks tend to become less frequent and milder as the body develops antibodies to the virus. For some people, the outbreaks never stop.
A recurrence may be triggered by stress, illness, fever, sun exposure, menstruation, or even a surgery. If sun exposure is a trigger, wearing sunscreen and a lip balm with sun protection can help. Look for broad-spectrum sunscreen and lip balm with a Sun Protection Factor (SPF) of 30 or higher.
HOW DO DERMATOLOGISTS DIAGNOSE HERPES SIMPLEX?
During an outbreak, your dermatologist often can diagnose herpes simplex by looking at the sores. To confirm the diagnosis, the dermatologist may take a swab from a visible sore and send this swab to a laboratory. Other medical tests, such as a blood test, can detect the herpes simplex virus when sores are not present.
HOW DO DERMATOLOGISTS TREAT HERPES SIMPLEX?
There is no cure for herpes simplex. The good news is that sores often clear without treatment. Many people choose to treat herpes simplex because treatment can relieve symptoms and shorten an outbreak. For example, an
over-the-counter anti-viral cream or ointment may relieve cold sore symptoms.
Prescription antiviral medications approved by the U.S. Food and Drug Administration for the treatment of both types
of herpes simplex include:
These medications do not cure herpes. Taken daily, these treatments can shorten an outbreak of oral or genital
herpes and reduce the severity and frequency of outbreaks. They also can help prevent infected people from spreading
ARE THERE ANY COMPLICATIONS THAT CAN ARISE WITH HERPES SIMPLEX?
Serious complications rarely occur in healthy people with herpes simplex.
Complications occur most often in unborn babies, newborns, and people who have a long-term illness or weak immune system. If you have cancer or HIV/AIDS, or you have had an organ transplant, seek medical help right away if you have signs or symptoms of a herpes infection.
If the herpes virus spreads to the eye, it can cause an eye infection called herpes keratitis. Pain, light sensitivity, discharge, and a gritty sensation in the eye can occur. Without prompt treatment, scarring of the eye may result, leading to cloudy vision and even loss of vision. Talk with your dermatologist if you are experiencing these eye symptoms.
HOW DO I PREVENT SPREADING THE VIRUS?
An infected person can take precautions to prevent spreading the virus.
If you have oral herpes:
- When sores are present on the face, avoid kissing, oral contact, and sharing items such as eating utensils, towels,
and lip balms.
- If tingling, burning, itching, or tenderness develops in an area of your body where you have had a herpes sore, do
not touch it and do not touch others with it.
If you have genital herpes:
- When you have sores or symptoms, avoid sexual
- At other times, condoms can reduce the risk of spreading the virus. It is important to know that while a condom can help, it is possible to spread the virus if it lies on nearby skin that a condom does not cover. For persons who suffer frequent outbreaks of herpes, taking an antiviral drug daily prevents most outbreaks and reduces transmission of the virus to others.
A board-certified dermatologist is a medical doctor who specializes in diagnosing and treating the medical, surgical, and cosmetic conditions of the skin, hair and nails. To learn more about herpes simplex or find a dermatologist in your area, visit aad.org or call toll free (888) 462-DERM (3376).
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Images used with permission of the American Academy of Dermatology National Library of Dermatologic Teaching Slides
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