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Overview of Herpes: Symptoms, causes, and treatment

Dr. SatabdiDec 20, 2023

Did you know that the term ‘Herpes’ originated from a Greek word which meant ‘to creep or crawl’? People were worried about Herpes even 2,000 years ago!

Currently, it is one of the most common viral infections in the world. Read on to learn more about the symptoms, causes, and treatment related to Herpes.

Herpes

Contents

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What is Herpes?

Herpes is a common infection caused by Herpes Simplex Virus. This infection is usually transmitted through intimate person-to-person contact. The infected persons experience water-filled blisters or sores that often heal without any scar. The sores usually take one or more weeks to heal completely. 

What are the types of Herpes?

There are two types of Herpes viruses.

  1. Herpes Simplex Virus-1 (HSV-1) is chiefly responsible for causing lesions around the mouth. This typically leads to cold sores or fever blisters on your face.

  2. Herpes Simplex Virus-2 (HSV-2) causes lesions in the genital region, inner thighs, buttocks, and anus. Genital Herpes is a Sexually Transmitted Disease (STD). 

It should be remembered that both viruses are capable of causing lesions around the mouth and genitalia. Many people with genital Herpes have HSV-1 infection, which they contracted through oral-to-genital contact.

What are the causes of Herpes?

As mentioned previously, the virus that causes Herpes spreads from person to person through close contact. HSV-1 is transmitted either through contact with the sores or the infected person’s saliva. This could occur through the following. 

  • Kissing

  • Shared water bottles, cups, or tumblers

  • Shared make-up

  • Oral sex

  • Any other form of skin-to-skin contact. 

HSV-2 is chiefly transmitted through sexual intercourse. Research has shown that even those without symptoms of Herpes, sometimes shed the virus in the genital tract. But, this frequency is much lesser compared to those with active Herpes lesions. 

What are the symptoms of Herpes?

Herpes does not always present with symptoms. The symptoms vary depending on whether you are having the infection for the first time (primary HSV infection) or if it is a recurrence of an old infection.

Primary HSV infection occurs any time between a few days to a few weeks after the first exposure to the HSV virus. It presents with flu-like symptoms. These symptoms include the following.

  • A general feeling of being unwell

  • Loss of appetite

  • Fever

  • Swollen and painful lymph nodes

  • Pain in the area

  • Burning or tingling sensation in the area before the onset of the lesions

There may be a burning or tingling sensation in the area of infection before the development of small painful, fluid-filled blisters. The blisters may appear alone or may appear as clusters. 

These would eventually burst and a crust appears over them before it begins to heal. Itching, popping, or breaking the blister may lead to scarring in the region. Otherwise, the lesion would heal over two to six weeks without any marks. Blisters continue to shed viruses until they are completely healed. Hence, direct contact with the blisters can lead to the transmission of infection. The sores in the genital region often cause pain during urination. 

The virus that enters the body at the time of first exposure lives in an inactive state in the nerves. They may get re-activated occasionally leading to recurrent infections. Some people may never experience recurrence. 

Although initially, the recurrence can occur more frequently, as time progresses, the frequency of this recurrence comes down. 

Recurrent HSV infection typically begins with a tingling sensation, burning, or itching in the area. Eventually, fluid-filled blisters appear in the area. These blisters shed viruses. Hence direct contact leads to the transmission of infection. The lesions heal over two to six weeks, often without any scars.

How is HSV infection diagnosed?

In most cases, your doctor will be able to diagnose HSV by its characteristic clinical appearance. The doctor may ask you for your history of fever, tingling, or burning sensation in the area. 

In some cases, you may be advised to undergo further tests to confirm the diagnosis. It usually involves swabbing the fluid in the blister and sending it to a laboratory. In addition, you may also be advised to undertake certain blood tests. 

How is Herpes treated?

The main goal of treating Herpes is to prevent the transmission of the infection and prevent the shedding of the virus. Regardless of the treatment, the lesions gradually heal over three to four weeks. Antiviral medicines can, however, reduce the duration of the illness and ease your symptoms. The antivirals used include the following.

  • Acyclovir

  • Valacyclovir

  • Famciclovir

  • Foscarnet

Take these medicines only under a physician’s advice. 

What are the complications of HSV infection?

In certain conditions, HSV infections can lead to complications. Here are some of these complications.

  1. HSV and HIV: Human Immunodeficiency Virus (HIV) is a life-threatening sexually transmitted infection that reduces the body’s immune response, thus predisposing the affected person to multiple infections. HSV-2 is one of the most common infections seen among those living with HIV. HSV infection increases the likelihood of acquiring as well as transmitting HIV infection. 

  2. Severe HSV disease: In people with low immunity, such as those with HIV infection, there is frequent reactivation of HSV with severe disease presentation. In such people, it can lead to a brain infection called ‘Herpes encephalitis’. It is a serious life-threatening condition. 

  3. Neonatal Herpes: A pregnant mother with genital Herpes can pass on the infection to the baby during pregnancy or childbirth. The babies may also acquire the infection shortly after birth, resulting in life-threatening neonatal Herpes infections. It is very important to screen mothers for Herpes infection.  

How do I prevent HSV infection?

The only sure way to prevent HSV infection is to abstain from any type of activity which would expose you to the virus. Since this is not always practically possible, here are some recommendations that help to reduce the risk of transmission. 

  • Avoid sharing personal utensils and equipment with others.

  • Adopt safe-sexual practices. 

  • Get yourself and your partner tested for Sexually Transmitted Infections and take the appropriate treatment if necessary. 

Frequently asked questions

Here are some of the frequently asked questions on Herpes.

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Is Herpes curable?

There is no cure for Herpes. However, antiviral medicines such as Acyclovir and Foscarnet help in reducing the intensity of the symptoms, frequency, and duration of the outbreaks. Long-term treatment with antiviral medicines can prevent the occurrence of outbreaks. 

What triggers recurrent Herpes outbreaks?

Recurrent Herpes infections are triggered by stress, exposure to sunlight, illness, and fatigue. Sometimes, the menstrual period can trigger an outbreak. 

What is Herpes labialis?

The Herpes lesions that occur on the lips are called Herpes labialis. They are referred to as cold sores or fever blisters. It appears as painful blisters that rupture, resulting in crusting over the area but heals over 10 to 15 days, often without a scar. 

How do I protect myself from contracting genital Herpes?

You can protect yourself from contracting genital Herpes by adopting safe sex practices. These include using a condom during intercourse, not having multiple sexual partners, and abstaining from intercourse with a partner with genital Herpes.  

I have oral Herpes. How do I prevent its transmission to other people?

You can prevent the transmission of oral Herpes by avoiding skin-to-skin contact with other people while you have an active lesion. It also means that you should not share water bottles, utensils, makeup, razors, etc. with other people while you have an active Herpes lesion. 

References

  1. https://www.cdc.gov/std/Herpes/stdfact-Herpes-detailed.htm#ref8 

  2. https://www.who.int/news-room/fact-sheets/detail/Herpes-simplex-virus 

  3. https://www.ncbi.nlm.nih.gov/books/NBK554427/ 

  4. https://www.ncbi.nlm.nih.gov/books/NBK482197/ 

Disclaimer: The content on this page is generic and shared only for informational and explanatory purposes. It is based on several secondary sources on the internet. Please consult a doctor before making any health-related decisions.

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