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Herpes Simplex

Herpes Simplex: Causes, Symptoms, Diagnosis, Treatment, and Prevention

A herpes simplex infection is a common viral infection that can leave blisters or sores on the skin. It consists of two types: type 1 (HSV-1) and type 2 (HSV-2). Cold sores or fever blisters are typically caused by HSV-1. Genital herpes is usually caused by HSV-2. Even if no symptoms are visible, both types of herpes can be transmitted by skin-to-skin contact.

Causes and Risk Factors

Herpes simplex virus is very contagious and can spread easily from person to person. The main ways of transmission are:

  • Oral contact: Kissing, sharing utensils, cups, or lip balm with someone who has oral herpes can transmit HSV-1.

  • Sexual contact: Having vaginal, anal, or oral sex with someone who has genital herpes can transmit HSV-2. Using condoms or dental dams can reduce the risk of transmission, but not eliminate it completely.

  • Vertical transmission: A pregnant person who has genital herpes can pass the virus to their baby during childbirth, which can cause serious complications for the newborn.

Some factors that can increase the risk of getting herpes simplex virus are:

  • Having multiple sexual partners or starting sexual activity at a young age.

  • Having a history of other sexually transmitted infections (STIs).

  • Having a weakened immune system due to certain diseases or medications.

  • Having breaks or cuts in the skin that can allow the virus to enter.

Symptoms and Complications

There are many people who do not experience symptoms of herpes simplex virus or only experience mild symptoms that may go unnoticed. Some people, however, may experience blisters or sores lasting up to 10 days. Different types and locations of infections may have different symptoms.

Oral herpes symptoms may include:

  • Tingling, itching, or burning sensation around the mouth or lips before the appearance of blisters.

  • Small, fluid-filled blisters that break open and form crusts on the mouth, lips, gums, tongue, or face.

  • Painful or swollen lymph nodes in the neck.

  • Fever, headache, muscle aches, or fatigue.

Genital herpes symptoms may include:

  • Tingling, itching, or burning sensation in the genital or anal area before the appearance of blisters.

  • Small, fluid-filled blisters that break open and form crusts on the genitals, anus, buttocks, or inner thighs.

  • Painful or swollen lymph nodes in the groin.

  • Fever, headache, muscle aches, or fatigue.

  • Painful urination or vaginal discharge.

Herpes simplex virus can also cause complications in some cases, such as:

  • Eye infections: HSV-1 can infect the eye and cause inflammation of the cornea (keratitis), which can lead to vision loss if not treated promptly.

  • Encephalitis: HSV-1 or HSV-2 can infect the brain and cause inflammation of the brain tissue (encephalitis), which can cause seizures, confusion, coma, or death if not treated promptly.

  • Neonatal herpes: HSV-2 can infect a newborn baby during delivery and cause severe problems such as skin lesions, eye infections, brain damage, or death if not treated promptly.

Diagnosis and Treatment

To diagnose herpes simplex virus infection, a healthcare provider may:

  • Ask about your symptoms and medical history.

  • Examine your skin for signs of blisters or sores.

  • Take a sample of fluid from a blister or sore and send it to a laboratory for testing.

  • Perform a blood test to check for antibodies to HSV-1 or HSV-2.

There is no cure for herpes simplex virus infection. However, antiviral medications can help reduce the frequency and severity of outbreaks and lower the risk of transmission to others. Antiviral medications may be taken:

  • As soon as you notice symptoms of an outbreak (episodic therapy).

  • On a daily basis to prevent outbreaks from occurring (suppressive therapy).

In addition to antiviral medications, you can also take some steps to ease your symptoms and speed up healing during an outbreak, such as:

  • Applying ice packs or cold compresses to the affected area.

  • Taking over-the-counter pain relievers such as ibuprofen or acetaminophen.

  • Keeping the affected area clean and dry.

  • Avoiding touching or scratching the blisters or sores.

  • Avoiding oral or sexual contact until the blisters or sores heal completely.

Prevention

To prevent getting or spreading herpes simplex virus infection, you should:

  • Avoid oral contact with someone who has cold sores or fever blisters.

  • Use condoms or dental dams during sexual contact with someone who has genital herpes.

  • Get tested for STIs regularly if you have multiple sexual partners.

  • Inform your sexual partners if you have herpes simplex virus infection and discuss the risks and precautions.

  • Avoid sexual contact during an outbreak or when you have symptoms of an outbreak.

  • Take antiviral medications as prescribed by your healthcare provider.

Infection with the herpes simplex virus is a common and manageable condition that can affect anyone. You can take charge of your health by knowing the causes, symptoms, diagnosis, treatment, and prevention of herpes simplex.

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