Herpes Simplex - Types, Symptoms, Risk, Diagnosis, and Treatment

What Is Herpes Simplex Virus?

Herpes simplex virus (HSV) commonly causes sores and blisters, usually affecting the mouth, anal area, and genital region. However, it is also possible that people don’t feel anything at all.

It can spread from one person to another through direct contact. Once it gets into your body, it can stay there forever and sometimes come back to cause more sores, which is called an outbreak.

It can not be cured completely, and management focuses on relieving pain.

What Are the Types of HSV?

There are two types:

• Herpes simplex type 1 or HSV-1:

This causes oral herpes and other symptoms like cold sores and fever blisters, but it can also cause genital sores (through oral-genital contact).

• Herpes simplex type 2 or HSV-2:

This is a sexually transmitted disease (STD) and causes genital herpes. In the United States, about 48 % of adolescents and adults under the age of 50 have HSV-1, and about 12 % have HSV-2.

Which Body Areas Are Commonly Affected by Herpes Simplex?

HSV is not limited to the mouth and genital areas; it can show up in different parts of your body, too! Let's have a look at where these viruses can go.

1. Mouth:

• HSV-1 can cause cold sores around the lips.

• It can cause sores inside the mouth, called herpetic gingivostomatitis.

• Sometimes it may also cause sores inside the nose, referred to as nasal herpes.

2. Genitals:

• HSV-2 can cause sores in the genital area (vulva, penis, and cervix).

• Along with soreness, there may be painful urination and itching.

• Some females may also experience vaginal discharge.

3. Skin:

• Herpetic whitlow (fingers are affected).

• Herpes gladiatorum (the body is affected).

• Eczema herpeticum (a widespread infection in individuals with eczema).

4. Brain:

• HSV can infect the brain, causing herpes simplex encephalitis.

• When it affects the protective layer around the brain, it is referred to as herpes meningitis.

5. Eye:

• When HSV affects the eye, it is referred to as herpes keratitis.

6. Other organs:

This is mostly seen in immunocompromised patients.

• When it affects the lungs, it is called HSV pneumonia.

• When it affects the liver, it is called HSV hepatitis.

• When it affects the esophagus, it is called herpes esophagitis.

What Are the Early and Common Symptoms of Herpes Simplex Infection?

Symptoms of HSV, according to the specific type, are:

• Oral herpes: Tingling, itching, and burning may happen for 48 hours before blisters appear. These blisters break down, ooze fluids, and may form crust and scabs. These may be associated with flu-like symptoms.

• Genital herpes: There are blisters around the genitals. Some may also experience swollen lymph nodes, fever, headache, itching, and tingling in the genitals.

• Herpes gladiatorum: Blisters may appear anywhere in the body, such as the chest, ears, face, and hands.

• Herpetic whitlow: Blisters appear on the fingers. This is accompanied by swelling in the fingers and discoloration around the nails.

• Herpes keratitis: Here, there may be eye pain, a feeling like something's in the eye, blisters around the eyelid, sensitivity to light, and irritation.

• HSV encephalitis: Symptoms can include changes in speech, focal seizures, fever, headache, etc.

• Herpes meningitis: Symptoms are sensitivity to light, fever, and headache.

The first symptoms can show up 2 to 20 days after touching someone who has the virus. Once you’re infected, the virus remains in your body, meaning sores can reappear over time.

However, recurring outbreaks do not last long and are not that painful. In some cases, people may not experience any symptoms at all.

How Does Herpes Simplex Virus Spread From Person to Person?

Herpes simplex virus can spread easily from one person to another, even when they don’t have any sores! Here's how it happens:

• HSV-1 can spread through direct contact, such as eating with the same utensils, kissing, and sharing lip balm.

• The virus can spread very fast if the infected person has an outbreak. HSV-1 can even cause genital herpes if the infected person has cold sores during oral sex.

• HSV-2 can be spread when a person has sexual contact with an infected person.

• Most people will get an HSV-1 infection from a person who is asymptomatic or without sores.

• Sometimes, a mother who has herpes can pass it to her baby during birth. This is called neonatal herpes.

You can get the HSV by touching someone who already has it. Here is how it can spread:

• If you touch someone’s blisters or sores.

• If you touch an infected person’s mouth, private parts, or skin around it.

• If you touch an infected person’s saliva, vaginal discharge, or semen.

What Triggers the Herpes Simplex Virus?

Sometimes, the virus, which stays in the body, can wake up and cause outbreaks, and certain things can make it happen. These things are called triggers, which are:

• Stress.

• Fever.

• Changes in hormones.

• Suppressed immune system.

• Sun exposure.

• Upper respiratory tract infection.

• Trauma to the mouth area.

• Fatigue.

• Overexertion.

What Are the Stages of an HSV Infection?

There are three stages, which are:

1. Primary infection:

• This is the first stage. After the virus gets into the body, it starts to make more copies of itself in the nearby nerve cells.

• Then, it travels to nearby skin, where your immune system notices it and tries to fight it.

• This can cause rashes, redness, swelling, and blisters to appear, which heal after 2 or 4 weeks.

2. Latency period:

During this period, the virus stays in the body without causing any problems.

3. HSV reactivation:

At this stage, the resting virus can wake up, alert the immune system, and cause an outbreak.

How Is HSV Diagnosed?

Doctors use several steps to find out if you have HSV.

1. Medical history:

• Doctors will ask about the symptoms you’re experiencing currently.

2. Examining the skin:

• Doctors will look for symptoms of HSV.

3. Laboratory tests:

• A swab sample of the fluid from the sore is collected for viral culture.

• If no sores are present, blood testing for antibodies to HSV-1 and HSV-2 can be useful to detect the infection.

• HSV polymerase chain reaction (PCR) test in case it has affected the brain and spinal cord.

• Lumbar puncture to analyze cerebrospinal fluid.

False negatives are possible if tests are done too soon, so one should wait 12 to 16 weeks after potential exposure.

How Is Herpes Simplex Infection Managed?

There is currently no cure for this virus, and the treatment focuses on reducing the sore throat and other symptoms. The sore will go on its own, but the doctor may ask you to take one or more of the following medicines:

1. Acyclovir, Valacyclovir, or Famciclovir (antiviral drugs). These come as pills you swallow or creams you can put on the sores. If the infection is very bad, medicine might be given by injection.

2. In case of pain due to blisters, Acetaminophen or Ibuprofen may be given.

3. Numbing creams like Benzocaine or Lidocaine can help soothe the skin.

4. Additionally, it is important to maintain hygiene, wear loose clothes, take warm baths, and avoid triggers.

How to Prevent Herpes Simplex Transmission and Infection?

The herpes infection usually spreads from person to person by skin-to-skin contact through vaginal, anal, or oral sex. Therefore, these can be prevented by having protected sex and having no contact with the infected person. Using protections like condoms can help lower the risk of getting herpes and STDs.

What Are the Potential Complications of Herpes Simplex Virus?

If HSV is not treated, it can cause bigger issues like:

• Encephalitis (brain inflammation).

• Meningitis (inflammation of the protective layers of the brain).

• Neonatal herpes.

• Painful sores on the eyelids.

• Secondary bacterial infections.

• Bladder issues.

• Vaginal yeast infections.

• In case of weakened immune systems, it can cause widespread infections.

Conclusion

Herpes simplex infection is a sexually transmitted disease with no cure. Mostly, it shows up on the mouth and genital area. Sometimes, it can involve other body parts, too!

Diagnosis is made by examining the skin and using a few tests. Medications may be prescribed to ease the pain. Taking precautionary measures becomes important as this virus cannot be eliminated once it gets inside the body.

Note from iCliniq

• Herpes simplex virus can spread through direct contact, even if there are no visible symptoms. It mostly affects the mouth and genital area.

• There is no cure for it. Once infected, it stays forever in the body, so prevention is of the utmost importance.

• If you have developed any blisters on your skin, oral cavity, or genitalia, consult an iCliniq dermatologist online for expert diagnosis and treatment.