Herpes simplex, commonly known as herpes, is a viral infection

scientifically classified under the herpesviridae family. It is categorized into two types: Herpes Simplex Virus type 1 (HSV-1) and Herpes Simplex Virus type 2 (HSV-2).

Most commonly, HSV-1 causes fever blisters or cold sores, which are usually found around the mouth and lips. It can cause genital herpes, however, most cases are caused by HSV-2. HSV-2 can cause sores around the genitals or rectum, or in other locations, but usually below the waist.

What causes herpes infection?

HSV-1 is transmitted through mouth secretions or sores on the skin, such as through kissing, or sharing of eating utensils. HSV-2, on the other hand, can only get infected through sexual contact with someone who has genital HSV-2 infection. However, it should be remembered that both types can be spread even if sores are not present. Such people who are infected but do not have any symptoms are referred to as “asymptomatic”.

Genital herpes can also infect newborn babies when they pass through the birth canal of an infected mother. Thus, pregnant women or women planning to get pregnant should undergo screening for Herpes simplex infection, so that management, treatment, and birthing plans could be arranged immediately to avoid infecting the baby.

The herpes virus can go through periods of being dormant. Outbreaks or attacks can be brought about by the following conditions:

  • General illness (from mild illnesses to serious conditions)
  • Fatigue
  • Physical or emotional stress
  • Lowered immune system due to AIDS or such medications as chemotherapy or steroids
  • Trauma to the affected area, including sexual activity
  • Menstruation

Signs and symptoms of Herpes Infection

HSV infection causes many distinct medical disorders. Common infection of the skin or mucosa may affect the face and mouth (orofacial herpes), genitalia (genital herpes), or hands (herpetic whitlow). Other, more serious disorders occur when the virus infects and damages the eye (herpes keratitis), or invades the central nervous system and damaging the brain (herpes encephalitis). Patients with immature or weak immune systems, such as newborns, transplant recipients, or AIDS patients are prone to severe complications from HSV infections.

Symptoms of HSV infection typically appear as a blister or as multiple blisters on or around affected areas, usually the mouth, genitals, or rectum. When the blisters break, they leave painful sores.

In all cases, HSV is never removed from the body by the immune system. After infecting a patient for the first time, the virus enters the nerves at the site of the first infection and stays there and never leaves the body. Many people who have been infected with HSV-1 and HSV-2 display no physical symptoms; they are described as asymptomatic or having subclinical herpes.

How is Herpes Simplex diagnosed?

Quite often, the medical history and appearance of the lesions of herpes simplex virus is typical, thus, there is no need for any laboratory tests to confirm the diagnosis. A strong index of suspicion, along with the medical and clinical background is sufficient for the diagnosis of HSV infection.

Treatment of Herpes simplex infection

There is no method to totally remove herpes virus from the body, but antiviral medications can reduce the frequency, duration, and severity of outbreaks.

Analgesics such as ibuprofen (Advil) and acetaminophen (Tylenol) can reduce pain and fever. Topical anesthetic cream or gel treatments such as prilocaine, lidocaine, benzocaine, or tetracaine can also relieve itching and pain when applied over affected areas.Doconasol is also available in cream or gel form.

Antiviral medications are the mainstay of treating herpes virus infection. Generic brands include acyclovir, valacyclovir, famciclovir, and penciclovir. All are available as oral or topical medications.

Alternative medicine and dietary supplements are also claimed to be beneficial in the treatment of HSV infections. However, there is very little clinical data and studies to support their effectiveness in treating herpes virus infection. These substances and compounds include echinacea, eleuthero, L-lysine, zinc, monolaurin bee products and aloe vera.

Warm baths or compresses may also alleviate pain from sores.

How to prevent HSV infection

HSV-1 can be spread through mouth secretions, or sores on the skin. Examples are via kissing or sharing of eating utensils. The best way to minimize the spread of HSV-1 infection is to limit contact with people who had been infected and untreated. Do not share utensils and other intimate things with patients. Likewise, patients should be responsible to wash their hands frequently, especially after touching their sores. They should also be responsible in seeking immediate treatment for their infection to minimize their spread.

HSV-2 is transmitted sexually, thus, barrier contraceptive methods are especially important in minimizing infection. These include the use of condoms and female condoms. Responsible sexual practices, such as not having multiple sexual partners, is also beneficial in controlling the spread of HSV-2 infection.

Pregnant women who are infected with HSV can transmit the virus to their newborn via normal delivery, when the baby passes through the mother’s birth canal. Thus, they are advised to undergo antiviral treatment with acyclovir during the 36th week of pregnancy, to also minimize any complications to the baby. An elective cesarean section is also advisable in order to minimize contact of the baby to the mother’s birth canal.



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