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HERPES SIMPLEX VIRUS

Introduction

Herpes virus and antibodies

Herpes simplex virus 1 (HSV-1) and 2 (HSV-2) are a set of viruses that produce viral infections that establish a low grade chronic infection. Both HSV-1 and HSV-2 are relatively common and contagious. They are closely related to other herpesvirus infections, namely: Varicella/Shingles, Epstein-Barr Virus (Mono), and CMV.

By prevalence, HSV-1 affects 8 out of every 10 persons, and HSV-2 affects 3 out of every 10 persons according to a study done by National Center for Biotechnology Information (NCBI). Many HSV-1 infections are acquired in early childhood as children share toys with each other. Its possible to be reinfected in new locations, and its also possible that the virus will reactivate in a same location as before. Furthermore, it is important to note that the herpes simplex virus is no respecter of age as it can affect anyone regardless of age.

Important Features

HSV-1

HSV-1 predominantly causes oral herpes, which manifests on lips and oral mucosa (buccal mucosa and gingivae). It is generally responsible for cold sores and fever blisters. It can also affect around the nose as well as the fingertips in patients who might have exposure to others saliva (i.e. dentists/hygienists/parents)

HSV-1 can be contracted from usual interactions such as sharing the same utensils, lip balms, toothbrushes and even kisses. The risk of spread is highest if there is an active cold sore, however, asymptomatic spread is also possible.

HSV-2

This is commonly known as genital herpes, although it can be acquired by numerous other means. It is often contracted through various forms of sexual contact with a person already infected with the HSV-2. HSV-2 can be subtle and most patients that are infected aren’t aware of it. In most patients with normal immune systems, the HSV outbreaks might be minor and confused for an ingrown hair or pimple that occasionally recurs. It is important to let a Pennsylvania Dermatology Specialist diagnose your lesion of concern to give you an appropriate and accurate diagnosis.

Young man suffering from herpes on his mouth
Cropped of black guy holding his groin

Risk Factors for Developing Herpes Simplex Virus

Risk is based largely or almost entirely on exposure. Risk factors of HSV-2 can be unprotected sex, multiple sexual partners. It could also be the prevalence of another STI (Sexually Transmitted Infection) such as HIV. If a pregnant woman experiences genital herpes towards delivery, it can predispose the child to both types of HSV.

Signs & Symptoms

Many people who get the herpes simplex virus sometimes don’t feel or notice anything.If signs (what is visible) and symptoms (sensation i.e., what you feel) occur, a person might notice tingling, itching or burning sensation.Before the blisters appear; an infected person might feel a tingle, itch or burn for a few days prior.

Painful sores, fluid-filled blisters often appear. Blisters often break open, and fluid might ooze out and form a crust. This could appear in the oral region or genitals, depending on the type of HSV.For genital herpes, there could be pain during urination.An infected person may also experience flu-like symptoms such asfever, headaches, fatigue, sore throat, lack of appetite etc.

Although most blisters are found on the lips, face, around the mouth/nose, the tongue etc., it is possible to find HSV-1 on any other area of the skin, including in the groin.

Both HSV-1 and HSV-2 can spread to the eye to cause an infection called Herpes Keratitis. However, type 1 is the most frequent cause. It can be transferred by touching an active lesion and then transferring to your eye. Symptoms include redness, cloudy vision, discharge, increased sensitivity to light. If not managed by a professional, it could cause severe damage to the eye.

Classic Herpes Simplex on the forearm – grouped blisters on a reddish base

Multinucleated giant cells seen under the microscope from a smear taken from herpes simplex virus lesions

Outbreaks

It is important to note that the Herpes simplex virus remains in the nerve roots even after the outbreak is gone. It remains dormant until it is triggered to recur by various factors. During the initial outbreak (Primary outbreak), most people experience the most severe physical symptoms.

Subsequent outbreaks may be triggered by stress, trauma, underlying illness, sun exposure/sunburn and even menstruation.Each patient can often times identify their own personal triggers as well.

Treatment for Herpes Simplex Virus

Treatment is quite similar for both HSV-1 and HSV-2, which includesoral antivirals such asAcyclovir, Valacyclovir, Famciclovir.

Topical therapysuch as acyclovir cream and ointment,penicylovir,docosanol cream. This is a cheaper method of managing HSV; however, these drugs offer low efficacy as they are superficial.

Intravenous therapy is often for disseminated and mucocutaneous HSV infections in immunocompromised patients or neonatal HSV.

Frequently, the effects of HSV can create psychological anxiety, low self-esteem, etc. Therefore, therapy and lack of stigmatization can do a lot of good.

Outbreaks generally become less frequent and less severe over time. There are numerous effective treatments so make an appointment at Pennsylvania Dermatology Specialists today!

Subsequent outbreaks may be triggered by stress, trauma, underlying illness, sun exposure/sunburn and even menstruation.Each patient can often times identify their own personal triggers as well. Pennsylvania Dermatology Specialists are your experts in treating HSV.