Herpes - Herpes Simplex | Herpes Simplex Virus | HSV-1 | HSV-1 | Symptoms of Herpes
Sexually Transmitted Diseases [STD], Women's Health

Herpes | Symptoms, Causes, Types & Prevention

Herpes simplex virus [HSV] is a common infection that causes painful or itchy blisters periodically. HSV is of two types HSV-1 and HSV-2. HSV-1 causes blisters in or around the mouth and face while HSV-2 causes genital herpes. Once contracted, HSV is a lifelong condition. Although there is no cure yet for herpes virus, it can be successfully managed through medications and lifestyle modifications. 

What is Herpes Simplex Virus [HSV]?  

Herpes simplex is a virus that causes a lifetime of skin infections. Once infected with herpes, it can remain inside the body and periodically reactivate causing painful or itchy blisters and sores. Although people with herpes can lead a healthy life, it can be dangerous for newborns or individuals with weakened immune systems. 

Related: Sexually Transmitted Diseases

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What are the Types of Herpes Simplex? 

There are two types of herpes virus, they are:

  1. Herpes Simplex Virus Type 1 [HSV-1]: This type of virus often spreads through oral contact which causes cold sores/fever blisters in or around the mouth. It can also cause genital herpes through oral-genital transmission. HSV-1 is highly contagious and is most commonly seen in adults. 
  2. Herpes Simplex Virus Type 1 [HSV-2]: This type of virus primarily spreads through sexual contact and causes genital herpes. It can lead to sores and ulcers in the genital and anal areas. Apart from sexual contact, HSV-2 can also be transmitted to a newborn during childbirth if the mother is infected. Usually, most people experience mild to no symptoms at all. 

Related: Anogenital Warts

What is the difference between HSV-1 and HSV-2? 

Although both types are closely related, there are some fundamental differences. They are: 

  1. Location of Symptoms: Typically, HSV-1 causes sores/blisters around or inside the mouth and sometimes around the genital. On the contrary, HSV-2 causes only genital herpes. 
  2. Transmission: HSV-1 is transmitted through saliva or skin touch and oral sex. Whereas HSV-2 is primarily spread through sexual contact, whether it’s by vaginal and anal intercourse or oral-genital intercourse. HSV-2 can also be transmitted from a mother to a newborn during childbirth. 
  3. Prevalence: It is estimated that a significant portion of the population is infected with HSV-1. Whereas HSV-2, although widespread among sexually active individuals, is less common in comparison. 
  4. Infection: HSV-1 can infect other parts of the body including hands, fingers, neck, and nostrils. However, HSV-2 can be more dangerous as it increases the risk of HIV infection by two to four times as it provides direct contact with blood. 

Causes and Transmission of Herpes Simplex 

What are the causes of herpes virus and how is it transmitted? 

Typically, herpes spreads through skin-to-skin contact. However, based on the type of herpes the cause can change. In HSV-1, the virus is transmitted through saliva or skin contact and it can cause infections in or around the mouth and genital herpes. In HSV-2, the virus spreads through sexual contact and causes genital herpes. 

Moreover, HSV can also spread through an infected person even when there are no obvious symptoms. This is known as asymptomatic viral shedding. The virus can be found in the skin or saliva and is easily transmitted when there’s direct contact with the infected person’s mucous membrane, saliva, or the fluid from the sore. Certain triggers like illness, fever, sun exposure, menstrual period, injury, stress, and surgery can trigger and activate the infection. 

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Symptoms & Stages of Herpes Simplex 

What are the symptoms of herpes simplex infection? 

Herpes simplex can manifest in many ways depending on the type of infection. Some of the common symptoms are: 

  1. Symptoms of HSV-1
    Blisters in or around the lips or mouth. Although these are the most common spots of infection, they can appear anywhere on the skin.
    Flu-like symptoms including fever, muscle aches, and swollen lymph nodes in the neck are also possible. 
  2. Symptoms of HSV-2
    Blisters around the penis, vagina, buttocks, or anus. In women, sores can appear inside the vagina as well. Similar to oral herpes, these sores can appear anywhere on the skin. Most people experience mild to no symptoms at all.
    Painful blisters that recur with time. 
  3. Common Symptoms of Both
    Tingling, itching, or burning when new sores appear
    Painful and recurring blisters or ulcers
    New infections that may cause fever, muscle aches, and swollen lymph nodes
    An eye infection that may result in scarring of the eye without prompt treatment
    Flu-like symptoms including fever, headaches, and others during the first outbreak of genital herpes
    Painful urination or difficulty to urinate
    Recurrent symptoms that are typically milder than the initial outbreak
    Symptoms that don’t last long
    Asymptomatic viral shedding 
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What are the stages of HSV infection? 

Herpes infection usually progresses in stages; however, its severity and timing can vary in individuals. Here are the common stages of infection in both types of herpes: 

HSV-1 

  • Primary Infection Stage: Early symptoms of genital herpes usually manifest with symptoms associated with flu, like fever, headache, and muscle pain. 

HSV-1 and HSV-2 

  • Prodrome Stage: This is the stage when the herpes symptoms start to show. During the initial stage, the infection progresses to the surface of the skin resulting in redness, itchiness, tingling, or burning pain in or around the affected area. 
  • Blister Stage: During this stage, herpes blisters or sores appear as small red bumps that are filled with fluid. It usually resembles pimples, ingrown hairs, and jock itch. These blisters are round or oval and may vary in size. Usually, they are red or pink and filled with clear or cloudy fluid. 
  • Ulcer Stage: In the ulcer stage, the blisters rupture leaving painful ulcers that can take several weeks to heal. Herpes infection usually appears as a cluster of small, fluid-filled blisters that are painful and may ooze or bleed. 
  • Healing Stage: The healing stage can take anywhere between several days to weeks. The skin may be red and irritated for a short period.  

HSV-2 

  • Latent Stage: During the latent stage, the person is asymptomatic. They may not have visible symptoms but are still infected. 

Who is at Risk of HSV Infection? 

Anyone can get infected with herpes virus. However, some are more at risk than others. They are:

  1. Sexually active individuals 
  2. People with multiple sexual partners 
  3. People who engage in risky sexual behaviors 
  4. People with a history of sexually transmitted infections 
  5. Older people
  6. Close contact with infected individuals 
  7. Immunocompromised individuals 
  8. Men who have sex with men 

As mentioned, it’s important to note that many people with herpes are asymptomatic. 

Diagnosis and Testing for Herpes Simplex

How is herpes diagnosed?  

Herpes can be diagnosed through a combination of physical examination, clinical evaluation, and lab tests. The specific type of test or diagnostic method will depend on the type of herpes infection and its stage. Some of the common methods of diagnosis are: 

  1. Physical Examination: An experienced doctor can usually identify herpes infection through physical examination and understanding their sexual activities. During the outbreak, a dermatologist can identify herpes simply by seeing the sores. 
  2. Swab Test: The doctor can also take swab tests from active sores to detect if they have herpes simplex virus [HSV] and what type it is. 
  3. Blood Test: Occasionally, the doctor may also request blood tests to confirm the diagnosis and to rule out other infections. Blood tests also help identify herpes antibodies and the type of herpes infection.
  4. Polymerase Chain Reaction [PCR] Test: PCR tests are highly accurate in detecting whether the infection is HSV-1 or HSV-2. 
  5. Serological Blood Test: Serological blood tests can detect the antibodies produced in response to the infection. There are two types of serological tests, IgM Antibody Test and IgG Antibody Test.
    An IgM antibody test can detect whether the initial infection has occurred, however, it is less reliable for finding recurrent or latent infections. IgG antibody tests are more commonly used to detect past or present infections and understand the type of herpes virus.
     
  6. Western Blot Test: Western blot test is a highly accurate blood test that detects herpes infections and their types. Often, it is used to confirm the reports of other blood tests. 
  7. Lumbar Puncture: A lumbar puncture or spinal tap may be done when the infection has spread to the central nervous system. 
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Treatment of Herpes Simplex 

Herpes infections cannot be cured but they are certainly treatable. Some of the treatment options for herpes infection are: 

  1. Antiviral Medications: Systemic antiviral drugs can partly control the symptoms of genital herpes when used in the initial episodes of the infection. Three of the FDA-approved medications are acyclovir, famciclovir, and valacyclovir. These medications can be taken orally or as a shot. They can reduce the severity of symptoms, facilitate healing, reduce the frequency of outbreaks, and prevent spreading to others.
     
  2. Topical Medications: Antiviral creams can be directly applied to the affected area to alleviate burning, itching, and tingling of the sores. 
  3. Pain Relievers: Over-the-counter medications like ibuprofen can reduce the pain and discomfort of the infection. 
  4. Suppressive Therapy: Daily suppressive therapy with antiviral medications may be prescribed for individuals with recurrent outbreaks or genital herpes. Taking antiviral medications daily can reduce the severity of symptoms, facilitate healing, reduce the frequency of outbreaks, and prevent spreading to others. 
  5. Keeping Clean: Keeping the affected area dry and clean can prevent secondary bacterial infections and stimulate healing.
  6. Lifestyle Modifications: Avoiding certain triggers like sun exposure and specific foods and mitigating stress can reduce the frequency and severity of outbreaks. 
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Lifestyle Modifications and Prevention of Herpes Simplex 

Living with Herpes Simplex Virus [HSV] – Coping Strategies

Living with herpes can be challenging but several coping strategies can help you achieve a fulfilling life. Some of the effective strategies are: 

  • Follow Your Doctor’s Treatment Plan: If you find out you’re infected with herpes, the best thing to do is to follow your doctor’s treatment plan closely. This may include taking the prescribed medications timely and following the recommended guidelines. 
  • Seek Support: Living with herpes can be difficult, that’s why it’s important to surround yourself with people close to you. Stay connected with your loved ones. You can also join a support group to share experiences and hear various perspectives. 
  • Practice Good Self-Care: As always, good self-care is key to a happy life. Take care of yourself physically and emotionally to the best of your ability. Try to build healthy habits like getting enough sleep, maintaining a healthy diet, regularly exercising, and managing stress. All these steps can help you build a better life. 
  • Be Honest with Your Partners: It’s important to disclose your herpes status with your partners. It may not be a comfortable conversation but it’s important. 
  • Educate Yourself: Continue to learn more about herpes, its triggers, and symptoms. This will help you manage the condition much better. 
  • Take Precautions During Pregnancy: If you’re pregnant and infected with herpes, closely work with your doctor to reduce the risk of transmitting it to the newborn. 
  • Manage Self-Stigma: Always remember that herpes doesn’t define your worth, instead, it’s just one aspect of you. 
  • Remain Positive: Know that herpes is a common condition, and it doesn’t hinder you from anything. Stay positive and find out strategies that help you better cope with the infection. 
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How can I prevent HSV? 

Although common, herpes simplex infection can be prevented through the following steps: 

  1. Abstinence: The most effective way to prevent HSV is to abstain from sexual activity or to have relations with one person who isn’t infected and doesn’t have multiple partners. 
  2. Condoms: Consistently and accurately using condoms during intercourse can reduce the risk of herpes infection. However, it’s important to mention that herpes can affect other parts of the body which cannot be protected through condoms. 
  3. Dental Dams: Dental dams can be used to create a barrier during oral-genital contact to reduce the risk of infection. 
  4. Practice Good Hygiene: Practicing good hygiene like cleaning hands with soap and water after touching sores can prevent HSV. 
  5. Regular Testing: If you and your partner are sexually active, it’s best to get tested regularly for HSV and other sexually transmitted diseases to ensure the safety of both. 
  6. Avoid Sexual Contact During Outbreaks: During a herpes outbreak, it’s best to avoid sexual contact to prevent transmission. 
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Get Help with Dr. Mozhgan 

As you can see, herpes infection is common and a treatable condition. If you’re infected with herpes or experience the aforementioned symptoms, it’s important to contact a qualified healthcare professional. Dr. Mozhgan is one the best female gynecologists in UAE who specializes in treating sexually transmitted diseases. With over 20 years of invaluable experience and knowledge, she will help you manage HSV better and help you lead a better life. 

Common FAQs

Q1. Can I still have sex if I have herpes? 

Yes, it’s possible to have sex even if you have herpes. But it’s important to follow the necessary precautions like using condoms and dental dams, avoiding intercourse during an outbreak, taking antiviral medications, openly communicating, and practicing good hygiene to prevent transmission to your partner. 

Q2. How common is HSV? 

HSV is a widespread condition with about 2 in 3 people infected with HSV-1 by the age of 50 and 15% of 15–49-year-olds infected with HSV-2. 

Q3. How painful is herpes simplex? 

Herpes can cause painful symptoms, but its severity varies from person to person. The initial outbreak can be painful and cause flu-like symptoms; however, the recurrent outbreaks tend to be less severe. 

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