Herpes simplex is a virus that causes an infection that mainly affects the mouth or genital zone.
There are several virus strains of the herpes simplex virus:
Type 1 (HSV-1) is associated with infections of the lips, mouth and face. This type of herpes simplex is the one that most often infects people and develops already in childhood.
HSV-1 often causes sores (lesions) inside the mouth, such as cold sores (herpes labialis) or infections of the eye (especially the conjunctiva and cornea).
It can also lead to infections of the meninges (meningoencephalitis). Transmission occurs through contact with infected saliva.
Herpes simplex type 2 or genital herpes (HSV-2) is transmitted sexually.
Signs and symptoms may include genital ulceration or sores.
However, some people with HSV-2 do not notice any symptoms.
An infection of the finger, also called herpetic circulation, is another form of herpes simplex infection.
Usually, healthcare workers who come into contact with saliva during surgical procedures or during work (dentists) are affected.
Sometimes even very young children can get sick.
HSV can infect fetuses and cause abnormalities.
A mother infected with HSV can transmit the virus to the newborn during childbirth, especially if the mother is acutely infected at the time of birth, but also if she is asymptomatically ill.
The virus can be transmitted even if no symptoms or visible lesions have already occurred.
HSV cannot be removed from the organism, it remains latent there and can reactivate at any time and cause symptoms.
The 8 types of the herpes virus
The human herpes viruses are designated by numbers from 1 to 8 (HHV1 – HHV8).
Typically, herpes virus 1 (HSV1) is the cause of cold sores around the mouth. HSV1 can also cause infection in the genital area, leading to genital herpes. Transmission occurs through oral-genital contact as with oral sexual intercourse.
As a rule, the lips and oral mucosa are affected. A herpes infection can also be present on the cheeks and nose, but facial herpes is very rare.
HSV1 infections are contagious and are usually transmitted through skin-to-skin contact with an infected person via minor injuries or through the mucosa. HSV1 is most likely to be transmitted via shared items such as cutlery, razors or towels used by a person with an acute outbreak.
In general, human herpes virus type 2 (HSV2) causes genital herpes, a sexually transmitted infection.
However, it can also cause cold sores in the facial area. As with HSV1, infection with HSV2 is contagious and spreads through skin-to-skin contact. The main route of transmission is sexual intercourse, as the virus is not able to survive for long outside the body.
The varicella-zoster virus (VZV), or herpes zoster, can cause chickenpox and an infection called herpes zoster or shingles. Herpes zoster occurs when a chickenpox virus dormant after initial infection is reactivated.
Herpes zoster infects the skin and nerve cells. This virus can also show up along the nerve pathways by causing vesicles where the nerve ends in the skin.
The herpes zoster blisters follow the course of the nerves. If the sciatic nerve is affected, they can occur along the leg, if they affect other nerves, they can be seen on the arm, chest, foot, etc.
Shingles is generally much more severe than a recurrence of herpes simplex, because often an entire group of nerve cells is affected.
As a rule, the blisters have a band-like arrangement, they appear on one half of the body and are often accompanied by itching, tingling or shooting pain.
Healing usually takes place after 3-4 weeks, scarring may remain. Postherpetic neuralgia is a complication of herpes zoster, in which the pain of infection can persist for months to years. Most people who have had herpes zoster once do not have a recurrence.
HHV-4 is also known as Epstein-Barr virus, which is the main cause of infectious mononucleosis, also known as glandular fever or kissing disease.
Mononucleosis is a contagious infection that is transmitted through saliva. The spread of the virus occurs via coughing, sneezing or sharing cutlery and drinking glasses with an infected person.
Cytomegalovirus (CMV) does not necessarily cause symptoms in people with healthy immune systems. The virus can be transmitted sexually and cause problems in newborns, such as jaundice.
CMV can be transmitted through sexual contact, breastfeeding, blood transfusion, and organ transplantation. CMV infection is one of the complications of AIDS.
Symptoms of cytomegalovirus are: diarrhoea, serious visual disturbances, stomach or intestinal infection, as well as death.
Human herpesvirus 6 causes the three-day fever (also known as exanthema subitum or sixth disease), which usually affects young children.
Symptoms include high fever and rash (roseola), but seizures can also be caused.
There is no therapy against the virus, only the symptoms can be alleviated and in the case of a bacterial superinfection, the doctor can prescribe antibiotics.
Human herpesvirus 7 is very similar to HHV6 and affects almost all children up to the age of 3 years.
HHV7 can cause roseola, but it is unclear what other symptoms it can cause.
Transmission occurs through saliva.
HHV8 was recently isolated in Kaposi’s sarcoma (KS), a tumor that manifests only in the skin, mucosa, and gastrointestinal tract.
KS affects patients suffering from AIDS, only very rarely are other people affected.
Kaposi’s sarcoma forms purple tumors on the skin and other tissues in some people with AIDS.
It is very difficult to treat by medication. HHV8 can also cause other tumors, including lymphomas (neoplasms of the lymph nodes) associated with AIDS.
The fact that these tumors are caused by a virus may explain why people suffering from AIDS are affected when the immune system is compressed.
Symptoms of cold sores
As a rule, cold sores (herpes labialis) is caused by the herpes simplex virus 1 (HSV-1), but can also be caused by type 2.
The oral primary infection (at the beginning) can be very painful, especially in young children.
The blisters form on the lips and sometimes on the tongue, rarely they reach the nose or eyes.
If the blisters tear open, open painful wounds remain, which develop a yellowish membrane before healing.
The wounds pass within 2 weeks.
One can perceive an increased salivation and bad breath.
In rare cases, the infection may be accompanied by difficulty swallowing, chills, muscle pain or hearing loss.
In children, the infection usually occurs inside the mouth. In adolescents, the primary infection occurs more often in the upper pharynx and causes pain.
During pregnancy, recurrence of herpes labialis is possible. Usually, however, this does not pose a danger to the child, because if the mother transmits the disease to the child, she also gives him the antibodies for healing.
If medication is taken, it must only be locally applied ointments to avoid harm to the child.
Symptoms of genital herpes
In patients with symptoms, the first focus of infection in the genital area develops 1-2 weeks after sexual contact with the virus.
The first signs are tingling in the affected areas (for example, genitals, anus, buttocks and thighs) and groups of red blisters.
In the following 2-3 weeks, the blisters can tear and thereby create open painful wounds.
In the end, the lesions dry up and are covered by a grind.
The grinds heal quickly and leave no scars. The blisters in the humid districts heal much slower than in other areas.
The lesions can sometimes cause itching, which decreases during the healing process.
About 40% of men and 70% of women have other symptoms with the first appearance of genital herpes, such as flu-like symptoms, headache, muscle pain, fever and swelling of the glands (the glands may swell in the lumbar region and neck). Some patients may experience discomfort when urinating and women may experience vaginal discharge.
During pregnancy, if the mother experiences reactivation of genital herpes, she can infect the child at the moment of birth. So you should talk to the doctor about it to discuss taking antiviral drugs.
Most of the time, doctors can tell if it’s an HSV infection simply by looking at the lips. However, some examinations may be prescribed to be sure in the diagnosis.
These investigations are:
- Blood test for antibodies against HSV (serology)
- Direct immunofluorescence (DIF) of the cells taken from the vesicles
- Virus culture from the bubbles
Treatment and medication
Some cases are mild and do not require any therapy.
People with severe or prolonged outbreaks, with immune system problems, or with frequent recurrences may benefit from antiviral medications such as acyclovir (Zovirax) and famciclovir (Famvir).
People with severe or frequent recurrences of lip and genital herpes may continue to take antiviral medications to reduce the frequency and severity of recurrences.
Cortisone is not a suitable remedy for the treatment of the herpes virus.
Natural treatments include physical therapy, which can help with herpes zoster (type 3). In fact, laser therapy reduces the times of scarring of open wounds and grinding.
One of the most effective home remedies for herpes labialis is to drizzle a cotton ball with lemon juice and apply it to the cold sores.
For disinfection you can also apply some toothpaste to the lips.
Applying honey directly to the areas affected by herpes reduces healing time and symptoms.
As an effective ointment to reduce the healing time, you can use a cream with lemon balm extract.
The tea tree oil gel is another local remedy to recover faster from the herpes virus.
How long does the disease last?
The sores on the mouth and genitals caused by herpes simplex heal spontaneously in 7-10 days. The infection can be severe and last longer in patients with a compressed immune system.
When infection occurs, the virus spreads to nerve cells and remains in a person’s body for the rest of his life. It may return from time to time and cause symptoms or blisters.
The recurrences can be caused by strong sunlight, fever, stress, an acute illness, medication or a disease that weakens the immune system (such as cancer, HIV/AIDS or cortisone).
How contagious is the disease?
Infection is always possible, even during asymptomatic phases. But it is much more likely that the virus will be transmitted from one person to another at a time when the blisters are open.
- Herpetiform dermatitis (herpes spread through the skin)
- Eye infection (herpes corneae) – keratitis
- Infection of the trachea
- Prolonged and severe infection in immunosuppressive individuals
Preventing HSV is difficult because people can spread the virus even if they don’t have symptoms of an active outbreak.
By avoiding contact with an open lesion, the risk of infection is also lower.
Safe behavior during sexual intercourse, including the use of condoms, reduces the risk of infection.
People with active HSV lesions should avoid contact with newborns, children with eczema, or people with immune system depression because these groups are at increased risk.
To minimize the risk of infecting a newborn, incision (cesarean section) is recommended for pregnant women who have active HSV infection at the time of delivery.