Herpes simplex virus (HSV) infections are very common worldwide. HSV-1 is the main cause of herpes infections on the mouth and lips, including cold sores and fever blisters. It is transmitted through kissing or sharing drinking glasses and utensils. HSV-1 can also cause genital herpes, although HSV-2 is the main cause of genital herpes.
HSV-2 is spread through sexual contact. You may be infected with HSV-1 or HSV-2 but not show any symptoms. Often symptoms are triggered by exposure to the sun, fever, menstruation, emotional stress, a weakened immune system, or an illness.
There is no cure for herpes, and once you have it, it is likely to come back. However, some people may have one outbreak and then never have another one. In between herpes outbreaks, the virus lies dormant (as if it is hibernating or sleeping) in nerve cells.
Exposure to HSV-1 is extremely common, as many as 90% of American adults have been exposed to the virus, and there is no stigma to having a cold sore. However, HSV-2, or genital herpes, can cause embarrassment. Although there is no cure for genital herpes, an infected person can take steps to prevent spreading the disease, and can continue to have a normal sex life.
While most herpes infections do not cause serious complications, infections in infants and in people with weakened immune systems, or herpes infections that affect the eyes, can be life threatening.
HSV-1 is spread through saliva. Kissing, using the same eating utensils, sharing personal items (such as a razor), and receiving oral sex from someone who has HSV-1 can cause you to contract the virus. HSV-2 is sexually transmitted.
Until recently, scientists assumed that HSV-1 infections were not sexually transmitted. Now, scientists know that either type can be found in either the oral or genital area, as well as at other sites. In fact, researchers estimate that HSV-1 is responsible for up to half of all new cases of genital herpes.
To infect people, HSV-1 and HSV-2 must get into the body through broken skin or a mucous membrane, such as inside the mouth or in the genital area. In addition to the fluid from fever blisters, each virus can be carried in bodily fluids like saliva, semen, and fluid in the female genital tract.
Both herpes viruses may cause genital infections, and both can be contagious even if the infected person does not have active symptoms or visible blisters.
Also, a mother can pass the infection to her baby during vaginal birth, especially if there are active blisters around the vagina at the time of delivery.
Oral herpes (cold sores)
Everyone is at risk for oral herpes from HSV-1. In fact, studies suggest that by adolescence, 62% of Americans are infected with HSV-1. By the time people are in their 60s, up to 85% have been infected.
All sexually active people are at risk for genital herpes. Having multiple sexual partners puts you at even greater risk. Women have a greater risk of being infected after sex with an unprotected partner than men do, about 1 in 4 women have HSV-2, compared to 1 in 8 men. Estimates of how many Americans are infected range from 20 to 30%. HSV-2 is 3 times higher among HIV-infected adults compared to the general population. There is also a very high prevalence and incidence of HSV-2 infection among adolescents, compared to the general population.
People with weakened immune systems, such as people with HIV/AIDS, or those who take immunosuppressant drugs to treat an autoimmune disease or because of organ transplant, are at increased risk for severe cases of herpes.
Often your doctor is able to make the diagnosis of herpes from examining you. If your doctor is not 100% certain, however, your doctor may take a sample from the blisters to test for the virus. Finally, there is a blood test that may help make a diagnosis, especially if your doctor suspects herpes but you do not have an active infection.
There is no cure for herpes, so the goals of treatment are to reduce the number of outbreaks and to lessen symptoms when you do have an outbreak.
Cold sores usually go away by themselves within 2 to 3 weeks, however, they can last for up to 6 weeks. Using medications may shorten the outbreak and decrease discomfort.
Antiviral medications for genital herpes can reduce outbreaks and help speed recovery when an outbreak does happen. They can also reduce the chances of spreading the virus.
Coping with the emotional and social aspects of having genital herpes is part of treatment. Relaxation techniques and support groups can help.
For cold sores, applying either heat or cold to blisters may help relieve pain. Try ice or warm compresses.
For genital herpes, wear cotton underwear and avoid tight fitting clothes as they can restrict air circulation and slow the healing of lesions.
Be sure to tell your partner or potential partner that you have herpes.
Antiviral medications may help shorten the length of a herpes outbreak and cut down on recurring outbreaks. These treatments can reduce outbreaks by up to 80%. For genital herpes, there are two types of therapy:
With episodic therapy, you take medication at the first sign of an outbreak and for several days to shorten the length or prevent a full outbreak. With suppressive therapy, you may take medication daily to keep outbreaks from happening. Antiviral medications include:
Topical medications (for oral herpes), include the antiviral cream Penciclovir (Denavir) and an over-the-counter cream, docosanol (Abreva).
Because supplements may have side effects or interact with medications, you should take them only under the supervision of a knowledgeable health care provider.
The use of herbs is a time-honored approach to strengthening the body and treating disease. Herbs, however, can trigger side effects and can interact with other herbs, supplements, or medications. For these reasons, you should take herbs with care, under the supervision of a health care practitioner.
Although few studies have examined the effectiveness of specific homeopathic therapies, professional homeopaths may consider the remedies described below for the treatment of herpes based on their knowledge and experience. One study of 53 people with genital herpes found that those who were treated with homeopathy experienced improvement in their symptoms and were less likely to have recurrent outbreaks. Participants in this study were followed for up to 4 years.
Before prescribing a remedy, homeopaths take into account a person's constitutional type. A constitutional type is defined as a person's physical, emotional, and psychological makeup. An experienced homeopath assesses all of these factors when determining the most appropriate remedy for each individual.
For cold sores:
For genital lesions:
Pregnant women who are infected with HSV-1 or HSV-2 have a higher risk of miscarriage, premature labor, slow fetal growth, or transmission of the herpes infection to the infant during vaginal delivery. Herpes infections in newborns can be life threatening or cause disability. In women with active, recurrent herpes, antiviral medication beginning at 36 weeks gestation reduces the risk of the mom transmitting HSV to her baby. Delivery by cesarean section (C-section) is recommended to avoid infecting the baby.
Herpes infections contracted during delivery, from the mother to the newborn, can lead to meningitis, herpes infection in the blood, chronic skin infection, and may even be fatal.
You are more likely to have severe, frequent outbreaks and to experience complications from herpes if your immune system is suppressed from:
If you are diagnosed with genital herpes, you should be tested for other sexually transmitted diseases (STDs) such as chlamydia and gonorrhea.
Herpes is a long-lasting infection with symptoms that come and go. The initial symptoms usually appear within 1 to 3 weeks of exposure to the virus and last 7 to 10 days (for cold sores) or 7 to 14 days (for genital lesions). Usually the number of outbreaks is greatest in the first year and higher for HSV-2 genital lesions than HSV-1 cold sores. Each year after that, the number of outbreaks usually goes down and they become less severe. Still, once you have been infected, you can never completely get rid of the virus.
Complications of herpes include:
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Reviewed By: Steven D. Ehrlich, NMD, Solutions Acupuncture, a private practice specializing in complementary and alternative medicine, Phoenix, AZ. Review provided by VeriMed Healthcare Network.
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