There is no cure for genital herpes, and once a person is infected with genital herpes, the infection persists throughout the individual’s life, with the potential for recurrent outbreaks. However, there are medications that can reduce the severity and frequency of outbreaks and treatments to manage the symptoms.
Although the cause is unknown, outbreaks are often associated with periods of weakened immune systems, skin wounds, menstruation, fever, nerve damage, tissue damage from surgery, or exposure to extreme climate situations. A genital herpes outbreak or episode occurs when the HSV-1 or HSV-2 virus is reactivated from its dormant stage. Genital herpes is an incurable disease, and once you contract it, you may experience outbreaks throughout your lifetime. Those who are experiencing their first herpes episode of genital herpes can expect to have several (typically four or five) outbreaks within a year. Over time these recurrences usually decrease in frequency and severity. The first outbreak of herpes is often the longest outbreak experienced. After that, short and inconsistent episodes can be managed and treated with antiretroviral medication.
18. Brown ZA, Wald A, Morrow RA, Selke S, Zeh J, Corey L. Effect of serologic status and cesarean delivery on transmission rates of herpes simplex virus from mother to infant. JAMA, 2003. 289(2):203–9
The CDC estimates as many as 25% of women have genital herpes and don’t know they have it because it is often asymptomatic. If you think you may have been exposed to genital herpes, get tested. Genital herpes can easily be managed with antiviral medication.
If one partner has a herpes outbreak, avoid sex — even with a condom or dental dam — until all sores have healed. Herpes can be passed sexually even if a partner has no sores or other signs and symptoms of an outbreak. Finally, one way to lessen this risk is to take antiviral medication even when no sores are present if you know you have genital herpes.
Neonatal herpes simplex is a HSV infection in an infant. It is a rare but serious condition, usually caused by vertical transmission of HSV-1 or -2) from mother to newborn. During immunodeficiency, herpes simplex can cause unusual lesions in the skin. One of the most striking is the appearance of clean linear erosions in skin creases, with the appearance of a knife cut. Herpetic sycosis is a recurrent or initial herpes simplex infection affecting primarily the hair follicles.:369 Eczema herpeticum is an infection with herpesvirus in patients with chronic atopic dermatitis may result in spread of herpes simples throughout the eczematous areas.:373
You may have concerns about how genital herpes will impact your overall health, sex life, and relationships. It is best for you to talk to a health care provider about those concerns, but it also is important to recognize that while herpes is not curable, it can be managed with medication. Daily suppressive therapy (i.e., daily use of antiviral medication) for herpes can also lower your risk of spreading genital herpes to your sex partner. Be sure to discuss treatment options with your healthcare provider. Since a genital herpes diagnosis may affect how you will feel about current or future sexual relationships, it is important to understand how to talk to sexual partners about STDs.
You should avoid consuming large quantities of alcohol as well as stress and eat a healthy diet. In some cases, sunburn has been found to be a herpes trigger. You should try to find out what triggers the virus’s activity in your case, so that you can prevent genital herpes episodes in future. The number of outbreaks and the symptoms they cause depend on the type of herpes virus you are infected with. People with herpes simplex 1 (HSV1 or herpes type 1) – which causes most herpes outbreaks above the waist – causes much less attacks and less severe symptoms than herpes simplex 2 (HSV2), which typically causes genital herpes symptoms.
Robert Belshe, director of the Saint Louis University Center for Vaccine Development, said the vaccine was partially effective at preventing herpes simplex virus type 1, but did not protect women from herpes simplex virus type 2.
According to the American College of Obstetricians and Gynecologists, “women who have their first genital herpes infection in late pregnancy (whether symptomatic or asymptomatic) and who give birth vaginally have a high risk (30–50%) of transmitting the virus to their infants. Similarly, nonprimary first-episode HSV infection occurring late in pregnancy also has a high risk of vertical transmission. The risk of transmission during a vaginal delivery is much lower with recurrent infection (less than 2–5%). Currently, most newborns infected with HSV are delivered to women who have asymptomatic or unrecognized infections. Genital herpes infection is classified as primary when it occurs in a woman with no evidence of prior HSV infection (ie, seronegative for both HSV-1 and HSV-2), as a nonprimary first episode when it occurs in a woman with a history of heterologous infection (eg, first HSV-2 infection in a woman with prior HSV-1 infection or vice versa), and as recurrent when it occurs in a woman with clinical or serologic evidence of prior genital herpes (of the same serotype).”
Some people do not experience symptomatic herpes recurrences, but for those who do, recurrences are usually shorter and less severe than the primary herpes episode. Recurrences are often preceded by warning symptoms (also known as prodromal symptoms) such as tingling, itching, burning or pain.
Interestingly, many herpes victims may not witness any symptoms immediately after contraction of the virus. In some cases, the symptoms may even be too mild for them to be associated with the condition. This makes it even more important for one to be vigilant so that the moment any of the signs appear, treatment can be sought and further transmission prevented.
At this time there is no cure for herpes; it remains in the body and can be passed to another person with any form of unprotected sex. This is the case even if blisters aren’t present, but more likely if they are. A person can lessen the chance of spreading the infection to someone else by taking an antiviral medicine. This is a medication that must be prescribed by a doctor.
During an outbreak, a dermatologist often can diagnose herpes simplex by looking at the sores. To confirm that a patient has herpes simplex, a dermatologist may take a swab from a sore and send this swab to a laboratory.
After the first outbreak, the symptoms and signs of genital herpes tend to be less severe and last fewer days – somewhere between 5-10 days (depending on when you’ve started your antiviral treatment). Early treatment, ideally within 24 hours of the first signs of a genital herpes outbreak, can alleviate the symptoms within a few days.
The consistent and correct use of condoms can help to prevent the spread of genital herpes. However, condoms can only reduce the risk of infection, as outbreaks of genital herpes can occur in areas not covered by a condom.
The biggest breakthrough in the treatment of genital herpes in recent years has been the use of acyclovir to control recurrences of genital herpes. People who are unfortunate enough to have frequent recurrences of genital herpes (say six or more recurrences in a year) can now be offered hope in the form of long-term “suppressive therapy” with acyclovir. This might start out at the full dose of acyclovir, but can usually be reduced to half the normal dose after a month or two . While this treatment is not a guarantee against any recurrences, it is very often most successful in reducing them. Usually the treatment is kept up for a year in the first place, and then the person and the doctor can reassess the situation.
Some people find that stress, being tired, illness, friction against the skin, or sunbathing may trigger recurrences of symptoms. Identifying and avoiding these triggers may help reduce the number of recurrences.
Treatment of genital herpes does not cure the disease. The virus usually lives (in an inactive form) in an infected person throughout their lifetime. Most people (85%) with genital herpes will have recurring outbreaks – sometimes 6 to 10 a year. Recurrences are likely to have less severe symptoms and sores usually last a shorter period of time.
Jump up ^ Reuven NB, Staire AE, Myers RS, Weller SK (2003). “The herpes simplex virus type 1 alkaline nuclease and single-stranded DNA binding protein mediate strand exchange in vitro”. J. Virol. 77 (13): 7425–33. doi:10.1128/jvi.77.13.7425-7433.2003. PMC 164775 . PMID 12805441.
A diet with a higher lysine to arginine ratio may reduce the frequency of herpes outbreaks. Check out the chart on Diet and Nutrition which evaluates the foods you are eating. Notice foods like nuts have a high arginine count, so try to reduce your consumption.
Sores: One or more painful, fluid-filled blisters may appear. Blisters break open and often ooze fluid and form a crust, before healing. The first time sores appear, they will show up between 2 and 20 days after a person has contact with an infected person. The sores can last from 7 to 10 days. Where the sores appear often varies with type:
The shingles vaccine reduces the risk of shingles by 50 to 90% depending on the vaccine used. It also decreases rates of postherpetic neuralgia, and if shingles occurs, its severity. If shingles develops, antiviral medications such as aciclovir can reduce the severity and duration of disease if started within 72 hours of the appearance of the rash. Evidence does not show a significant effect of antivirals or steroids on rates of postherpetic neuralgia. Paracetamol, NSAIDs, or opioids may be used to help with the acute pain.
Herpes simplex type 1, which is transmitted through oral secretions or sores on the skin, can be spread through kissing or sharing objects such as toothbrushes or eating utensils. In general, a person can only get herpes type 2 infection during sexual contact with someone who has a genital HSV-2 infection. It is important to know that both HSV-1 and HSV-2 can be spread even if sores are not present.
Genital herpes is not the only condition that can produce these symptoms. Sometimes, HSV is mistaken for vaginal yeast infections, bacterial infections, or bladder infections. The only way to know whether they are the result of HSV or another condition is to be checked by a health care provider.
Herpes is contracted through direct contact with an active lesion or body fluid of an infected person. Herpes transmission occurs between discordant partners; a person with a history of infection (HSV seropositive) can pass the virus to an HSV seronegative person. Herpes simplex virus 2 is typically contracted through direct skin-to-skin contact with an infected individual, but can also be contracted by exposure to infected saliva, semen, vaginal fluid, or the fluid from herpetic blisters. To infect a new individual, HSV travels through tiny breaks in the skin or mucous membranes in the mouth or genital areas. Even microscopic abrasions on mucous membranes are sufficient to allow viral entry.
A major concern with regard to herpes is that it is a communicable infection. It is transmitted through contact with bodily fluids and lesions of the infected person. Genital herpes is, therefore, the more commonly transmitted variant of HSV. Since there is no cure for herpes, it is very important for patients and those associating with them to be careful in their interactions, especially during herpes flares.
Jump up ^ O’Meara A, Deasy PF, Hillary IB, Bridgen WD (December 1979). “Acyclovir for treatment of mucocutaneous herpes infection in a child with leukaemia”. Lancet. 2 (8153): 1196. doi:10.1016/S0140-6736(79)92428-0. PMID 91931.
^ Jump up to: a b c d e f g Dworkin RH, Johnson RW, Breuer J, et al. (2007). “Recommendations for the management of herpes zoster”. Clin. Infect. Dis. 44 Suppl 1: S1–26. doi:10.1086/510206. PMID 17143845.
^ Jump up to: b Chow AW, Roland A, Fiala M, et al. (March 1973). “Cytosine Arabinoside Therapy for Herpes Simplex Encephalitis – Clinical Experience with Six Patients”. Antimicrob. Agents Chemother. 3 (3): 412–17. doi:10.1128/aac.3.3.412. PMC 444424 . PMID 4790599.
Until the mid 1990s, infectious complications of the Central Nervous System (CNS) caused by VZV reactivation were regarded as rare. The presence of rash, as well as specific neurological symptoms, were required to diagnose a CNS infection caused by VZV. Since 2000, PCR testing has become more widely used, and the number of diagnosed cases of CNS infection has increased.
Typically, recurrent episodes become milder and less frequent; however, some patients may experience weekly or monthly outbreaks that are severe and painful. Those with recurrent herpes usually have high antibody titers. Paradoxically, it has been noted that the higher the antibody titer the more severe the symptoms and the more frequent the recurrences. Thus, it is apparent that the body’s immune system is not effective in providing protection against herpes infection or in mitigating its effects.
Alternatively, our online doctor offers a free photo assessment for genital herpes (you only pay if you are diagnosed with herpes and choose to buy a treatment from us). If you have already been diagnosed with herpes, we can provide a quick and discreet antiviral treatment.
Jump up ^ Thompson, Richard L.; Preston, Chris M.; Sawtell, Nancy M. (2009-03-01). “De novo synthesis of VP16 coordinates the exit from HSV latency in vivo”. PLOS Pathogens. 5 (3): e1000352. doi:10.1371/journal.ppat.1000352. ISSN 1553-7374. PMC 2654966 . PMID 19325890.