Can genital herpes be asymptomatic. How to recognize subtle signs of herpes infection. What are the common and uncommon symptoms of genital herpes. Why some people experience painless herpes outbreaks. How to differentiate between herpes and other skin conditions.

The Spectrum of Genital Herpes Symptoms: From Painful to Painless

Genital herpes, caused by the herpes simplex virus (HSV), is often associated with painful outbreaks. However, the reality is more complex. Many individuals with genital herpes experience mild or even no symptoms, leading to the question: can herpes not be painful?

The answer is yes, herpes can indeed be painless for some people. This fact often surprises those who associate the condition with severe discomfort. Understanding the range of possible symptoms is crucial for proper diagnosis and management of genital herpes.

Asymptomatic Herpes: The Silent Carrier

A significant number of people infected with HSV never develop noticeable symptoms. These individuals are referred to as asymptomatic carriers. They can still transmit the virus to sexual partners, even without experiencing outbreaks themselves.

• Up to 80% of people with genital herpes may be unaware of their infection
• Asymptomatic shedding can occur, leading to transmission without visible symptoms
• Regular testing is crucial for those at risk, even in the absence of symptoms

Recognizing Subtle Signs of Genital Herpes

While some herpes infections are truly asymptomatic, others may present with subtle signs that are easily overlooked. These mild symptoms can be mistaken for other skin conditions or dismissed as insignificant.

Mild Symptoms of Genital Herpes

• Slight itching or tingling in the genital area
• Faint redness or skin irritation
• Barely noticeable bumps or blisters
• Mild burning sensation during urination
• Slight swelling in the genital or anal region

Can these subtle symptoms be easily missed? Yes, particularly if an individual is not aware of their herpes status or is not actively looking for signs of an outbreak. This underscores the importance of regular sexual health check-ups and open communication with healthcare providers.

The Classic Painful Herpes Outbreak: What to Expect

While painless herpes is possible, many individuals do experience the more typical painful symptoms associated with genital herpes outbreaks. Understanding these symptoms can help in early detection and prompt treatment.

Common Symptoms of a Painful Herpes Outbreak

1. Painful blisters or sores in the genital, anal, or mouth area
2. Intense itching, burning, or tingling sensations
3. Painful urination
4. Flu-like symptoms (fever, body aches, swollen lymph nodes)
5. Headaches and fatigue

How long does a typical herpes outbreak last? Most outbreaks resolve within 2-4 weeks, with proper treatment potentially shortening the duration and reducing symptom severity.

Factors Influencing Herpes Symptom Severity

The wide range of herpes experiences, from painless to severely painful, can be attributed to several factors. Understanding these can help individuals better manage their condition and predict potential outbreaks.

Key Factors Affecting Herpes Symptoms

• Viral strain (HSV-1 vs HSV-2)
• Individual immune system strength
• Stress levels
• Overall health and nutrition
• Frequency of outbreaks
• Time since initial infection

Does the type of herpes virus affect symptom severity? Generally, HSV-2 is associated with more frequent and severe outbreaks compared to HSV-1, although this can vary between individuals.

Distinguishing Herpes from Other Skin Conditions

Given that herpes can sometimes present with mild or atypical symptoms, it’s important to be able to differentiate it from other skin conditions that may affect the genital area.

Conditions Often Confused with Herpes

• Ingrown hairs
• Yeast infections
• Bacterial vaginosis
• Eczema
• Psoriasis
• Molluscum contagiosum

How can one distinguish herpes from these other conditions? While definitive diagnosis requires medical testing, herpes typically presents with clustered blisters that eventually crust over, unlike most other genital skin conditions. However, atypical presentations can occur, making professional evaluation crucial.

The Importance of Accurate Diagnosis

Given the potential for painless or mild herpes symptoms, accurate diagnosis is crucial. Relying solely on visible symptoms can lead to misdiagnosis or missed infections.

Diagnostic Methods for Genital Herpes

1. Visual examination by a healthcare provider
2. Viral culture from a swab of an active lesion
3. Polymerase chain reaction (PCR) test
4. Blood tests for HSV antibodies

Which test is most accurate for diagnosing herpes? PCR tests are generally considered the gold standard for herpes diagnosis, especially when combined with a visual examination during an active outbreak.

Managing Genital Herpes: From Painless to Painful Outbreaks

Regardless of symptom severity, managing genital herpes is crucial for both personal health and preventing transmission. Treatment approaches may vary depending on whether outbreaks are painful or painless.

Treatment Options for Genital Herpes

• Antiviral medications (e.g., acyclovir, valacyclovir)
• Topical treatments for symptom relief
• Lifestyle modifications to reduce outbreak frequency
• Stress management techniques
• Dietary adjustments to support immune function

Is daily suppressive therapy necessary for those with painless herpes? While not always required, daily antiviral therapy can reduce the risk of transmission, even in asymptomatic individuals. Consult with a healthcare provider to determine the best approach for your situation.

The Psychological Impact of Genital Herpes

The psychological effects of a genital herpes diagnosis can be significant, regardless of whether the symptoms are painful or not. Understanding and addressing these mental health aspects is crucial for overall well-being.

Common Psychological Challenges

• Anxiety about future outbreaks
• Feelings of shame or stigma
• Concerns about disclosure to partners
• Impact on self-esteem and body image
• Fear of rejection in relationships

How can individuals cope with the emotional aspects of a herpes diagnosis? Seeking support through counseling, support groups, or trusted friends and family can be beneficial. Education about the condition and open communication with partners can also alleviate many concerns.

Preventing Herpes Transmission: Beyond Visible Symptoms

Understanding that herpes can be transmitted even when symptoms are absent or painless is crucial for prevention strategies. Both infected individuals and their partners should be aware of the risks and take appropriate precautions.

Strategies for Reducing Herpes Transmission

1. Consistent use of barrier methods (condoms, dental dams)
2. Avoiding sexual contact during outbreaks
3. Taking daily suppressive antiviral therapy
4. Open communication with sexual partners about herpes status
5. Regular testing for both partners

Can herpes be transmitted when there are no visible symptoms? Yes, asymptomatic viral shedding can occur, allowing transmission even when no symptoms are present. This underscores the importance of consistent prevention strategies.

Living with Genital Herpes: A Holistic Approach

Managing genital herpes extends beyond just treating outbreaks. A holistic approach that addresses physical, emotional, and social aspects can lead to a better quality of life for those affected by the virus.

Components of Holistic Herpes Management

• Regular medical check-ups and consultations
• Stress reduction techniques (meditation, yoga, exercise)
• Nutritional support for immune function
• Building a support network
• Educating oneself about the latest herpes research and treatments
• Practicing self-compassion and positive self-talk

How can individuals with herpes maintain a positive outlook? Focusing on overall health, cultivating supportive relationships, and remembering that herpes is a manageable condition can help maintain a positive perspective. Many people with herpes lead fulfilling lives with minimal impact from the virus.

The Future of Herpes Treatment and Prevention

Research into genital herpes continues to advance, offering hope for improved treatments and potential preventive measures in the future. Staying informed about these developments can provide valuable insights and options for those affected by the virus.

Promising Areas of Herpes Research

• Development of therapeutic vaccines
• Gene editing techniques to target the herpes virus
• Novel antiviral medications with fewer side effects
• Improved diagnostic tools for early detection
• Strategies to boost natural immunity against HSV

What potential breakthroughs are on the horizon for herpes treatment? While a cure remains elusive, researchers are exploring innovative approaches such as CRISPR gene editing and mRNA vaccine technologies that could revolutionize herpes management in the coming years.

Navigating Relationships with Genital Herpes

For many individuals with genital herpes, navigating romantic and sexual relationships can be challenging. However, with proper communication and understanding, herpes does not have to be a barrier to fulfilling relationships.

Tips for Discussing Herpes with Partners

1. Choose an appropriate time and place for the conversation
2. Be prepared with accurate information about herpes
3. Be honest about your status and symptoms (or lack thereof)
4. Discuss prevention strategies and risks
5. Allow your partner time to process the information
6. Be open to answering questions and addressing concerns

When is the best time to disclose a herpes diagnosis to a new partner? While there’s no perfect time, it’s generally recommended to have this conversation before engaging in sexual activity. This allows for informed decision-making and builds trust in the relationship.

Herpes and Pregnancy: Special Considerations

For individuals with genital herpes who are pregnant or planning to become pregnant, there are additional factors to consider. While herpes during pregnancy is manageable, it requires careful monitoring and potentially adjusted treatment approaches.

Key Points for Managing Herpes During Pregnancy

• Increased risk of transmission to the baby during vaginal delivery
• Potential need for cesarean section if outbreaks occur near delivery
• Safety considerations for antiviral medications during pregnancy
• Importance of disclosure to healthcare providers
• Monitoring for outbreaks throughout pregnancy

How does herpes affect pregnancy outcomes? With proper management, most pregnancies in women with herpes proceed normally. However, neonatal herpes is a serious concern, making close monitoring and preventive measures crucial during pregnancy and delivery.

The Role of Healthcare Providers in Herpes Management

Healthcare providers play a crucial role in the diagnosis, treatment, and ongoing management of genital herpes. Regular consultations and open communication with medical professionals are essential for optimal care.

What to Expect from Your Healthcare Provider

• Accurate diagnosis and testing
• Prescription of appropriate antiviral medications
• Guidance on managing outbreaks and reducing transmission
• Information on latest treatment options and research
• Support for emotional and psychological aspects of living with herpes
• Referrals to specialists or support groups as needed

How often should individuals with herpes consult their healthcare provider? Regular check-ups, typically annually or biannually, are recommended. However, more frequent visits may be necessary during initial diagnosis, pregnancy, or if experiencing complications or frequent outbreaks.

Debunking Myths and Misconceptions about Genital Herpes

Misinformation about genital herpes is widespread, contributing to stigma and unnecessary anxiety. Addressing common myths can help individuals better understand the condition and make informed decisions about their health.

Common Herpes Myths Debunked

1. Myth: Herpes always causes painful symptoms
2. Myth: You can only transmit herpes during an outbreak
3. Myth: Herpes is rare and only affects promiscuous individuals
4. Myth: Herpes can be cured with natural remedies
5. Myth: Having herpes means you can’t have children

Why do these myths persist despite scientific evidence? Stigma, lack of comprehensive sexual education, and sensationalized media portrayals contribute to the spread of misinformation about herpes. Combating these myths requires ongoing education and open dialogue about sexual health.

The Global Impact of Genital Herpes

Genital herpes is a global health concern, affecting millions of people worldwide. Understanding the prevalence and impact of herpes on a global scale can provide context and reduce feelings of isolation for those affected.

Global Statistics and Trends

• Estimated 491 million people aged 15-49 have HSV-2 infection globally
• Higher prevalence in developing countries and certain populations
• Increased risk of HIV acquisition in individuals with genital herpes
• Economic impact due to healthcare costs and productivity loss
• Variations in stigma and cultural attitudes towards herpes worldwide

How does the global prevalence of herpes impact public health strategies? The high prevalence of herpes worldwide has led to increased focus on prevention, education, and research efforts. It also highlights the need for improved access to testing and treatment in many regions.

In conclusion, genital herpes presents a complex spectrum of experiences, from painless and asymptomatic cases to severe and recurrent outbreaks. Understanding this range is crucial for proper diagnosis, management, and destigmatization of the condition. Whether experiencing painful symptoms or no symptoms at all, individuals with herpes can lead healthy, fulfilling lives with proper care and support. As research continues to advance, the future holds promise for improved treatments and potential preventive measures against this common viral infection.

Genital herpes: Signs and symptoms

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STD Facts – Genital Herpes

People who are sexually active can get genital herpes, a common sexually transmitted disease (STD). This fact sheet answers basic questions about genital herpes.

What is genital herpes?

Genital herpes is an STD caused by two types of viruses – herpes simplex virus type 1 (HSV-1) and herpes simplex virus type 2 (HSV-2).

What is oral herpes?

HSV-1 often causes oral herpes, which can result in cold sores or fever blisters on or around the mouth. However, most people with oral herpes do not have any symptoms. Most people with oral herpes get it during childhood or young adulthood from non-sexual contact with saliva.

Is there a link between genital herpes and oral herpes?

Yes. Oral herpes caused by HSV-1 can spread from the mouth to the genitals through oral sex. This is why some cases of genital herpes are due to HSV-1.

How common is genital herpes?

Genital herpes is common in the United States. In 2018, CDC estimates show there were 572,000 new genital herpes infections in the United States among people aged 14 to 49.¹

How is genital herpes spread?

You can get genital herpes by having vaginal, anal, or oral sex with someone who has the infection. You can get herpes if you have contact with:

• A herpes sore;
• Saliva from a partner with an oral herpes infection;
• Genital fluids from a partner with a genital herpes infection;
• Skin in the oral area of a partner with oral herpes; or
• Skin in the genital area of a partner with genital herpes.

You also can get genital herpes from a sex partner who does not have a visible sore or is unaware of their infection. It is also possible to get genital herpes if you receive oral sex from a partner with oral herpes.

You will not get herpes from toilet seats, bedding, or swimming pools. You also will not get it from touching objects, such as silverware, soap, or towels.

If you have more questions about herpes, consider discussing your concerns with a healthcare provider.

How do I know if I have genital herpes?

Most people with genital herpes have no symptoms or have very mild symptoms. Mild symptoms may go unnoticed or be mistaken for other skin conditions like a pimple or ingrown hair. Because of this, most people do not know they have a herpes infection.

Herpes sores usually appear as one or more blisters on or around the genitals, rectum or mouth. This is known as having an “outbreak”. The blisters break and leave painful sores that may take a week or more to heal. Flu-like symptoms (e.g., fever, body aches, or swollen glands) also may occur during the first outbreak.

People who experience an initial outbreak of herpes can have repeated outbreaks, especially if they have HSV-2. However, repeat outbreaks are usually shorter and less severe than the first outbreak. Although genital herpes is a lifelong infection, the number of outbreaks may decrease over time.

Ask a healthcare provider to examine you if:

• You notice any symptoms; or
• Your partner has an STD or symptoms of an STD.

STD symptoms can include an unusual sore, a smelly genital discharge, burning when peeing, or bleeding between periods (if you have a menstrual cycle).

How will my healthcare provider know if I have genital herpes?

Your healthcare provider may diagnose genital herpes by simply looking at any sores that are present. Providers can also take a sample from the sore(s) and test it. If sores are not present, a blood test may be used to look for HSV antibodies.

Have an honest and open talk with your healthcare provider about herpes testing and other STDs.

Please note: A herpes blood test can help determine if you have herpes infection. It cannot tell you who gave you the infection or when you got the infection.

How can I prevent genital herpes?

The only way to completely avoid STDs is to not have vaginal, anal, or oral sex.

If you are sexually active, you can do the following things to lower your chances of getting genital herpes:

• Being in a long-term mutually monogamous relationship with a partner who does not have herpes.
• Using condoms the right way every time you have sex.

Be aware that not all herpes sores occur in areas that a condom can cover. Also, the skin can release the virus (shed) from areas that do not have a visible herpes sore. For these reasons, condoms may not fully protect you from getting herpes.

If your sex partner(s) has/have genital herpes, you can lower your risk of getting it if:

• Your partner takes an anti-herpes medicine every day. This is something your partner should discuss with his or her healthcare provider.
• You avoid having vaginal, anal, or oral sex when your partner has herpes symptoms (i. e., during an “outbreak”).

Is there a cure for genital herpes?

There is no cure for genital herpes. However, there are medicines that can prevent or shorten outbreaks. A daily anti-herpes medicine can make it less likely to pass the infection on to your sex partner(s).

What happens if I don’t receive treatment?

Genital herpes can cause painful genital sores and can be severe in people with suppressed immune systems.

If you touch your sores or fluids from the sores, you may transfer herpes to another body part like your eyes. Do not touch the sores or fluids to avoid spreading herpes to another part of your body. If you do touch the sores or fluids, quickly wash your hands thoroughly to help avoid spreading the infection.

If you are pregnant, there can be problems for you and your unborn fetus, or newborn baby. See “I’m pregnant. How could genital herpes affect my baby?” for information about this.

I’m pregnant. How could genital herpes affect my baby?

If you are pregnant and have genital herpes, prenatal care visits are very important. Some research suggest that a genital herpes infection may lead to miscarriage or make it more likely to deliver your baby too early. You can pass herpes to your unborn child before birth, but it more commonly passes during delivery. This can lead to a deadly infection in your baby (called neonatal herpes). It is important that you avoid getting genital herpes during pregnancy. Tell your healthcare provider if you have ever had a genital herpes diagnosis or symptoms. Also tell them about any possible exposure to genital herpes.

If you have genital herpes, you may need to take anti-herpes medicine towards the end of your pregnancy. This medicine may reduce your risk of having signs or symptoms of genital herpes when you deliver. At the time of delivery, your healthcare provider should carefully examine you for herpes sores. If you have signs or symptoms of genital herpes at delivery, a ‘C-section’ is likely to occur.

Can I still have sex if I have herpes?

If you have herpes, you should talk to your sex partner(s) about their risk. Using condoms may help lower this risk but it will not get rid of the risk completely. Having sores or other symptoms of herpes can increase your risk of spreading the disease. Even if you do not have any symptoms, you can still infect your sex partners.

You may have concerns about how genital herpes will impact your health, sex life, and relationships. While herpes is not curable, it is important to know that it is manageable with medicine. Daily suppressive therapy (i.e., daily use of antiviral medication) can lower your risk of spreading the virus to others. Talk to a healthcare provider about your concerns and treatment options.

A genital herpes diagnosis may affect how you will feel about current or future sexual relationships. Knowing how to talk to sexual partners about STDs is important.

What is the link between genital herpes and HIV?

Herpes infection can cause sores or breaks in the skin or lining of the mouth, vagina, and rectum. This provides a way for HIV to enter the body. Even without visible sores, herpes increases the number of immune cells in the lining of the genitals. HIV targets immune cells for entry into the body. Having both HIV and genital herpes increases the chance of spreading HIV to a HIV-negative partner during oral, vagina, or anal sex.

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8 myths about herpes – GBUZ “Crimean Central District Hospital” MH KK

Herpes is a common viral disease, with a characteristic rash of clustered blisters on the skin and mucous membranes. The famous ancient Greek historian Herodotus wrote about this unpleasant disease even before our era. It was he who gave her the appropriate name (from the Greek “herpein” – to crawl), thanks to the ability of herpetic ulcers to “spread” in different directions from the primary bubble. For many centuries of “communication” with herpes, humanity has recreated many myths about this disease, the most common of which we asked to comment on the acting head of the Health Center of the State Budgetary Institution of Health “TsOZiMP” of the Ministry of Health of the Territory Irina Volkova.

Myth 1. Herpes is not contagious.

– Exactly the opposite. Herpes is transmitted by airborne droplets (when coughing, sneezing, talking), contact (when kissing, using shared utensils, lipstick) and sexually. Perhaps also infection of the child from the mother at birth.

Myth 2. Herpes is a manifestation of the “cold”.

– In fact, herpes is an independent disease that predetermines the herpes simplex virus. It is usually activated during hypothermia, stress, overwork, exacerbation of chronic diseases or a decrease in general immunity.

Myth 3. If a rash appears on the lips, the cold subsides.

– A common point of view, which, however, has nothing to do with reality. The appearance of a rash means that a respiratory infection has weakened the immune system, and this has given the herpes virus the opportunity to actively act.

Myth 4. If the rash is gone, herpes is cured.

– That would be great, but, unfortunately, it is impossible to remove the virus from the body. He stays with a person for life, and you can only force him to be in a “sleeping” state.

Myth 5. You can get herpes only if you have a rash.

– Indeed, in the active phase of the disease, a greater number of viral particles are released and the likelihood of infection is higher. But the infection can be transmitted at any time through invisible microtraumas of the skin and mucous membranes.

Myth 6. A condom completely protects against infection with genital herpes.

– A condom does reduce the risk of infection, but, unfortunately, it does not give a 100% guarantee. Transmission of the virus can take place through parts of the body that are not covered by a condom.

Myth 7. The best treatment for herpes is cauterization with alcohol, iodine or brilliant green.

– Cauterization does not affect the herpes virus and its activity, but it is very easy to burn damaged skin and mucous membranes in this way. It is better to gently lubricate the rash with an antiseptic that does not contain alcohol so that a purulent infection does not join. Manifestations of the disease are treated with special antiviral drugs. If you have herpes, be sure to consult a doctor!

Myth 8. Herpes affects only the skin and does not pose a particular danger to humans.

– In fact, herpes is the second leading cause of death from viral infections, second only to SARS. The herpes simplex virus is built into the genome of nerve cells, so the rash occurs at the sites of nerve endings and is accompanied by severe pain. Theoretically, herpes can be everywhere where there is nervous tissue, and therefore – in almost any organ. With a decrease in general and local immunity, herpetic inflammation can develop in the mucous membrane of the mouth and larynx, cornea and conjunctiva of the eye, lymph nodes, internal genital organs, intestines, liver, kidneys, lungs and central nervous system. Moreover, genital herpes significantly increases the risk of cervical cancer in women and prostate cancer in men.

Herpes is a very insidious disease, which is much easier to prevent than to cure. Remember this, strictly follow the rules of personal hygiene!

Earlier, a therapist at the Health Center of the State Budgetary Institution of Health “TsOZiMP” of the Ministry of Health of the Territory spoke about the prevention of psoriasis.

GBUZ “Center for Public Health and Medical Prevention” of the Ministry of Health of the Krasnodar Territory

Herpes: symptoms and treatment, doctor’s recommendations

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“Cold” on the lips is familiar to almost everyone. It is worth catching a runny nose or getting nervous, as an unpleasant harbinger immediately appears – a tingling sensation somewhere near the mouth.

The herpes simplex virus is present in the body of 95% of people. And only a few have immunity, the reasons for which are still not understood.

The virus enters the body in early childhood: at 3-4 years old, when the antibodies against the herpes virus transmitted to the baby by the mother are depleted. Most often, infection occurs if the child is kissed by carriers of the infection. In addition to a kiss, the virus can enter the body, for example, with saliva. It penetrates into the mucous membranes, reaches the nerve endings, rises into the cranial cavity, where it “hides” in the nerve plexus, called the trigeminal ganglion, and “sleeps” there until it is reactivated.

Herpes “wakes up” with a decrease in immunity

Causes of recurrence of herpes on the lips: stress or emotional upset; various other diseases, in particular colds, flu, diabetes, HIV; poisoning or intoxication; alcohol, caffeine and smoking; excessive ultraviolet radiation; hypothermia or overheating; the onset of menstruation; overwork and exhaustion; malnutrition/diet or indigestion; other individual factors for each person.

After “waking up” the virus is sent back to the skin. When moving through a nerve, the virus causes inflammation of the nerve tissue.

The development of herpes can be divided into several stages. At the first stage, the person feels unwell. Pain, tingling appear at the site of the appearance of the “fever”, the skin turns red. At the stage of inflammation, a small, painful vesicle filled with fluid forms. After a while, the vial bursts and a colorless liquid containing billions of viral particles flows out of it. An ulcer appears in its place. At the final stage, the sore is covered with a crust.

Most often, herpes appears on the lips, but lesions can also appear on the face, around the ears, or in the oral cavity.

What to do if you have a “cold” on your lips

At the moment, no medicines and treatments have been developed that would completely destroy the herpes simplex virus in the human body. But a few tips for those suffering from herpes can be given.

• Strictly follow the rules of personal hygiene! Since herpes is contagious, wash your hands with soap and use separate dishes and towels.

• Don’t bring your hands to your eyes! And don’t wet your lenses with saliva! Herpes can affect the mucous membrane of the eye.

• It is not recommended to touch a viral rash, kiss. The virus can be transmitted by wearing one lipstick or smoking one cigarette.

• If you try to remove a blister or crust over an ulcer, the virus can spread to other parts of the body.

• Give up oral sex! A virus from affected lips can cause genital herpes in a partner.

• A young mother must also take certain precautions to protect her baby from contracting herpes. If you have cold sores, wash your hands with soap every time before touching your baby. And in no case should the affected surface come into contact with the skin of the child.

How to minimize discomfort

Starting to use anti-herpes drugs should begin as soon as you feel a tingling sensation. Medications won’t get rid of the virus, but they will stop it from progressing and speed up your recovery. There are drugs that prevent the development of the virus: tablets, ointments for external use, which help the healing of blisters and ulcers, reduce discomfort.

When applying the ointment, use cotton swabs to avoid transmitting the virus from the lips to the skin of the fingers.

Herpes requires the attention of specialists! A “cold” on the lips can be a symptom of serious diseases: a sharp decrease in immunity, cancer, HIV infection.

If you suffer from relapses of herpes – consult a doctor. The specialist will not only relieve you of unnecessary worries and eliminate the danger to health, but will also help you choose a comprehensive program for the prevention and treatment of herpes.

To make an appointment with an immunologist or a dermatologist for the program of diagnosis and treatment of herpes, call the Family Doctor clinic +7 (495) 775 75 66 (clinic hours: Mon-Fri from 8.