Oral Herpes

Oral herpes is an infection typically caused by herpes simplex virus type 1 (HSV-1). Commonly referred to as “cold sores” and “fever blisters,” symptoms of oral herpes most commonly appear on or around the lips. Oral herpes is not always limited to this area, though. For some, symptoms may appear between the upper lip, on or inside the nose, or on the chin or cheek. In these instances, herpes is referred to as oral-facial herpes. You have most likely seen someone experiencing an oral herpes outbreak before.

How does someone get oral herpes?

Oral herpes is transmitted through direct contact between the contagious area and broken skin (a cut or break) and mucous membrane tissue (such as the mouth or genitals). In other words, HSV can be passed on through kissing or oral sex.

Herpes can also be transmitted when there are no symptoms present. There are several days throughout the year when the virus reactivates yet causes no symptoms (called asymptomatic shedding, viral shedding, or asymptomatic reactivation).

If a person is experiencing symptoms orally, we recommend abstaining from performing oral sex and kissing others directly on the mouth until signs have healed and the skin looks normal again. Because most adults have oral herpes, we don’t suggest that a person should stop giving or receiving affection altogether between outbreaks (when there are no signs or symptoms) simply because they have oral herpes. However, using a barrier (such as a dental dam) or condom when performing oral sex (even though there are no symptoms present around the mouth) can reduce the risk of contracting genital herpes.

By performing oral sex on someone who has genital herpes, it would be possible to contract oral herpes – but this is rare. Most cases of genital herpes are caused by HSV-2, which rarely affects the mouth or face. Also, and even more importantly, most adults already have oral HSV-1, contracted as a child through kissing relatives or friends.

The First episode

A primary infection with oral herpes can be similar to a first episode of genital herpes in that symptoms can be more severe. During the first episode, classic lesions tend to form as small fluid-filled blisters that can appear as a single blister or in a cluster. Sores may also appear inside the mouth or on the back of the throat, and the lymph nodes in the neck may swell.

Like genital herpes, though, symptoms of oral herpes can be very mild and go unnoticed. Subtle symptoms can be easily mistaken for another infection or condition such as a small crack or cut in the skin, chapped lips, bug bite, or a pimple, to name a few examples.

Recurrences

At least a quarter of people with oral herpes experience recurrences. Again, as with the first episode, symptoms vary from person to person. Lesions may appear as either a blister or a cluster of blisters or sores. It is possible that a recurrence will involve only the subtle symptoms described above.

Signs and symptoms of a recurrent episode (when they occur) tend to last about 8 – 10 days on average. Blister- or sore-like lesions will usually crust over during the healing phase.

If a person had fairly mild symptoms in their first episode, then recurrences will likely also tend to be mild. The number of recurrences varies from person to person and tends to decrease over time. Exposure to sunlight’s ultraviolet rays may trigger a recurrence.

Many people will experience a “prodrome” or warning symptom prior to developing an outbreak. As you may recall from the section on genital herpes, a “prodrome” is an itching, tingling, or painful sensation in the area where their recurrent lesions will develop. The prodrome often precedes lesions by a day or two. During this time, it is best to assume virus is active (and, therefore, can be spread through close contact).

Herpes simplex Information | Mount Sinai

Except in very rare instances and special circumstances, HSV is not life threatening. However, herpes can cause significant and widespread complications in people who don’t have a fully functioning immune system.

Herpes and HIV

People infected with herpes have an increased risk for acquiring and transmitting HIV, the virus that causes AIDS. The CDC recommends that all people diagnosed with HSV-2 get tested for HIV.

People with HIV who are co-infected with HSV-2 are particularly vulnerable to its complications. When a person has both viruses, each virus increases the severity of the other. HSV-2 infection increases HIV levels in the genital tract, which makes it easier for the HIV virus to be spread to sexual partners.

Herpes and Pregnancy

Pregnant women who have genital herpes due to either HSV-2 or HSV-1 carry a risk of transmission of the herpes infection to the infant in the uterus or at the time of delivery. Herpes in newborn babies (herpes neonatalis) can be a very serious condition.

Fortunately, neonatal herpes is rare. Although about 25% to 30% of pregnant women have genital herpes, less than 0.1% of babies are born with neonatal herpes. The baby is at greatest risk during a vaginal delivery, especially if the mother has an asymptomatic infection that was first introduced late in the pregnancy. In such cases, 30% to 50% of newborns become infected. This is because:

• During a first (primary) infection, the virus is shed for longer periods.
• An infection that first occurs in the late term of pregnancy does not allow enough time for the mother to develop antibodies that would help her baby fight off the infection at the time of delivery.
• Recurring herpes, or a first infection that was acquired early in the pregnancy, pose a much lower risk to the infant.

The risk for transmission also increases if infants with infected mothers are born prematurely, there is invasive monitoring, or instruments are used during vaginal delivery. Transmission can occur if the amniotic membrane of an infected woman ruptures prematurely, or as the infant passes through an infected birth canal. This risk is increased if the woman is having or has recently had an active herpes outbreak in the genital area.

Very rarely, the virus is transmitted across the placenta, a form of the infection known as congenital herpes. Also rarely, newborns may contract herpes during the first weeks of life from being kissed by someone with a herpes cold sore.

Infants may get congenital herpes from a mother with an active herpes infection at the time of birth. Aggressive treatment with antiviral medication is required.

Most infected pregnant women do not have a history of symptoms, so herpes infection is often not suspected or detected at the time of delivery.

• The American College of Obstetricians & Gynecologists recommends that Cesarean delivery should be performed on women with recurrent HSV infection who have active genital lesions or prodromal symptoms at delivery.
• Expectant management of patients with preterm labor or preterm premature rupture of membranes and active HSV infection may be warranted.
• For women at or beyond 36 weeks of gestation who are at risk for recurrent HSV infection, antiviral therapy also may be considered, although such therapy may not reduce the likelihood of cesarean delivery.
• In women with no active lesions or prodromal symptoms during labor, cesarean delivery should not be performed on the basis of a history of recurrent disease.

If you are pregnant and have a history of HSV, it is very important that you notify your health care provider of that history. You should notify them even if you’re not sure of the diagnosis.

Herpes and Newborn Infants

Herpes infection in a newborn can cause a range of symptoms, including skin rash, fevers, mouth sores, and eye infections. If left untreated, neonatal herpes is a very serious and even life-threatening condition. Neonatal herpes can spread to the brain and central nervous system, causing encephalitis and meningitis. It also can lead to intellectual disability, cerebral palsy, and death. Herpes can also spread to internal organs, such as the liver and lungs.

Infants infected with herpes are treated with acyclovir, an antiviral drug. They usually receive several weeks of intravenous acyclovir treatment, often followed by several months of oral acyclovir. It is important to treat babies quickly, before the infection spreads to the brain and other organs.

Herpes Encephalitis and Meningitis

Herpes Encephalitis

Herpes simplex encephalitis is inflammation of the brain caused by either HSV-1 or HSV-2. It is a rare but extremely serious brain disease. Untreated, herpes encephalitis is fatal most of the time. Respiratory arrest can occur within the first 24 to 72 hours. Fortunately, rapid diagnostic tests and treatment with acyclovir have significantly improved survival rates and reduced complication rates. Nearly all who recover have some impairment, ranging from very mild neurological changes to paralysis.

Herpes Meningitis

Herpes simplex meningitis is inflammation of the membranes that line the brain and spinal cord. It is mainly caused by HSV-2. Like encephalitis, meningitis symptoms include headache, fever, stiff neck, vomiting, and sensitivity to light. Fortunately, herpes meningitis usually resolves after about a week without complications, although symptoms can recur.

Herpes Eye Complications

Ocular herpes is a recurrent infection that affects the eyes. It is mainly caused by HSV-1, but can also be caused by HSV-2. Ocular herpes is usually a simple infection that clears up in a few days, but in its more serious forms, and in severe cases, it can cause blindness. As a result, medical attention should be sought immediately for any suspicion of herpes infections around or in the eyes.

Types of ocular herpes include:

• Superficial Keratitis. This condition involves infection and inflammation of the cornea. It is the most common form of ocular herpes. It only affects the upper layer (epithelium) of the cornea and heals with scarring.
• Stromal Keratitis. This condition involves deeper layers of the cornea. Corneal scarring develops, which may result in blindness. Although rare, it is a leading cause of blindness in the US.
• Iridocyclitis. Iridocyclitis is another serious complication of ocular herpes, in which the iris and the area around it become inflamed. Iridocyclitis is related to the eye condition uveitis. It can cause increased sensitivity to light. If left untreated, it can result in vision loss.

Herpes Skin Complications

Eczema Herpeticum

A rare form of herpes infection called eczema herpeticum, also known as Kaposi varicelliform eruption, can affect people with atopic dermatitis and other skin disorders and those with a weakened immune system. The disease tends to develop into a widespread skin infection that resembles impetigo. Symptoms appear abruptly and can include fever, chills, and malaise. Clusters of dimpled blisters emerge over 7 to 10 days and spread widely. They can become secondarily infected with staphylococcal or streptococcal bacteria. With treatment, lesions heal in 2 to 6 weeks. Untreated, this condition can be extremely serious and possibly fatal.

Gingivostomatitis

Oral herpes can cause multiple painful ulcers on the gums and mucous membranes of the mouth, a condition called gingivostomatitis. This condition usually affects children ages 1 to 5 years. It often subsides within 2 weeks. Children with gingivostomatitis commonly develop herpetic whitlow (herpes of the fingers).

Herpetic Whitlow

A herpetic whitlow is an infection of the herpes virus involving the finger, often around the fingernail. In children, this is often caused by thumb sucking or finger sucking while they have a cold sore. It can also occur in adult health care workers, such as dentists, because of increased exposure to the herpes virus. The use of latex or polyurethane gloves prevents herpes whitlow in health care workers.

Cold Sores in Children: About the Herpes Simplex Virus

​A child’s toddler and preschool-age years are filled with new experiences, like a first playdate or first tricycle. Often by around age 5, however, a less-than-fun first also may pop up: a child’s first cold sore.

What are Cold Sores?

Cold sores (also called fever blisters or oral herpes) start as small blisters that form around the lips and mouth. They sometimes appear on the chin, cheeks, and nose, too. After a few days, the blisters usually begin to ooze, then form a crust and heal completely in one to two weeks.

Despite their name, cold sores actually have nothing to do with colds. In children, cold sores are usually caused by the herpes simplex virus type 1 (HSV-1).  Genital herpes is usually caused by a different strain, herpes simplex virus type 2 (HSV-2), although both virus strains can cause sores in any part of the body. 

Most people are first exposed to HSV between ages 1 and 5 years of age, and more than half of people in the United States are infected with it by the time they become adults. Beyond the uncomfortable sores that the virus can cause, HSV is usually harmless.

How Do Cold Sores Spread?

Cold sores are highly contagious. They can spread through saliva, skin-to-skin contact, or by touching an object handled by someone infected with the virus.

When a child develops a cold sore for the first time (also called primary HSV), the blisters often spread beyond the lips to the mouth and gums. A child may also have a fever, swollen and tender lymph glands, sore throat, irritability and drooling. Sometimes symptoms are so mild, though, parents may not even notice any of them.

When problems can arise:

• The virus from cold sores can spread to the eyes, which can  lead to HSV keratitis, an infection of the cornea—the clear dome that covers the colored part of the eye. The infection usually heals without damaging the eye, but more severe infections can lead to scarring of the cornea or blindness. HSV keratitis is a major cause of blindness worldwide.

• HSV is especially dangerous to babies under 6 months of age. Parents or relatives with cold sores should be especially careful not to kiss babies—their immune systems are not well developed until after about 6 months old. Signs that a baby may have been infected with HSV include low grade fever and one or more small skin blisters. These symptoms can occur 2 to 12 days after HSV exposure. If these occur or if you have any concerns, call your pediatrician.

Do Cold Sores Come Back?

After a child’s first cold sore, the virus settles into bundles of nerve cells in the body—causing no symptoms unless it activates and travels back up to the skin’s surface. While the virus remains in the body for the rest of your life, the recurrence of cold sores is highly variable.  Some children may never get another cold sore, while others may have multiple outbreaks a year. When the virus does reactivate, cold sores tend form again at the same spot but usually not inside of the mouth.

The first signs of a flare up include tingling, itching, or burning where the cold sore moves toward the skin. Parents might notice their child keeps touching or scratching a spot on the lip that starts to swell and redden before sores form.

Common Cold Sore Triggers:

Once a child is infected with the cold sore virus, it is more likely to return during times when the body’s immune system is run down or the skin becomes irritated from other causes.

Common cold-sore triggers for children previously exposed to the virus include:

• Fatigue and stress

• Exposure to intense sunlight, heat, cold, or dryness

• Injuries to or breaks in the skin

• Illness (i.e., cold or flu)

• Dehydration and poor diet

• Fluctuating hormones (i.e., during a teen’s menstrual periods, etc.)

What Parents Can Do:

Although there is currently no cure for cold sores, the good news is that they go away on their own. Some may take a little longer than others to heal.  Cold sores are typically not treated, because the medications currently available only slightly speed up healing time. Parents can protect against the cold sores’ spread, help relieve the child’s discomfort during a flare-up, and try to avoid possible triggers.

Stop the spread.

• Try to prevent your child from scratching or picking at cold sores. This can spread the virus to other parts of the body, such as fingers and eyes, as well as to other children who touch toys and other objects they play with. Wash hands and clean toys regularly. 

• During a cold sore flare-up, don’t let your child share drinks or utensils, towels, toothpaste or other items to avoid spreading the infection through saliva. Also, wash items such as towels and linens in hot water after use.

• Children usually can go to child care or school with an active infection, but your pediatrician may suggest keeping them home if they drool a lot or are having their very first HSV outbreak. See When to Keep Your Child Home from Child Care for more information.

• If your child participates in sports that involve skin-to-skin contact such as wrestling, he or she should sit out during an active cold sore infection. Make sure mats and other equipment are cleaned regularly after use.

Ease discomfort.

• Apply ice or a warm washcloth to the sores to help ease your child’s cold sore pain.

• Chilled or icy treats such as smoothies may be soothing to tender lips and can help avoid dehydration.

• Avoid giving your child acidic foods during a cold sore outbreak (e.g., citrus fruits or tomato sauce). These can irritate cold sores.

• If your child’s cold sores continue to hurt—especially if he or she does not want to eat or drink because of mouth pain—ask your pediatrician about giving a pain reliever such as acetaminophen or ibuprofen. Your pediatrician may also suggest an over-the-counter cream or a prescription anti-viral cream to help reduce cold sore symptoms and shorten outbreaks by a day or two.

Avoid triggers.

• Skin irritation can bring on a cold sore outbreak, so be sure your child uses lotion and a lip balm containing sunscreen or zinc oxide before heading outdoors. 

• Make sure your child gets enough sleep, exercise, and eats a well-balanced diet.

• Help your child manage stress, which can increase the likelihood of cold sore outbreaks. 

When to See Your Pediatrician:

• During your child’s first cold sore infection: This is especially recommended if your child has a known difficulty in fighting infections or a chronic skin condition such as eczema.

• If your newborn develops a blister-like rash or fever: This could be symptoms of a dangerous, neonatal herpes simplex infection.

• If there are sores or blisters near your child’s eyes: HSV is the most common cause of corneal infections.

• If your child develops a headache, combined with confusion, seizure or fever during a cold sore outbreak: This could signal a dangerous brain infection caused by the virus, including meningitis or encephalitis.

• If the sores do not heal on their own within seven to 10 days: Your pediatrician might want to rule out a secondary bacterial infection and/or any other medical condition.

• If skin surrounding cold sores becomes reddened, swollen or feels hot to the touch: This may be signs of a secondary bacterial infection. Infection that spreads to the bloodstream and body-wide (sepsis) can also be a concern for children whose immune systems are weakened by certain diseases and medications.

• If your child gets frequent cold sores: Children with more than five or six outbreaks a year might benefit from antiviral medications. Talk to your pediatrician about a prescription if your child’s outbreaks are frequent.  

Additional Information & Resources:

The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.

Herpes Simplex Virus in the Newborn

Last Reviewed: October 2011

What is herpes simplex virus?

Herpes simplex virus (HSV) is a virus that usually causes skin infections. There are two types of HSV: HSV type 1 usually causes small blisters on the mouth, eye or lips (cold sores) and HSV type 2 usually affects the genital area. HSV infection in newborn babies can be very severe and can even cause death. This is because newborns’ immune systems are not fully developed.

Who gets HSV and how is it spread?

• About 70 percent of all adults in the U.S. are infected with HSV-1 and may shed virus in their saliva at any time during their lifetime, even if they don’t have symptoms like sores in the mouth or cold sores.
• Anyone can get either type of HSV. HSV-1 infection usually occurs in childhood, before age 5, from close contact with someone shedding HSV-1, often with cold sores.
• Most HSV infections in newborns are caused by HSV-2 that the infant catches from the mother’s birth canal.
• Newborns can sometimes get HSV-1 from close contact with someone who is shedding HSV-1 virus in their saliva or has an active HSV-1 outbreak (cold sores).

What are the symptoms of HSV infection?

• Most people with HSV-1 can shed it in their saliva with no symptoms, or they may have a cold sore: a small fluid filled skin blister which breaks open, crusts over, and disappears in about 21 days.
• Infected newborns may have mild symptoms at first, such as low grade fever (100.4 degrees F., or more, rectally), poor feeding, or one or more small skin blisters. This can happen two to 12 days after HSV exposure. If any of these occur, notify your doctor immediately.
• Newborns can become very sick quickly with high fever and seizures, and may become lethargic (floppy).
• HSV infection in newborns can be very severe and can even cause death.

What is the treatment for HSV?

• Cold sores in children and adults don’t need to be treated. Creams with anti-HSV medicine can treat cold sore symptoms, if necessary.
• Newborns with HSV require hospitalization for intravenous antiviral medication for 21 days. Even with this treatment, some newborns can suffer death or brain damage from HSV infection.

How can you prevent your newborn from getting HSV?

• If you are pregnant and have a history or signs and symptoms of genital HSV-2 infection, tell your doctor as soon as possible. A C-section delivery is recommended if a mother has an HSV-2 outbreak near the time of birth.
• Everyone should wash their hands before touching the newborn.
• Do not kiss your baby or let others kiss your baby if you or they have cold sores on the mouth or lips.

Care instructions (recommendations for parents and caregivers):

• Wash hands thoroughly with soap and water before touching the newborn.
• Contact your doctor immediately if there are any signs of HSV infection. These include low grade fever (100.4 degrees F., or more, rectally), poor feeding, irritability, and skin rash in the form of pimples or blisters, seizures or other similar symptoms that may develop within six weeks following birth.
• All newborns should be seen by their health care provider between the first and third week of life.

Cold Sores (Orofacial Herpes) in Adults: Condition, Treatments, and Pictures – Overview

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Overview

Herpes simplex infection of the mouth and face, known as orofacial herpes simplex, herpes labialis, cold sores, or fever blisters, is a common, recurrent skin condition associated with infection by the herpes simplex virus (HSV). Orofacial HSV usually appears as small blisters or sores around the mouth, nose, genitals, and buttocks, though infections can develop almost anywhere on the skin. Furthermore, these cold sores may periodically come back in the same sites.

Infections with HSV are very contagious and are spread by direct contact with the skin lesions. There are 2 types of HSV: herpes simplex virus type 1 (HSV-1) and herpes simplex virus type 2 (HSV-2). HSV-1 infections usually occur around the mouth, lips, nose, or face, while HSV-2 infections usually involve the genitals or buttocks. However, HSV-1 can sometimes cause infections in the genitals or buttocks, while HSV-2 can occasionally cause infections around the mouth, lips, nose, or face.

Both types of virus produce 2 kinds of infections: primary and recurrent. Because it so contagious, HSV causes a primary infection in most people who are exposed to the virus. However, only about 20% of people who are infected with HSV actually develop visible blisters or sores. Appearing 2–12 days after a person’s first exposure to HSV, the sores of a primary infection last about 1–3 weeks. These sores heal completely, rarely leaving a scar. Nevertheless, the virus remains in the body, hibernating in nerve cells.

Certain triggers can cause the hibernating (latent) virus to wake up, become active, and travel back to the skin. These recurrent HSV infections may develop frequently (every few weeks), or they may never develop. Recurrent infections tend to be milder than primary infections and generally occur in the same location as the primary infection.

Most people get cold sores as children, through contact with a friend or family member who is already infected with HSV. It can be spread (transmitted) by kissing, sharing eating utensils or drinking vessels, or by using the same towel.

Who’s at risk?

HSV infections occur in people of all races, of all ages, and of both sexes.

Increasing age is associated with increased likelihood of infection. Up to 80% of Americans are infected with HSV-1 by the time they are 30 years old.

Only 20% of people who are infected with HSV actually develop visible blisters or sores. That means that approximately 80% of people with HSV infections have not been diagnosed and are unaware of their condition. Nevertheless, they can still transmit the infection to others.

Signs and Symptoms

The most common locations for HSV-1 infections include:

• Lips
• Mouth (including gums, tongue, roof of mouth, and inside the cheeks)
• Nose
• Chin
• Cheeks

Shortly after exposure to the virus, a newly infected person may develop fluid-filled blisters, occurring singly or in a cluster of several blisters. These blisters may be yellow to gray and are fragile, so that many people never notice blisters but instead see tiny open sores (ulcers). These ulcers subsequently become scabbed over and may appear dry and yellow. The scabs eventually fall off, leaving a red area that fades. The first (primary) outbreak of HSV typically lasts 1–3 weeks.

In mild cases of primary orofacial HSV infection, an individual may develop 1–2 cold sores or may notice no symptoms at all. The lymph nodes in the neck may or may not be swollen. In severe cases of HSV infection, cold sores may involve the entire lining of the mouth and both lips. These severe infections may be accompanied by fever, sore throat, foul breath, and difficulty eating.

Repeat (recurrent) HSV infections are often milder than the primary infection, though they look alike. However, some people never develop the symptoms of a primary HSV infection and may mistake a recurrent infection for a primary infection. A recurrent infection typically lasts 7–10 days. People who are prone to recurrent outbreaks tend to get them 3–4 times per year.

Many people with recurrent HSV infections report that the skin lesions are preceded by sensations of burning, itching, or tingling (prodrome). About 24 hours after the prodrome symptoms begin, the actual lesions appear as one or more small blisters or open sores, which eventually become scabbed over.

Triggers of recurrent HSV infections include:

• Fever or illness
• Sun exposure
• Hormonal changes, such as those due to menstruation or pregnancy
• Stress
• Trauma, such as that caused by dental work or cuts from shaving
• Surgery

Self-Care Guidelines

Acetaminophen or ibuprofen may help reduce fever, muscle aches, and pain caused by cold sores. Try to drink as many fluids as possible to prevent dehydration. Applying ice packs may relieve some of the swelling and discomfort.

Because HSV is very contagious, it is important to take the following steps to prevent spread (transmission) of the virus during the prodromal phase (burning, tingling, or itching) and active phase (presence of blisters or sores) of HSV infections:

• Avoid sharing cups or eating utensils.
• Avoid kissing or performing oral sex.
• Avoid sharing lip balm or lipstick.
• Avoid sharing razors, towels, and other personal care items.
• Wash your hands with soap and water if you touch an active lesion.

Unfortunately, the virus can still be transmitted even when someone does not have active lesions.

When to Seek Medical Care

If you develop tender, painful sores in the mouth or on the lips or nose, see a physician.

Contact your doctor immediately if an HSV outbreak has not gone away in 2 weeks, if you are not eating or drinking because of the pain, or if you develop blisters or sores near your eye.

If you have an underlying medical condition such as cancer or HIV, or if you have undergone organ transplantation, you are at higher risk for more serious complications. Seek medical advice as soon as possible, especially if you are at risk for more serious complications.

Treatments Your Physician May Prescribe

Most HSV infections are easy for physicians to diagnose. On occasion, however, a swab from the infected skin may be sent to the laboratory for viral culture, which takes a few days to grow. Blood tests may also be performed.

Untreated HSV infections will go away on their own, but medications can reduce the symptoms and shorten the duration of outbreaks. There is no cure for HSV infection.

Treatment for primary HSV infection includes the following oral antiviral medications:

• Acyclovir pills
• Valacyclovir pills
• Famciclovir pills

These medications are usually taken for 5–14 days.

More severe primary HSV infections may require additional medications:

• Oral antibiotic pills if the areas are also infected with bacteria
• Topical anesthetic, such as viscous lidocaine, if the areas inside the mouth are very painful

In addition, very severe infections may require intravenous fluids (and even intravenous antiviral medications) or painkillers if the pain prevents you from drinking fluids.

Treatment for recurrent HSV infection includes the same oral antiviral medications used to treat primary infection:

• Acyclovir pills
• Valacyclovir pills
• Famciclovir pills

People who experience early signs (prodromes) before recurrent infections may benefit from episodic treatment, by starting to take medication after the onset of tingling and burning but before the appearance of blisters and sores.

Other people have recurrent infections that are frequent enough or severe enough to justify suppressive therapy, in which medications are taken every day in order to decrease the frequency and severity of attacks.

Trusted Links

MedlinePlus: Mouth DisordersClinical Information and Differential Diagnosis of Herpes Simplex Virus (HSV), Orofacial

References

Bolognia, Jean L., ed. Dermatology, pp.1235-1241. New York: Mosby, 2003.

Freedberg, Irwin M., ed. Fitzpatrick’s Dermatology in General Medicine. 6^th ed, pp.1252. New York: McGraw-Hill, 2003.

Herpes simplex | DermNet NZ

What is herpes simplex?

Herpes simplex is a common viral infection that presents with localised blistering. It affects most people on one or more occasions during their lives.

Herpes simplex is commonly referred to as cold sores or fever blisters, as recurrences are often triggered by a febrile illness, such as a cold.

Herpes simplex

What causes herpes simplex?

Herpes simplex is caused by one of two types of herpes simplex virus (HSV), members of the Herpesvirales family of double-stranded DNA viruses.

• Type 1 HSV is mainly associated with oral and facial infections
• Type 2 HSV is mainly associated with genital and rectal infections (anogenital herpes)

However, either virus can affect almost any area of skin or mucous membrane.

After the primary episode of infection, HSV resides in a latent state in spinal dorsal root nerves that supply sensation to the skin. During a recurrence, the virus follows the nerves onto the skin or mucous membranes, where it multiplies, causing the clinical lesion. After each attack and lifelong, it enters the resting state.

During an attack, the virus can be inoculated into new sites of skin, which can then develop blisters as well as the original site of infection.

Who gets herpes simplex?

Primary attacks of Type 1 HSV infections occur mainly in infants and young children. In crowded, underdeveloped areas of the world, nearly all children have been infected by the age of 5. In less crowded places, the incidence is lower; for example, less than half of university entrants in Britain have been infected. Type 2 HSV infections occur mainly after puberty and are often transmitted sexually.

HSV is transmitted by direct or indirect contact with someone with active herpes simplex, which is infectious for 7–12 days. Asymptomatic shedding of the virus in saliva or genital secretions can also lead to transmission of HSV, but this is infrequent, as the amount shed from inactive lesions is 100 to 1000 times less than when it is active. The incubation period is 2–12 days.

Minor injury helps inoculate HSV into the skin. For example:

• A thumb sucker may transmit the virus from their mouth to their thumb.
• A health-care worker may develop herpetic whitlow (paronychia)
• A rugby player may get a cluster of blisters on one cheek (‘scrumpox’).

What are the clinical features of herpes simplex?

Primary herpes simplex

Primary infection with HSV can be mild or subclinical, but symptomatic infection tends to be more severe than recurrences. Type 2 HSV is more often symptomatic than Type 1 HSV.

Primary Type 1 HSV most often presents as gingivostomatitis, in children between 1 and 5 years of age. Symptoms include fever, which may be high, restlessness and excessive dribbling. Drinking and eating are painful, and the breath is foul. The gums are swollen and red and bleed easily. Whitish vesicles evolve to yellowish ulcers on the tongue, throat, palate and inside the cheeks. Local lymph glands are enlarged and tender.

The fever subsides after 3–5 days and recovery is usually complete within 2 weeks.

Primary Type 2 HSV usually presents as genital herpes after the onset of sexual activity. Painful vesicles, ulcers, redness and swelling last for 2 to 3 weeks, if untreated, and are often accompanied by fever and tender inguinal lymphadenopathy.

In males, herpes most often affects the glans, foreskin and shaft of the penis. Anal herpes is more common in males who have sex with men than with heterosexual partners.

In females, herpes most often arises on the vulva and in the vagina. It is often painful or difficult to pass urine. Infection of the cervix may progress to severe ulceration.

Recurrent herpes simplex

After the initial infection, whether symptomatic or not, there may be no further clinical manifestations throughout life. Where viral immunity is insufficient, recurrent infections are common, particularly with Type 2 genital herpes.

Recurrences can be triggered by:

• Minor trauma, surgery or procedures to the affected area
• Upper respiratory tract infections
• Sun exposure
• Hormonal factors (in women, flares are not uncommon prior to menstruation)
• Emotional stress

In many cases, no reason for the eruption is evident.

The vesicles tend to be smaller and more closely grouped in recurrent herpes, compared to primary herpes. They usually return to roughly the same site as the primary infection.

• Recurrent Type 1 HSV can occur on any site, most frequently the face, particularly the lips (herpes simplex labialis).
• Recurrent Type 2 HSV may also occur on any site, but most often affects the genitals or buttocks.

Itching or burning is followed an hour or two later by an irregular cluster of small, closely grouped, often umbilicated vesicles on a red base. They normally heal in 7–10 days without scarring. The affected person may feel well or suffer from fever, pain and have enlarged local lymph nodes.

Herpetic vesicles are sometimes arranged in a line rather like shingles and are said to have a zosteriform distribution, particularly when affecting the lower chest or lumbar region.

White patches or scars may occur at the site of recurrent HSV attacks and are more evident in those with the skin of colour.

Herpes simplex

See more images of herpes simplex.

How is herpes simplex diagnosed?

If there is clinical doubt, HSV can be confirmed by culture or PCR of a viral swab taken from fresh vesicles. HSV serology is not very informative, as it’s positive in most individuals and thus not specific for the lesion with which they present.

What are the complications of herpes simplex?

Eye infection

Herpes simplex may cause swollen eyelids and conjunctivitis with opacity and superficial ulceration of the cornea (dendritic ulcer, best seen after fluorescein staining of the cornea).

Throat infection

Throat infections may be very painful and interfere with swallowing.

Eczema herpeticum

In patients with a history of atopic dermatitis or Darier disease, HSV may result in severe and widespread infection, known as eczema herpeticum. The skin disease can be active or historical. Numerous blisters erupt on the face or elsewhere, associated with swollen lymph glands and fever.

Erythema multiforme

A single episode or recurrent erythema multiforme is an uncommon reaction to herpes simplex. The rash of erythema multiforme appears as symmetrical plaques on hands, forearms, feet and lower legs. It is characterised by target lesions, which sometimes have central blisters. Mucosal lesions may be observed.

Nervous system

Cranial/facial nerves may be infected by HSV, producing temporary paralysis of the affected muscles. Rarely, neuralgic pain may precede each recurrence of herpes by 1 or 2 days (Maurice syndrome). Meningitis is rare.

Widespread infection

Disseminated infection and/or persistent ulceration due to HSV can be serious in debilitated or immune deficient patients, for example in people with human immunodeficiency virus (HIV) infection.

Complications of herpes simplex infection

What is the treatment for herpes simplex?

Mild, uncomplicated eruptions of herpes simplex require no treatment. Blisters may be covered if desired, for example with a hydrocolloid patch. Severe infection may require treatment with an antiviral agent.

Antiviral drugs used for herpes simplex and their usual doses are:

• Aciclovir — 200 mg 5 times daily for five days
• Valaciclovir — 1 g 3 times daily for seven days
• Famciclovir — as a single dose of 3 x 500 mg

In New Zealand, famciclovir is not currently funded by PHARMAC (April 2019).

Higher doses of antiviral drugs are used for eczema herpeticum or for disseminated herpes simplex.

Topical aciclovir or penciclovir may shorten attacks of recurrent herpes simplex, provided the cream is started early enough.

Can herpes simplex be prevented?

As sun exposure often triggers facial herpes simplex, sun protection using high protection factor sunscreens and other measures are important.

Antiviral drugs will stop HSV multiplying once it reaches the skin or mucous membranes but cannot eradicate the virus from its resting stage within the nerve cells. They can, therefore, shorten and prevent attacks but a single course cannot prevent future attacks. Repeated courses may be prescribed, or the medication may be taken continuously to prevent frequent attacks.

Herpes Simplex Virus | SmartSexResource

Herpes can be managed.  It is a very common STI in British Columbia.

There are two types of herpes simplex virus: herpes simplex 1 (HSV-1) and herpes simplex 2 (HSV-2).

HSV-1 is commonly found around the mouth and is often called “cold sores”. It can be passed orally by kissing and it can be passed to the genitals through oral sex. HSV-2 is commonly found in the genital area and is passed through vaginal and anal sex, but it can also be passed to the mouth through oral sex. It is uncommon for HSV-2 to be found on the lips, but it is becoming more common to find HSV-1 in the genital area. Both types are sometimes passed to other areas of the body through skin-to-skin contact.

After the first outbreak, herpes stays in the body and becomes inactive. The virus may become active from time-to-time. When this happens, symptoms usually show up in the same general area as the first time. There is no way of knowing if, or how often, a person will have future outbreaks. For most people, outbreaks happen less often over time.

Causes

Herpes is passed through vaginal, oral, and anal sexual contact.  This includes both penetrative sex and sexual activities where there is skin-to-skin contact. The contact needs to be directly with the part of the body where a person has the virus. 

Herpes can be passed to others even if you don’t have symptoms.  The virus can be found on the skin even when there are no symptoms, called “asymptomatic shedding”.  However, it’s more likely to be passed when symptoms are present. 

Once you have one type of HSV, it is unusual to get the same type on another area of your body. The exception is within the first few months after you are exposed to HSV, while your body is building up antibodies to the virus. HSV can be passed to other parts of the body during this time. Try not to touch the sores and wash your hands often, to lower the chances of passing it to another part of your body.

If you have one type of herpes, then it is not possible to get that same type again.

Symptoms

If you have herpes, it is common to not notice any symptoms. If you do get symptoms, they will most likely show up between 2 to 21 days after sexual contact. 

The first time you come in contact with the virus and get symptoms is called a primary outbreak. The first outbreak can last longer and be more severe than future outbreaks. Early symptoms include itching, burning, or tingling at the site where blisters or sores may appear, followed by painful red sores or tiny blisters and sometimes swollen glands, fever and body aches. You may have severe flu-like symptoms, such as fever, headache and muscle aches. Over time, outbreaks usually happen less often and the symptoms are milder.

Herpes outbreaks may be triggered by different things.  These can include sun exposure, lack of sleep, alcohol use, skin irritation, and stressful events. Symptoms may be reduced by using sunscreen, getting enough sleep, drinking water, using lube, eating well and using coping strategies for stress.

Tests and Diagnosis

Most testing for herpes is done by an exam and a swab taken from a blister. Results are the most accurate if you see a health care provider as soon as a sore develops.  They will look at the sore to determine what it is.  If possible, they will take a swab. 

There is a blood test for herpes but it is not routinely done.  The patient guide at the bottom of this page has more information on blood testing for herpes.

It is best to get tested for herpes when you have symptoms.

Window Period (how long you should wait to get tested): Most swab tests are accurate once you have symptoms.  Most blood test results are accurate 12 to 16 weeks after you come in contact with herpes.  In British Columbia, most test results should be ready in 10 days.

Treatment

You can choose if you want to treat herpes.  Symptoms will go away without treatment, though they may go away sooner with treatment.  Herpes is treated with prescription antiviral medications.  These medications can lessen the severity of an outbreak and lower the chances of passing it to sexual partners. Medication works best if it is started as soon as possible after an outbreak begins. 

To help with the symptoms of a genital outbreak, you can try the following:

• wear loose-fitting clothing and cotton underwear
• bathe in warm water to soothe sores
• keep the area dry
• apply an ice pack, wrapped in a clean covering, to sores
• take acetaminophen or ibuprofen (over-the-counter pain medication) if needed
• drink plenty of fluids to keep urine diluted (to lower pain when urinating)
• if urinating is painful, try urinating in a warm shower or bath, or try pouring warm water over the genitals when urinating
• only use medications, ointments or creams as directed by your health care provider

Sexual Partners

It is your choice if you talk to your current sexual partners about herpes.  Telling your partners lets them make informed choices, but you may not want to or you may not feel safe telling your partners.  You need to make the decision that is best for you.

Current partners can check themselves regularly for herpes.  If they notice any symptoms, they can see their health care provider for testing.  Once your outbreak is over, it is less likely that you can pass herpes to sexual partners.

Complications

Herpes does not usually cause any other health problems.   Serious complications, although extremely rare, may include:

• higher chance of getting and passing HIV
• ongoing, frequent and painful outbreaks
• eye herpes
• brain infection and inflammation (encephalitis or meningitis)

Pregnancy:  Tell your health care provider if you are pregnant and have herpes.  You can pass herpes to your child during birth.

Prevention

To lower the chances of passing or getting herpes:

• you can still be sexual when you have an outbreak, but take care to avoid skin-to-skin contact in the area where you have sores (for example, do not give oral sex when you have a sore on your mouth)
• consider antiviral medication if you have frequent outbreaks

It is a good idea to be tested regularly for STIs, especially if you have new sexual partners or open relationships.  Talking with partners about safer sex makes sure everyone knows what to expect.  Condoms are great if they work for you – the correct use of condoms might reduce your chance of getting and passing herpes (depending where outbreaks are located).

Resources

These two resources – a detailed 25-page patient’s guide and a 4-page handout – have been produced by the BC Centre for Disease Control. You can download or print these booklets for more information on herpes, including testing, treatment, and talking to your partners about herpes.

HealthLink BC – Information about herpes in multiple languages
SmartSexResource – If you are worried or have anxiety about herpes
Trans Care BC – Gender-affirming sexual and reproductive health information

Download and print this page (below).

“Acute herpetic stomatitis (cold)”, by dentist O. Korobeynikova

Cases of a patient with a cold on the lips in the dental chair are quite common. As a rule, the doctor in such cases postpones dental treatment if there is no acute pain, since the herpes simplex virus without treatment can further spread in the oral cavity, penetrate into the lymph nodes, then into the blood and internal organs, the brain. This can cause herpetic bronchitis, pneumonia, and other infectious diseases.

What is herpes?

Herpes simplex, synonym – blister lichen. Herpes simplex often affects the skin. After the incubation period (3-4 days), bubbles with a diameter of 0.1-0.3 cm appear on the skin against the background of a limited, slightly edematous pink spot. Before the rash, patients feel a burning sensation and itching of the skin at the site of the future rash. Subsequently, the vesicles open up, forming erosive surfaces covered with a white bloom in the form of aft, which heal without scarring after 6-8 days.

The usual localization is the skin of the face: the circumference of the mouth, the red border of the lips, nose, less often the skin of the cheeks, eyelids, auricles. Often, skin rashes are accompanied by an increase in body temperature up to 38-39 ° C and symptoms of general intoxication.

Diseases caused by the herpes simplex virus are divided into primary and secondary (recurrent) herpes infection.

Primary herpes infection usually occurs when a person first comes into contact with the herpes simplex virus.This most often occurs in early childhood under 5 years of age. Usually, 80-90% of the initially infected have the disease in a latent form, 10-20% of those infected have clinical manifestations in the form of a general infectious syndrome with fever and other signs of intoxication. Primary herpes can be manifested by lesions of the skin and mucous membranes, including the conjunctiva or cornea of ​​the eye.

Secondary (recurrent) herpes infection occurs at any age after primary herpes.It proceeds with a mild general infectious syndrome and, as a rule, against a background of diseases that reduce immunity: somatic diseases and other infectious diseases, as well as under the influence of a number of adverse factors: hypothermia, overheating, UV radiation, endocrine changes, emotional stress.

Herpes simplex relapses can occur with varying frequency. If they appear once every few years, the rash is moderate and fixed in the same place, then this is a good prognostic sign.If relapses occur more often, then this indicates a defect in the immune system and the need for its correction.

There are three degrees of severity of the disease with acute herpetic stomatitis – mild, moderate and severe.

At mild severity there are no symptoms of intoxication of the body. Formed aphthae rapidly epithelialize, there are usually no new lesions.

Average severity proceeds with symptoms of severe intoxication – an increase in body temperature to 38-39 ° C, malaise, weakness, lack of appetite, nausea.On the edematous, hyperemic mucous membrane of the mouth, there are single or grouped aphthae. Intense salivation, soreness and enlargement of regional lymph nodes appear. Recovery occurs in 2-3 weeks.

Severe form of the disease is characterized by all signs of intoxication, adynamia, headache, nausea, vomiting. The body temperature rises to 38-39 ° C. The mucous membrane of the mouth is hyperemic, edematous, covered with a large number of aphthous elements, which can merge, forming large erosions.Lips, mucous membrane of the cheeks, hard and soft palate, tongue, gingival margin are affected. With insufficient care of the oral cavity, catarrhal gingivitis turns into ulcerative, and with the addition of fusospirochetous microflora, a transition to necrotizing gingivostomatitis is possible.

Herpes treatment

Treatment of viral (herpes) infection should be comprehensive.

General treatment. From the moment the first clinical signs of the disease appear, antiviral therapy is carried out: lubrication of the red border of the lips and skin around the mouth with antiviral ointments (0.25-0.5% bonafton, 0.5% florenal, 5% acyclovir, 1% alpisarin , 1% helepinic and others) 3-4 times a day for 5-7 days.

immunomodulatory drugs are prescribed: viferon, kipferon 1500 IU in rectal suppositories every 12 hours for 10 days, reaferon, imudon.

Reaferon is a recombinant interferon. The effectiveness of the drug increases in combination with antioxidants: vitamin A – retinol acetate, E – tocopherol and C – ascorbic acid.

The therapeutic effect of Imudon is directed against the main symptoms of inflammation: pain, erythema, edema, ulceration, bleeding.Imudon regulates local immunity, enhances salivation, reduces the viscosity of saliva – creates optimal conditions for the regeneration of the oral mucosa. Imudon tablets must be kept in the oral cavity until they are completely absorbed. Imudon is used in 6-8 sublingual tablets per day for 14-21 days.

The general treatment plan should include desensitizing therapy: suprastin, pipolfen, tavegil, fenkarol and others, 1 tablet 2 times a day for 5-10 days.30% sodium thiosulfate solution, 10 ml intravenously, slowly, every other day, for a course of treatment – 5-10 injections (the drug has a powerful anti-inflammatory, hyposensitizing and anti-toxic effect).

Complex vitamin preparations containing vitamins A, E, C, P and microelements (triovit, duovit, komplivit and others) should be taken in therapeutic doses 1-2 times a day for 2-3 weeks.

Local treatment should be aimed at relieving pain and regenerating lesions.In order to anesthetize the mucous membrane of the mouth and lips, 1% pyromecaine ointment is used; 0.5-1% solutions of anesthetics (novocaine, lidocaine, pyromecaine) in the form of applications or oral baths for 5 minutes; 10% aerosol lidocaine; 5-10% solution of anesthesin in peach oil. From modern drugs that have analgesic and at the same time suppressing inflammation, you can use the Tantum Verde aerosol. Tantum Verde liquid is also used – a 0.15% solution for rinsing the mouth (15 ml).

To improve metabolic processes in the affected tissues and to accelerate the epithelialization of erosion, during the period of extinction of rashes, keratoplastic preparations are prescribed: rosehip and sea buckthorn oil, carotolin, vitamin A oil solution, ointment and solcoseryl gel.

From the first day of treatment of a patient with herpetic eruptions on the oral mucosa and red border of the lips and until the complete epithelialization of erosions is completed, physiotherapeutic treatment is used – laser therapy (has an anti-inflammatory, anti-edema effect, normalizes microcirculation, has an analgesic and bactericidal, bacteriostatic effect , stimulates metabolism and accelerates regeneration).

Due to the fact that herpetic eruptions are accompanied by symptoms of severe intoxication of the body, attention is paid to the introduction of a large amount of liquid, rational nutrition (crushed, high-calorie, fortified, non-irritating diet).

To prevent secondary infection, antiseptic rinses or oral baths are prescribed for 15 minutes (1% hydrogen peroxide solution, 0.05% chlorhexidine, 0.01% miramistin) 4-5 times a day for 5 days.

Herpes: types, symptoms, treatment and prevention

Herpes is a viral pathology in which rashes in the form of bubbles form on the skin and mucous membranes. They appear in groups and reach 2–3 centimeters in diameter. Affects different parts of the body. According to WHO statistics, around 4 billion people all over the world suffer from “colds” on the lips and mucous membranes of the mouth, and about half a billion are infected with genital herpes.

Types of herpes

Science knows 8 types of herpes.

• Herpes simplex virus type 1 (HSV-I). This type affects the skin of the face, hands, mucous membranes of the mouth, conjunctiva of the eyes, causes meningoencephalitis, neonatal herpes. You can get infected by talking, kissing.
• Herpes simplex virus type 2 (HSV-II). It affects the mucous membranes of the genitals. It is transmitted through sexual intercourse. A third of those infected have frequent relapses.
• Varicella zoster virus (VVZ). It is the cause of diseases such as chickenpox and shingles.
• Epstein-Barr virus (EBV). Causes infectious mononucleosis, B-lymphoproliferative pathologies.
• Human cytomegalovirus (CMV). It is the cause of the development of primary and congenital CMV infections.
• Human herpes viruses 6,7,8 (HR-6, HR-7, HR-8). Causes exanthema in newborns.

Pathogens can remain unnoticed in the body for a long time and become activated in the event of an exacerbation of infection and a decrease in immunity.

The most common herpes simplex viruses are type 1 and type 2 Herpes simplex virus.In the external environment, they are unstable. At room temperature, they “live” up to a day, on metal surfaces – 2 hours. When heated above 50 ° C, they die within half an hour. Alcohol and chlorine-containing substances “kill” them within a couple of minutes. But freezing is quite favorable for these viruses and keeps them for up to 5 days.

Once in the body, these viruses remain with a person until the end of life. Most often they become infected with them at an early age.

Herpes symptoms

Let us describe the signs characteristic of HSV-1 and HSV-2.

Herpes of the first type

• Sometimes the infection develops without any signs. Many people are unaware that they are carriers of the virus.
• Obvious manifestations include painful blisters, a red border around the mouth, and sores in the mouth.
• Before their appearance, itching and tingling sensations, burning sensations occur.
• The frequency of relapses depends on the individual.
• HSV-1 may cause genital herpes.It proceeds imperceptibly or with slight signs that are difficult to recognize. If it manifests itself actively, then you can understand that a person is sick by the presence of bubbles and ulcers in the genital area. The first time, as a rule, the disease is difficult. Genital herpes caused by HSV-1 usually recurs rarely, which cannot be said about the pathology caused by the type 2 virus.

Herpes of the second type (HSV-2)

• This disease may also not manifest itself in any way. As with HSV-1, carriers of the virus are unaware of their condition.
• Research by WHO shows that one third of people who get sick have symptoms.
• Symptoms include the formation of vesicles and ulcers in the genital and anal area.
• Body aches and fever may be troubling. Lymph nodes are often inflamed.
• Before the appearance of ulcers, patients may notice a tingling sensation and intermittent shooting pain in the thighs and buttocks.

Herpes Treatment

Diagnosis and treatment of various pathologies caused by these viral agents are under the jurisdiction of a dermatovenerologist.Anamnesis and clinical picture allow the specialist to make an accurate diagnosis. In difficult cases, the doctor prescribes additional examinations: clinical and biochemical blood tests, urinalysis.

Of the most effective drugs, antiviral agents are noted. However, experts believe that the infection cannot be completely cured. You can only muffle the manifestations and reduce the frequency of relapses.

Complications

However, this virus and its consequences for the body should not be underestimated.

• When a baby comes into contact with viral agents in the genital tract during childbirth, neonatal herpes can develop. In some cases, the newborn is threatened with neurological disability, and sometimes death. Moreover, it is most dangerous if a woman first becomes infected with the virus in the last weeks of pregnancy.
• The link between HSV-2 and HIV has been proven. Diseases caused by a pathogen increase the chances of contracting HIV. Herpetic infection in this case is difficult and often recurs.Among the possible undesirable consequences for health, such diseases as hepatitis, pneumonitis, esophagitis and others are called.
• When HSV-induced neuroinfection occurs, the facial and trigeminal nerves are affected, and neuralgia and paralysis may develop. Herpes encephalitis and meningoencephalitis are also dangerous.
• With a pronounced decrease in immunity, herpes infection can affect the internal organs, with localized rashes in the perineum – disrupt the function of the bladder.
• Ophthalmic herpes can cause keratitis, in which the cornea becomes inflamed, retinitis, when the retina is affected, or rapidly progressive retinal necrosis. The latter pathology leads to blindness in 80% of cases.

Prevention

• It is possible to get infected during the period when the symptoms are clearly visible, and in those cases when the infection proceeds without signs.
• If symptoms are pronounced, patients should avoid communicating with other people and use separate dishes, cutlery, towels.
• Patients with severe genital herpes should avoid intimacy with a partner and use condoms at all times.
• Pregnant women who have noticed symptoms of the disease should inform their doctor about their condition.

Herpes is an insidious disease that sometimes does not manifest itself. It is impossible to protect yourself from it 100%, however, you can minimize the risk of infection with an obvious manifestation of symptoms.And, of course, you should immediately consult a doctor if the symptoms are very intense. This will help avoid complications.

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HIV MANIFESTATIONS IN THE ORAL CAVITY

AIDS – acquired immunodeficiency syndrome – immunological disease of viral etiology. This virus enters the human body and causes a violation of the immune system, the virus suppresses and destroys T-lymphocytes, which ultimately leads to the complete destruction of the body’s defense mechanisms in the fight against infection. According to official data from WHO, there are currently about 34 million people with HIV status on our planet.
Acute HIV infection often goes unrecognized due to the similarity of its manifestations to the symptoms of influenza and other infections. An acute infection usually develops into an asymptomatic infection. The next period begins – the carrier of viruses, which lasts for several years (from 1 to 8 years). During this period, a person considers himself healthy, leads a normal life, being a source of infection.

The stage of secondary diseases is characterized by various infections of a viral, bacterial, fungal nature.There are repeated diseases of the upper respiratory tract, superficial skin lesions – a localized mucocutaneous form of recurrent herpes simplex, recurrent herpes zoster, candidiasis and others. Shingles, hairy leukoplakia, localized Kaposi’s sarcoma join. The person begins to lose weight, night sweats, fever, unexplained diarrhea appear for more than one month.

Candidiasis of the oral mucosa may be one of the early clinical symptoms of AIDS.Unlike ordinary candidiasis in patients infected with HIV, the formed white plaque quickly grows together with the underlying mucous membrane and is not removed by scraping. After the forcible removal of plaque, bleeding erosion is formed. Candidal eruptions are difficult to treat.

Hairy leukoplakia. The presence of “hairy leukoplakia” by 99% indicates that the patient is infected with HIV. Usually hairy leukoplakia is localized on the lateral surface of the tongue, less often on the mucous membrane of the cheeks.Clinically, hairy leukoplakia is the keratinized small papillae of the lateral surface of the tongue, like hairs. Hair growths are from several millimeters to 1 cm long. Subjective sensations are usually absent.

Necrotizing ulcerative gingivitis is characterized by the progression of the process with ulceration and necrosis of the gingival papillae and marginal gums. Spontaneous bleeding is possible. An alarming factor regarding the presence of HIV infection in a patient is the generalized form of the lesion.The presence of deep ulcers on the alveolar processes up to sequestration.

Viral infection in HIV-infected patients manifests itself in the form of herpes simplex and herpes zoster.

With an increase in the immunodeficiency state , a generalization of the process with damage to the central nervous system, liver, lungs and other internal organs is observed. Round or oval small multiple sharply painful ulcers appear. Localization – lips, hard palate, soft palate, cheeks.The ulcers can coalesce and form bleeding ulcerations, covered with a yellowish pseudomembranous plaque.

Alarming points are:

1. The spread of herpes sores to several areas of the skin and oral mucosa;
2. Often there is a necrotic ulcerative form of the disease;
3. The only therapeutic agent that can alleviate the patient’s condition is intravenous acyclovir.

Shingles . In people infected with HIV infection, herpes zoster can be at any period of the clinical course of the disease and manifest in varying severity. At the AIDS stage, these changes reach the most severe gangrenous forms and are accompanied by severe pain.

Kaposi’s sarcoma is a frequent and severe manifestation of AIDS. Localization: the mucous membrane of the soft and hard palate, cheeks, tongue, lips, less often – alveolar processes and the floor of the mouth.At the onset of the disease, spots of stagnant red or purple may appear. Then they infiltrate with the formation of tumor-like formations, the size of a hazelnut. Outwardly, the formations are similar to hemangioma, on the gums they are similar to epulis, but blue in color.

Author: dentist Dubrovskaya Yu.V.

What do we know about herpes?

DocDeti clinic dermatologist Maria Zhuravleva has prepared an article about herpes: what kind of disease is it and how to deal with it?

Herpes simplex is a chronic viral relapsing disease, mainly affecting the skin and various areas of the mucous membrane.

Many people have experienced herpetic eruptions, but most of the infection goes away without symptoms.

Herpes simplex can be of two types:

1. Herpes simplex virus type 1 is the cause of a rash in the mouth (infection in or around the mouth, another name for orolabial or orofacial herpes). Common among children.

2. Herpes simplex virus type 2 is the cause of genital herpes.

Factors provoking the onset of herpes:

• Any acute respiratory viral infection.
• Stress, both on the physical and emotional levels.
• Violation of the integrity of the skin and / or mucous membranes.
• Immunosuppression and certain medicinal products.
• Menses

Herpes treatment.

Mild illnesses often go away without any therapy within a week.

For protracted and severe forms, with repeated manifestation of infection, use: acyclovir; valacyclovir; famciclovir.

As an external therapy, the following have been proven effective:

• Penciclovir 1% cream: Apply every two hours for four days. If you start using it from the first symptoms, then the healing process is accelerated by a day.
• Doconazole 10% cream: 5 times a day from the onset of the first symptoms.

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Herpes | “Dermatovenerologic dispensary No. 3”

Herpes

Herpes is one of the most common human diseases caused by the herpes simplex virus (HSV), which is present in 90% of the population. Clinically significant viruses include herpes simplex virus types 1 and 2 (HSV-1,2), varicella zoster, cytomegalovirus, Epstein-Barr, human herpes types 6 and 8.

Virus transmission occurs:

• with direct contact (including sexual contact)
• by airborne droplets
• through household and hygiene items (general towels, handkerchiefs, etc.)
• vertical path (from mother to fetus)

Herpes virus can infect:

• skin and mucous membranes (face, lips, genital herpes, etc.)
• female genital organs (colpitis, intrauterine HSV infection, endometritis, amnionitis, chorionitis, metroendometritis, fertility disorders)
• male genital organs (prostatitis, urethritis, sperm damage)
• visual tract
• ENT organs
• oral organs
• light
• cardiovascular system
• GIT
• CNS
• lymphatic system.

Obviously, herpes is not as harmless as many people think. In most cases, people encounter herpes infection in childhood, contracting from a sick person when kissing, using shared cutlery or hygiene items, or airborne droplets when sneezing and coughing.

Symptomatically, the disease manifests itself by the appearance on the lips, and sometimes on the skin of the nasolabial triangle and nasal mucosa, of small bubbles, which, when dried, turn into crusts (the so-called “cold on the lips”).Then the virus spreads along the nerves and permanently “lodges” in the nerve ganglia. We mentioned above that according to statistics, up to 90% of people are infected with the herpes virus. But this infection manifests itself in different ways. In more than 80% of those infected, the virus is in an inactive form and does not make itself felt. However, in 17-20% of people, the herpes virus periodically “wakes up” and begins to actively multiply. This process is called a relapse and is accompanied by the appearance of herpes sores.

Treatment of herpes includes the use of both antiviral drugs and drugs that increase the body’s immune status and should be carried out by a specialist under the supervision of modern diagnostic tests.

Make an appointment at KVD No. 3 by phone: (812) 251-5451

90,000 Treatment of genital herpes in women and men

GENITAL HERPES TREATMENT AVAILABLE IN BRANCHES:

Treatment of genital herpes in Primorsky district

Address: St. Petersburg , Primorsky district, st. Repishcheva, 13

Treatment of genital herpes in the Petrogradsky district

Address: g.St. Petersburg , Petrogradskiy district, st. Lenin, 5

Treatment of genital herpes in Vsevolozhsk

Address: Vsevolozhsk , Oktyabrsky prospect, 96 A

Genital herpes

More than 90% of people in the world carry herpes, a contagious virus that spreads from one person to another. In some, it appears as a bubble on the lip, in others – in intimate places.

If you have ever had a so-called “cold” on your lip, the presence of which was accompanied by a burning sensation, then most likely you are a carrier of the herpes simplex virus type 1 (HSV-1).

In 95% of cases genital herpes the disease is caused by the herpes simplex virus type II (HSV-2), which is transmitted during classical sexual intercourse. In other cases, it is a type 1 virus (HSV-1), which is transmitted from the lips to intimate places (oral sex) or through the hands (self-infection).

Infection of children can occur as a result of a simple contact of the virus on the skin, while causing inflammation of the oral mucosa (stomatitis), and if untreated, go into herpetic sore throat.

It should be remembered that the herpes virus after infection is in saliva, cerebrospinal fluid, tears, urine, semen. Therefore, infection can occur through a towel, cosmetics, creams, common utensils, and so on.

Genital herpes is subdivided into:

• primary (symptoms occur after infection)
• recurrent (recurrent manifestations)

Primary herpes can be asymptomatic and lead to latent carriage.About 70% of infections occur against the background of an asymptomatic course of the disease.

Symptoms of genital herpes

How to recognize genital herpes? Its symptoms are similar to herpes on the lips, but appear in intimate areas. Symptoms of the herpes simplex virus type 2 (HSV-2) in men after an incubation period of 1-10 days (the period from the moment of infection to the onset of symptoms) is manifested by rashes on the foreskin, head and shaft of the penis. In women, symptoms of the genital virus are localized on the labia, clitoris, vagina, or cervix.In addition, sores can appear on the buttocks, groin or thighs.

Burning sensation, soreness at the site of the lesion can often disturb. These symptoms may be accompanied by general weakness, fever, swollen lymph nodes, muscle pain, and difficulty urinating. The human condition with primary herpes is characterized by a rather severe course of manifestations.

After some time, the bubbles burst, leaving ulcers that gradually crust over and heal.But this does not mean that the body has overcome the virus. It remains hidden in an inactive form in nerve cells (in the ganglia), for example, the lower part of the spine (type 2) or nerve cells that innervate the face (type 1), from where, in case of favorable conditions for it, it rises up, passes along the nerves and leads to repeated rashes (possible up to 4-5 times a year).

Many of those who had “colds” on their lips have their own theories about when the virus comes out of the “underground”: a long bike ride, depression, God’s punishment, but scientists have identified several reasons for the activation of the virus:

1. Sun and hypothermia.Research shows that cold sores are common in skiers who tend to be exposed to the sun for a long time. Here, in the first place, ultraviolet radiation is “to blame” (it is recommended to use sunscreens with a high degree of protection on the lips). In summer, sudden changes in body temperature can also lead to the activation of the virus, for example, when they jump into cold water after prolonged sun exposure.
2. Stress that weakens the immune system and opens the door to the virus.
3. Weakening of immunity after suffering diseases.

In addition, the herpes virus often manifests itself in the winter, when our weakened immunity cannot cope with the attacks of viruses and bacteria, especially during sudden changes in temperature. Hence the popular name for herpes “cold sore”.

Recurrences of genital herpes can also be associated with mental and physical stress. In women, recurrent manifestations can occur before menstruation and in connection with pregnancy.

In addition to recurrent typical herpes, an atypical form of the disease is possible – chronic inflammatory processes of the internal genital organs in the presence of a herpes virus diagnosed in the blood. However, this does not cause blistering lesions, but there may be redness of the genitals with an itching sensation.

Herpes virus and pregnancy

The threat of genital herpes virus during pregnancy is the occurrence of infection in the fetus (very rare) or in the newborn.

The consequences of infection in newborns can be quite serious, with infections of the skin, eyes, mouth, and the central nervous system. Advanced forms of herpes can lead to the death of a child.

The highest risk (30-50%) of transmission of the virus to the newborn during natural childbirth occurs when the mother becomes ill shortly before the birth of the baby. In women with primary infection in the third trimester of pregnancy, the likelihood of a caesarean section should be considered, which significantly reduces (but does not exclude) the risk of infection in the baby.

In most cases, recurrent manifestations of herpes in pregnant women are mild and do not require treatment. In women who have had a primary infection before pregnancy, antibodies cross the placenta and protect the fetus from disease.

Diagnostics of herpes

How the disease is diagnosed depends on the severity of herpes symptoms. If the disease is accompanied by rashes on surfaces accessible for inspection, the diagnosis can be made without laboratory tests.If the patient is worried about itching and burning of internal organs, then a number of laboratory tests are performed, including:

• analysis of a smear (scraping) for the determination of the herpes virus directly
• blood test for antibodies to the herpes virus (allows you to identify hidden asymptomatic infections) – enzyme immunoassay
• PCR method – analysis (the presence of a virus and its type is determined)

Each of the methods has a number of advantages and disadvantages.To date, there is no method that would diagnose the presence of the herpes virus with 100% probability. Sometimes it happens that even with severe symptoms, blood tests give a negative result. This can happen if the virus dies in the sample before it reaches the laboratory. Therefore, a second blood donation may be prescribed.

Due to the fact that the genital herpes virus can occur along with other genital infections, the doctor may recommend testing to determine the diseases of chlamydia, ureaplasmosis, mycoplasmosis and others.

Prevention and treatment of herpes virus

In the fight against the herpes virus, the key word is “prevention”, not “therapy”, as there is currently no cure for the herpes virus. Trying to eradicate it with antiviral drugs is like a neurological version of the hide-and-seek game in which the virus always wins.

Carriers of the virus may try to reduce the risk of infecting another person:

1. The risk of contracting the virus during sex is increased, when the sexual partner suffers from the external manifestations of the virus in an active form.The idea is to abstain from sex when cold sores develop on the lips or intimate areas.
2. Using condoms even if the partner is taking birth control pills. Condoms reduce the risk of herpes transmission, but do not protect 100% against other viral diseases.
3. Treatment with antiviral drugs. The action of such drugs is based on damage to the DNA of the virus and disruption of the process of its reproduction. Studies show that taking an antiviral drug (Acyclovir, Valacyclovir, Famciclovir) reduces the risk of transmitting the virus to another person by 77%, shortens the duration of skin symptoms, and may reduce the number of relapses.

It must be remembered that the prescription of drugs for genital herpes should be carried out only by a doctor, since their prolonged use can lead to impaired liver function.

The use of popular antiviral ointments such as Zovirax (containing acyclovir) to treat the manifestations of herpes on the face and genitals, makes sense only in the early stages of herpes. If you feel itchy and burning, it means that the virus is on the lip and the ointment can actually relieve symptoms.If a wound has already formed, the use of the ointment does not make sense. Then it is better to use funds aimed at accelerating healing. In the presence of a severe course of the disease with fever and an increase in lymph nodes, a doctor’s consultation is necessary.

It is also necessary to consult a doctor if children, especially young children, get sick with the herpes virus.

In addition to antiviral agents, immunomodulators can be used to maintain the immune system and reduce the possibility of relapses.

You can get a qualified consultation of specialists on this and other problems, carry out diagnostics using modern equipment, by signing up by phone or using the feedback form at the bottom of the page.

Appointments are conducted by doctors:

Select the branch “Dynasty” on Novocherkassky prospect, Krasnogvardeisky district “Dynasty” on Lenina, Petrogradsky district “Dynasty” on Repishcheva, Primorsky district “Dynasty” in Vsevolozhsk

Genital herpes treatment cost:

The prices indicated on the website are not a public offer. Check the cost with the administrators.

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