Herpes - Symptoms Treatment and Prevention

February 27, 2014

What is herpes?

Herpes simplex is a viral disease from the herpesviridae family caused by both Herpes simplex virus type 1 (HSV-1) and type 2 (HSV-2). Infection with the herpes virus is categorized into one of several distinct disorders based on the site of infection.

Oral herpes, the visible symptoms of which are colloquially called cold sores or fever blisters, is an infection of the face or mouth. Oral herpes is the most common form of infection.
Genital herpes, known simply as herpes, is the second most common form of herpes.
Other disorders such as herpetic whitlow, herpes gladiatorum, ocular herpes, cerebral herpes infection encephalitis, Mollaret's meningitis, neonatal herpes, and possibly Bell's palsy are all caused by herpes simplex viruses.

The following text is about herpes labialis (oral herpes).

Oral herpes

Oral herpes, also known as herpes labialis, is the most common type of herpes which occurs on the lip. An outbreak typically causes small blisters or sores on or around the mouth commonly known as cold sores or fever blisters. They tend to occur in the same location, be unilateral and recur two or three times a year on average.

Signs and symptoms

The initial viral tissue invasion occurs typically in childhood or adolescence. This primary infection is often asymptomatic and may not be noticed by the patient or parents. When perioral symptoms do occur with the primary infection, they usually manifest 6-24 hours before the appearance of a lesion and include tingling, pain and/or itching in the perioral area. Cold sores are usually seen on the lips and extend to the skin around the mouth. Other areas on the face, chin, or nose are sometimes involved. Lesions begin as erythematous areas that swell into papules. These become vesicles, which then collapse into ulcers. This takes 1-3 days. The ulcers crust over and the skin returns to normal within about two weeks. Oral mucosal lesions are rare and not generally associated with fever. They are usually restricted to small clusters of micro vesicles that rupture to leave punctate ulcers, typically on the palatal gingiva. Immunocompromised people may develop chronic ulcers, often on the tongue.

Causes of herpes labialis

Herpes labialis infection occurs when the herpes simplex virus comes into contact with oral mucosal tissue or abraded skin of the mouth. The majority of the viruses enter after an uninfected person has direct contact with someone carrying the virus (either with or without noticeable lesions). Simply touching an infected person is often the way children get exposed. Adolescents and adults frequently get exposed by skin contact also but may get their first exposure by kissing or sexual contact, especially for HSV-2.

Triggers

Cold sore outbreaks may be influenced by stress, menstruation, sunlight, sunburn, fever, dehydration, or local skin trauma. Surgical procedures such as dental or neural surgery, lip tattooing, or dermabrasion are also common triggers. HSV-1 can in rare cases be transmitted to newborn babies by family members or hospital staff who have cold sores; this can cause a severe disease called Neonatal herpes simplex.

Herpes treatment

Since this is a viral infection antibiotics will be of no use in treatment. Symptoms may go away on their own without treatment in 1 to 2 weeks. Currently, there is no treatment able to eliminate the infection permanently. Only a few products help accelerate healing and reduce the duration of the symptoms. Your health care provider may prescribe you one of these antiviral medicines:

Acyclovir,
Famciclovir,
Valacyclovir.

While using medications you can also make yourself feel better by following some of these steps:

Apply ice or a warm washcloth to the sores to help ease pain.
Wash the blister gently with germ-fighting (antiseptic) soap and water. This helps prevent spreading the virus to other body areas.
Avoid hot beverages, spicy and salty foods, and citrus.
Gargle with cool water or eat popsicles.
Rinse with salt water.
Take a pain reliever such as acetaminophen (Tylenol).

Possible complications

Herpes infection may be severe and dangerous if:

It occurs in or near the eye
You have a weakened immune system due to certain diseases and medications.

Less dangerous complications are:

Return of mouth sores and blisters,
Spread of the virus to other skin areas,
Bacterial skin infection.

Prevention

To prevent an outbreak, it is important that you avoid avoid the triggers listed above. Prevention of HSV-1 transmission is of equal importance. Some patients shed the virus in the absence of active lesions, an occurrence that cannot be remedied. Patients who undergo an active outbreak must be constantly alert to ensure that the virus in the infective exudate does not touch others. They must never kiss another person, nor engage in oral/genital sexual activity. Furthermore, they must avoid oral contact with anything that might touch the lips or skin of another person before it is decontaminated. They must avoid sharing such objects as drinking glasses, coffee mugs, straws, washcloths, towels, spoons, forks, lip balms, and medication dosing devices. All infected objects must be washed in hot water; boiling water is the most protective. They must refrain from touching the lesions, since they may transfer the virus to their hands. During a typical day, the hands contact hundreds of surfaces, and the virus could reach an object that is picked up by another person. If that person touches their lips, an invasion of the lips is likely. Lesions should be washed gently with soap and water, but the washcloth used should be laundered immediately after contact, as it is also infective. It may be worthwhile to advise patients to utilize a one-time use towel that can be discarded to further reduce the chance of cross-infection. You can also prevent cold sore by getting enough sleep, improving your diet, try taking a multi-vitamin & mineral pill. If sunlight is one of your triggers, use a good quality sun block.

Epidemiology

Herpes labialis is endemic throughout the world. A large survey of young adults on six continents reported that 33.2% of males and 28% of females had herpes labialis on two or more occasions during the year before study. Important note: If your symptoms get worse and the infection spreads on other parts of your skin, do not try to heal them yourself. See a medical doctor to get a proper treatment!