Herpes simplex is an infectious disease caused by viruses. The disease is divided into 2 subtypes. While type 1 (HSV-1) is predominantly located on the lips, type 2 (HSV-2) occurs primarily on the genitals. This disease is usually harmless, but can be dangerous in individual cases.
What is herpes simplex?
The word ” herpes ” derives from the ancient Greek language of “herpein” (= “to crawl”). This means the creeping spread of the individual skin lesions. “Simplex” means “the simple form”. This addition distinguishes the disease from herpes zoster, the causative agent of chickenpox and shingles.
In most cases, both types of herpes appear as skin diseases. A generalized form can occasionally develop in immunocompromised people. This usually occurs due to herpes sepsis or inflammation of internal organs, such as on the retina (herpes simplex retinitis) of the eye or in the esophagus (herpes simplex esophagitis). About 90% of all adults are affected by HSV-1, compared to only 5% to 30% of HSV-2.
In a person who has been infected with the herpes virus once in their life, the disease remains dormant in the nerve nodes (ganglia) of the body.
The initial infection can be asymptomatic. The virus lies dormant in the body for life, which is called persistent infection. In fact, the disease is transmissible even in this condition. HSV-1, which mainly appears as cold sores, is passed on in childhood.
This occurs either through direct mucosal contact (e.g. kissing) or as droplet infection through the air (e.g. sneezing, breathing on). Infection with HSV-2 occurs mainly during sexual intercourse. The infection is therefore one of the sexually transmitted diseases.
Symptoms, Ailments & Signs
Herpes simplex typically presents as itchy, burning sores around the mouth, lips, face, and genitals. The blisters are usually filled with water or pus and burst open after a few days or weeks. A painful crust then forms on the affected area, which usually falls off after a few days.
As the disease progresses, it can spread to other parts of the body and affect, for example, the cheeks, the area around the eyes, the entrance to the nose and the earlobes. Occasionally there is a feeling of illness. Those affected then feel tired and listless or have a slight fever. If it is genital herpes, there is pain and burning when urinating and an unpleasant itching. The lymph nodes are often swollen.
If herpes simplex is not treated, the symptoms can increase in intensity and significantly affect the well-being of the person affected. There is also an acute risk of infection. Two-thirds of people who carry the virus have no symptoms.
The first signs that indicate an impending outbreak of the disease are painful areas in the corners of the mouth and nose and an acute feeling of illness, which apparently has no underlying cause. If these symptoms are noticed, a doctor should be consulted.
Diagnosis & History
Symptoms only occur in 1% of cases when HSV-1 is first infected. Typically, the first disease occurs in the form of mouth rot (aphtosa stomatitis). The result is aphthae and lesions on the oral mucosa. It can also lead to blisters on the lips. Usually there is a cluster and not individual lesions as in a recurrence.
An acute state of a herpes infection is accompanied by a typical course. It starts with a feeling of tightness and swelling in an area of the lips (in HSV-1). Visible swelling is present in a few hours. After 1 to 2 days, the skin forms a series of small, fluid-filled blisters. Over the course of another 3 to 5 days, the blisters will crust over and dry up.
In most cases, the initial infection with HSV-2 causes severe symptoms. In principle, an infection with genital herpes is similar to an outbreak of HSV-1. However, because of the sensitive region, HSV-2 is significantly more painful. In the worst case, the virus can lead to years of suffering due to frequent recurrences.
Herpes simplex can be diagnosed in a number of ways. A clinical diagnosis is usually sufficient. A laboratory test of the blood can determine whether antibodies against HSV-1 or HSV-2 are present. However, this method is only of limited value.
Since the infection rate for cold sores is around 90%, the majority of people in the laboratory have positive values without being able to establish a connection with the current symptoms. An expensive and very complex diagnostic technique is the PCR method (polymerase chain reaction), which can be used to directly detect the DNA of the virus if it is present.
Infection with the herpes simplex virus can cause serious complications. First, there is a risk that the infection will spread to areas of skin that have already been damaged. Such a superinfection makes the healing process considerably more difficult and is associated with other general symptoms such as fever and exhaustion.
In certain risk groups (newborns, HIV patients, patients undergoing chemotherapy), the immune system can be overloaded as a result of herpes simplex. This can lead to life-threatening complications such as pneumonia, herpes encephalitis or herpes inflammation of the brain. Occasionally, the eyes can also be affected (herpes simplex retinitis), associated, among other things, with impaired vision and scarring of the cornea.
In severe cases, infection can cause herpes sepsis. This leads to blood poisoning and a partial failure of the immune system, which usually ends fatally. Rarely, there is also nerve involvement and, as a result, nerve paralysis and functional disorders. Sometimes infection with the virus can also lead to herpes simplex meningoencephalitis.
This is an inflammation of the brain that is associated with flu-like symptoms and impaired consciousness. If left untreated, meningoencephalitis can lead to a coma or even death.
When should you go to the doctor?
Herpes simplex is usually a harmless infection that doesn’t usually require medical attention. Almost everyone carries the herpes virus. At times, however, it can become active, with the infection usually being noticeable through blisters on the lip. In rare cases, there are other localizations of the virus, special forms or generalized infections that make a medical examination necessary.
The doctor should be consulted, among other things, if larger areas of skin are affected by cold sores (eczema herpeticum), if retinal inflammation occurs, if facial paralysis occurs, if there is aphthous stomatitis (mouth rot) or esophagitis. Eczema herpeticum is often associated with a severe feeling of illness and can even lead to herpes simplex encephalitis in immunocompromised people, which is often fatal.
Therefore, the doctor must be consulted immediately if psychotic symptoms such as changes in behavior, confusion or disorientation suddenly occur in addition to high fever. The retinal inflammation caused by herpes viruses can lead to blindness without medical treatment.
A generalized herpes simplex should also be taken as an opportunity to see a doctor, as it can lead to sepsis-like disease progression. In the case of a herpes infection during pregnancy, it is also essential to consult a doctor because there is a high risk of the virus being transmitted to the unborn child.
To avoid infection, the child must be delivered by caesarean section. Herpes infections in newborns also require urgent treatment because they can lead to serious complications including herpes simplex encephalitis.
Treatment & Therapy
Herpes simplex is primarily treated with antivirals (medicines against viruses). Common preparations are aciclovir or penciclovir. In mild cases, a skin cream with the appropriate active ingredients is prescribed. In the case of serious illnesses or people with a weakened immune system, the medication can also be administered in tablet form or as an infusion. An alternative are herpes plasters, which form a moist cushion around the blisters with hydrocolloids and thus prevent them from spreading.
The disease itself cannot be cured. Only the acute outbreak can be treated. The course of the disease is shortened and alleviated by the medication. The viruses in the nerve cells could not be destroyed by any therapy so far.
Research is currently focusing on helicase primase inhibitors, which target the enzymes that the virus needs for duplication. So far, initial successes have already been recorded in animal experiments. The effectiveness of certain home remedies such as toothpaste, zinc paste or tea tree oil has not been scientifically proven.
Outlook & Forecast
The prognosis for herpes simplex is favorable. Normally, the symptoms will be relieved within a few days. The course of the disease can be positively influenced if the person concerned takes medication immediately when the first symptoms appear. The application of ointments or special patches curbs the herpes simplex. This prevents the virus from spreading and the damaged areas of the skin also heal faster.
Without medical treatment, the course of the disease will be delayed. The disease resolves on its own after about seven to ten days. There is also a risk of the virus spreading. If herpes blisters burst, liquid escapes and new blisters form.
However, most patients heal within a week. The use of alternative healing methods can also contribute to recovery from herpes simplex.
The use of home remedies or suitable natural healing products can help to alleviate symptoms and improve healing.
Despite the good prognosis, most of those affected experience repeated outbreaks of herpes simplex over the course of their lives. In children, the infection can spread to the entire body and can also lead to a life-threatening course.
A recurrence is often associated with an immunocompromised situation, such as a cold. In order to avoid reactivation of the virus, a healthy diet rich in vitamins is important. In the event of an acute outbreak, skin contact with other people should be avoided. With HSV-2, sexual intercourse should not take place during a recurrence.
Compared to the initial infection, renewed infection with the herpes simplex disease is significantly weaker. This is because the body is already familiar with the virus and thus establishes effective defense mechanisms more quickly. It is not uncommon for those affected to not even notice herpes simplex in the event of a recurrence. However, if symptoms persist, patients should definitely consult a doctor.
This makes a diagnosis based on external observation. Only rarely is the pathogen determined separately in the laboratory. The nature of the disease means that there is no scheduled follow-up examination. Herpes simplex either goes away on its own or is successfully treated with antiviral drugs. In order to prevent the recurrence of the disease, no special precautionary measures based on medical action are suitable.
There is currently no effective vaccination. Patients are responsible for their own preventive measures. You should strengthen your immune system by eating a balanced diet, exercising regularly and getting enough sleep. Prolonged stress can also contribute to weakening the immune system. Contraception is recommended for contact with strangers. After the symptoms have subsided, it is possible to continue with a normal life. Complications are not to be expected.
You can do that yourself
Herpes simplex is a viral disease that occurs particularly in people with a weakened or unstable immune system. Those affected can therefore contribute a lot through their lifestyle to ensure that their organism is and remains strengthened.
He should eat as healthily as possible and drink enough fluids. A vitamin-rich and balanced diet helps to avoid obesity and promotes your own health. Sufficient exercise, doing sports or regular sauna sessions, especially in the winter months, also support the immune system and contribute to maintaining your own well-being.
People who are convinced that herpes simplex occurs due to psychological problems, stress or emotional strain should independently create framework conditions in which these trigger factors are minimized as much as possible.
Already at the first feeling of blistering due to herpes simplex, the person concerned should take measures to alleviate it. Without intervention, the viruses often spread and multiply within a few hours. The symptoms can be alleviated and treated with medicinal preparations or various home remedies.
The opening of the cold sore should be avoided. The fluid in the blisters is contagious and can cause more blisters to form in the surrounding areas. In order to avoid infection in principle, the exchange of saliva with infected people should be avoided.