Herpes is a viral disease that results in the appearance of small, clustered vesicles. It is a contagious disease and there are two types, labial (mouth) and genital (sexual organs). Because of its contagion, herpes is a disease to watch closely so that it does not spread.

Definition: what is herpes?

Herpes is a viral and contagious disease caused by the herpes simplex virus (HSV) characterized by conditions of the skin and mucous membranes. In the presence of herpes grouped vesicles appear on the affected area.

Herpes is a virus, there are two types, herpes simplex type 1 (HSV-1) which causes cold sores, and herpes simplex type 2 (HSV-2), which affects the genital herpes. Herpes manifests itself in flare-ups. The vesicles are in fact visible for 6 to 10 days to disappear for several months until they reappear.

Genital herpes is a sexually transmitted infection (STI), it appears as small, painful blisters on the sexual organs.

Depending on the region of the world, 50 to 90% of the population has already been infected with HSV-1. The first infection occurs before the age of 20, often in infancy. However, the majority of people have the virus but it remains inactive.

HSV-2 infection is different, it usually occurs in adulthood between the ages of 20 and 40. In Europe genital herpes is not widespread, however it is very common in Africa, where 30 to 40% of the population is infected, even going up to 90% in some regions.

Causes: where does herpes come from?

The herpes virus is very contagious. Especially for people who have never been confronted with the virus, pregnant women and infants. Regarding herpes as a whole, the most risky transmission period is when the blisters have burst. From this point on, anything that comes in contact with the wound is a potential source of transmission.

It should still be noted that the virus can be dormant, that is to say that a person can hold the virus without having contracted it, and transmit it via saliva or other, without being aware of it.

Regarding HSV-2, or genital herpes, herpes are most often spread during unprotected vaginal or anal sex with someone who is already infected. Upon penetration, the viruses contained in the vesicles enter the body of their new host through microscopic lesions present on the skin or through the mucous membranes. However, it is impossible to contract genital herpes by indirect contagion, that is to say by being in contact with objects previously used by infected people (toilet, towel, water…) because the virus dies quickly once outside the body.

More rarely, in adults, kissing and oral/genital sexual contact are the main routes of transmission. The virus can also be transmitted to the same host, for example the virus can be transmitted by fingers, genitals to the mouth or eyes. For example, cold sores can cause genital herpes, and vice versa.

What are the symptoms of herpes?

Herpes labialis: During the first cold sore attack most of the time there are no symptoms. Eventually, and especially in young children, the mouth as a whole can be affected, leading to acute gingivostomatitis. Recurrences (periods of herpes reactivation) are preceded by tingling, itching, burning sensation, swelling on the edges of the lips, as well as general malaise including fatigue and fever. After a few hours to a day, small, red, painful blisters appear around the mouth. Filled with liquid, they eventually burst, then they form a crust.

Genital herpes: Genital herpes is characterized in much the same way as cold sores except for the appearance of swollen glands in the groin. Following the herpes outbreak, small blisters appear. In men, these blisters can be seen on the penis, buttocks, scrotum, thighs, anus, and urethra. In women, they are found at the entrance to the vagina, on the buttocks, on the vulva and on the cervix.

Stages of herpes

The first push. Symptoms appear 2 to 6 days after the contagion. Usually, the first flare-up causes more intense symptoms than the next. In addition to the blisters, there may be fever, headache, and fatigue. Herpetic lesions can last longer, up to 3 weeks. In more than 20% of cases, the first outbreak is asymptomatic and therefore goes unnoticed.

The dormant period. After the symptoms disappear, the virus travels up the nerves at the base of the spine. It then lodges in a lymph node, where it remains inactive until it is reactivated, for example when the immune system is weakened.

Recurrences with symptoms. The majority of those infected have at least one recurrence within the first year after the first outbreak. According to some sources, the lesions recur on average 4 or 5 times during this first year. Subsequently, the frequency of recurrences varies a lot: some individuals will have only 2 attacks in their lifetime, while others will have several per year. However, as the years go by, the recurrences become less frequent and their severity lessens.

Silent reactivations. In this case, the virus is reactivated but it does not cause visible symptoms, while being very contagious. Silent reactivations are more common in women with genital HSV-2 infection than in those with HSV-1 (55% vs. 29%). There could be a similar difference in men.

Possible consequences and complications

In healthy people, herpes usually does not have serious physical consequences. However, when the immune system is weakened (by another disease, for example), symptoms can be more severe and last longer.

Although the physical damage is not dangerous, the psychological stress caused by genital herpes can be difficult to deal with. Those affected may be embarrassed to talk about their disease and fear passing it on to their partner. This infection has profound consequences on intimate and sex life, which can lead to depression.

In rare cases, the virus can cause meningitis or encephalitis (inflammation of the brain). Infection of the eye (ocular herpes) can cause corneal damage and even blindness.

How to treat herpes

There is as yet no treatment to permanently eliminate the virus from the body. It is then a question of treating only the symptoms with the help of drugs when a flare arises. Among them paracetamol, acyclovir cream, docosanol.

Regarding genital herpes, the treatment is the same, however when the attacks are frequent, the doctor may prescribe different dosages for a prolonged period of one year or more. Taking these drugs over the long term helps reduce flares, or even stop them, but also consequently reduces the risk of transmission, reducing the risk of recurrence by 85 to 90%. Be careful not to use over-the-counter creams, especially those containing antivirals. These are only used for cold sores.

What to do when a flare occurs

• Avoid having genital or oral sex during the flare. Wait until the symptoms have disappeared and all the lesions are completely healed;
• Make an appointment with your doctor, if you do not have a reserve of prescribed antiviral drugs at home;
• Avoid touching the lesions so that the virus does not spread elsewhere in the body. If touched, wash your hands each time;
• Keep lesions clean and dry.

Pain relief measures

• Putting Epsom salt in your bath water: This can help cleanse and sanitize the lesions. Epsom salt is sold in pharmacies;
• Apply an ice pack on the lesions;
• Favor loose clothing, made of natural fibers (avoid nylon);
• Avoid touching or scratching the lesions;
• If necessary, take a pain reliever
• If you experience painful urination, pour lukewarm water over the painful area when you urinate, or urinate in the shower just before getting out.