Also
known as: Cold Sores, Herpes Simplex, Genital Herpes, Oral Herpes
Myths
dispelled
Here are some facts to clear up some common misconceptions.
Cold
sores are herpes, and herpes can spread even without signs of
a visible outbreak. A canker sore (aphthous ulcer) is not herpes.
Intro
The word "herpes" actually refers to a large class of
viruses that causes many different types of infections, from chicken
pox (herpes zoster) to Kaposi's sarcoma (HHV-8). The Centers for
Disease Control and Prevention (CDC) estimates that there are
more than 500,000 new cases of genital herpes in the United States
each year, with over 30 million Americans infected. Once you have
herpes, you have it for life. Herpes outbreaks typically come
and go. When an outbreak subsides, the virus enters a latent phase
where it hides in your body until something triggers it to travel
back down the nerves to your skin and start another attack cycle.
What
is it?
Genital herpes is caused by a herpes simplex type of herpes virus.
There are two types: herpes simplex I (HSV-1) and herpes simplex
II (HSV-2). Doctors used to think that HSV-1 infections were confined
to the area above your belt and caused common cold sores, while
HSV-2 infections were thought to appear below your belt and were
responsible for the common genital infections. We now know that
HSV-1 can also spread to your anal or genital region and HSV-2
can turn up in your mouth.
Diagnosis
Doctors can diagnose a herpes infection based on the classic appearance
of the blisters. They also diagnose herpes by actually culturing
the virus from the blisters. It's worth noting that if you wait
to see your doctor until your blisters are gone or have already
crusted, your diagnoses may not be accurate. A negative result
might lull you into a false sense of security that you never had
herpes when, in fact, you did. Your doctor can also check your
blood for antibodies to herpes. This test is useful after your
outbreak, when the blisters are gone but the presence of antibodies
determines that you did have a prior attack.
Symptoms
The first sign of a herpes infection might be the same symptoms
you've come to recognize from any viral illness: fever, aches,
fatigue and loss of appetite. Within a week you begin to notice
a burning pain in the skin at the site of infection, followed
by a cluster of blisters a day or two later. The blisters are
full of herpes virus making you highly contagious. Within three
to five days the blisters rupture, leaving behind pink shallow
ulcers that crust over and heal. Scarring is extremely rare (unless
you scratch the blisters and they get infected with bacteria).
The entire cycle lasts about two weeks. If the herpes infection
begins in your mouth or throat, you will have a typical sore throat
and the blisters will be hard to spot. When oral herpes recurs,
it is usually in the form of a cold sore or blister at the edge
of your lip.
Anal
herpes is usually very painful and the blisters appear at the
edge of your anus. If the infection spreads inside your anus and
rectum, you can develop colitis with intense pain during bowel
movements, and blood and mucus in your stool. If you've had prior
outbreaks, no matter where they were on your body, you will probably
learn to recognize the earliest symptoms and begin your medication
immediately. This will drastically shorten the attack and lessen
the symptoms. Attacks can vary with respect to severity of symptoms
and duration. Typically with time the frequency, duration and
severity of outbreaks diminishes.
How
Can You Get It?
Herpes is spread between partners during sex. Penetration is not
required and a condom may not be protective. Although the virus
rarely grows on fingers and never on toys, they can act as conduits
and carry the virus from one partner to the other.
How
to treat it?
There are three different drugs that treat herpes infections well.
Which one your doctor prescribes may depend on a number of factors
-- from personal preference to ease in dose schedules. Although
resistance and side effects are rare, some patients and physicians
prefer one drug over the other.
Prevention
A condom may not prevent you from getting herpes and penetration
isn't necessary. The virus can pass between partners during foreplay
involving close skin to skin contact or during oral sex. Although
the virus won't grow on fingers or toys, they can act as a conduit
carrying the virus between partners (use your imagination). If
your partner has a cold sore or blisters on his/her anus or genitals,
it might be best not to have sex. A condom covering the blisters
will probably protect you as long as you use it from the start
of any skin to skin contact. Washing with soap and water after
sex may also help decrease your chances of infection.
If
you have a herpes infection, keep your hands, partners or toys
away from the blisters. You can spread the herpes to other parts
of your body (including your eyes). If you've had herpes before,
you might learn to notice the earliest signs of an infection (tingling
or burning in the skin) and begin the medication immediately.
This can drastically shorten if not abort the attack. Although
doctors do not know what triggers an attack, they think that stress,
immune compromise, sunburn and injury might play a role. Avoiding
these typical instigators might help prevent attacks. You might
also learn (and avoid) what triggers an outbreak in your own body.
Incubation period
The incubation period lasts from several days to one week.
Sex
Although you are more contagious during an acute outbreak, herpes
can spread between partners even when there are no signs of blisters.
Toys and fingers can carry the virus between partners. A condom
may not protect you. If you have herpes on your lip, beware of
kissing or oral sex, when you can easily spread the infection.
Prevalence
There are over 500,000 new cases in the U.S. each year and over
30 million Americans are infected.
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