Herpes is a common viral infection spread through skin to skin contact and looks like small, painful blisters. These blisters can appear on the lips (oral herpes) and are called cold sores, on the genitals (genital herpes) or non-genital areas (shingles). Cold sores are spread through kissing whilst genital herpes is spread through vaginal, anal and oral sex without a condom, and genital skin-to-skin contact. Additionally, herpes can be spread from the mouth to genitals during oral sex. Shingles is not sexually transmitted and is a reactivation of the previously acquired chicken pox.
The two major strains of herpes simplex virus (HSV) are HSV-1 and HSV-2. HSV-1 is commonly found on the lips or face as cold sores in children or young adults but can be transmitted at any age. Genital herpes is usually caused by HSV-2 but is increasingly being caused by HSV-1, believed to be due to oral sex.
Cold sores are caused by the herpes simplex virus and appear as painful blisters around the lips and mouth. The first symptom is itchiness and tingling, usually on the edge of the lips. Blisters appear soon after and later burst to become crusted sores. At the same time the person usually feels unwell, like the start of a cold. Some individuals will only get occasional cold sores whilst others may experience frequent outbreaks. Cold sores are contagious as the virus is present in the blister can be spread in a family by the sharing of drinking and eating utensils and toothbrushes, or by kissing. It is most important not to kiss an infant if you have an active cold sore.
Although our immune system fights the infection, the herpes virus has a clever strategy for survival. It infects the nerve endings in the skin and travels along nerve fibres until it finds a cluster of nerve cells in which to hide. Here the herpes virus lies dormant, out of reach of the immune system. Once we become infected, the virus stays with us for life. Occasionally it reactivates, traveling back down the nerves and causing lesions.
The following situations can precipitate cold sore eruptions:
Cold sores in normal healthy individuals are not dangerous but complications or extending circumstances can make infection a serious matter. For example infection of newborn infants or those who are immune compromised.
Genital herpes means an infection in the genital, anal or buttock region with either HSV-1 or HSV-2. It is transmitted by close physical contact : genital-to-genital, anus-to-genital, or mouth-to-genital. The virus can't easily penetrate intact skin, but readily enters dry or broken skin or the lining of the vagina. Women are twice as likely to become infected as men. Once inside the skin, the virus multiplies and as with cold sores causes symptoms such as itching, burning and/or tingling before the blisters appear. At the same time you may also experience tiredness, headaches, muscle aches and pains, pain on passing urine, fever and swollen glands. Recurrent episodes are usually not as prolonged or severe as the first episode, but frequent outbreaks can cause significant stress.
Some people show no signs of infection so the use of condoms provides some protection, but only protects the skin that is covered. You should avoid having sex with someone who has blisters present as there is a high risk of being infected.
Studies have shown that genital herpes increases the risk of acquiring HIV up to threefold, because herpes lesions make it easier for HIV to penetrate the skin and infect target cells.
Testing for herpes involves a swab taken from an open blister. Your doctor can order this test for you. At Holdsworth House sexual health clinic, tests can be done confidentially on the day of your consultation. You are then required to return for follow up on the results within a week.
There is no cure for genital herpes however there are medications that help manage outbreaks. Antiviral medications can reduce the length and severity of outbreaks and reduce viral shedding.
Until a cure for genital herpes is found, prevention is the key.
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