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Herpes
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Doctors refer to the infection commonly known as "herpes" as herpes simplex. The herpes simplex virus can cause sores anywhere on a person's skin. It usually occurs around the mouth and nose or the buttocks and genitals. Herpes simplex infection is painful, embarrassing and often, will reappear again and again.

Say the word "herpes" and most people think of the sexually transmitted disease genital herpes. But herpes is actually the name of a family of viruses, which includes the cold sore virus (HSV-1), genital herpes (HSV-2), infectious mononucleosis (Epstein-Barr Virus), chicken pox and shingles (varicella zoster virus).

The two Herpes Simplex viruses, HSV-1 and HSV-2, look identical under the microscope, and either type can infect the mouth or genitals. Most commonly, however, HSV-1 occurs above the waist, and HSV-2 below.

These viruses blend into the DNA of genes after they infect, especially in the nerves. They try to force the body to make copies of them so they can spread to other people. The body's immune system resists this. When one's immune system is weakened, the virus finds a path to the skin and leaks out in tiny blisters. This is referred to as having a recurrence. Pain, burning or unusual tenderness of the skin may begin between one to several days before a recurrence.

Rarely, herpes can be serious in those with weak immune systems, such as newborn babies. More often, herpes is a mild infection. Many people who are infected don't even know that they are, and instead think they are having some chaffing or skin irritation. Years later, when there is a recurrence of HSV, it may be mistaken for an initial attack. This can lead to unfair accusations of infidelity.

Herpes simplex is very common. At least one in six adults in the United States has HSV-2 and half to three quarter of all adults test positive to HSV 1. But only 10% of those exposed get visible sores.

Maintaining general good health and keeping stress to a minimum give the best possible chance to limit recurrences. Fortunately, recurrent infections tend to be milder than the initial attack. Also, HSV-1 infections tend to have fewer recurrences than HSV-2. Both may be set off by a variety of stress factors including fever, stress, irritation at a site previously infected, sun exposure and menstruation. However, for many the recurrence is unpredictable and has no recognizable cause.

Take care of the affected skin area. Keep the area dry and clean during outbreaks to help healing. Avoid physical contact with the area from the time of the first symptoms (tingling, itching, burning) until all sores are completely healed, not just scabbed-over. Wash hands with soap and water if a sore is touched. Better yet, don't touch the sores as the virus can spread. HSV may infect the eye and lead to a condition called herpes keratitis. It feels like there is something in the eye. There is also pain and sensitivity to light and a discharge. This can cause serious eye damage if not promptly treated.

There is a vaccine to prevent herpes being tested, but it has not been approved by the FDA for general use. Several oral anti-viral medications (Zovirax, Famvir and Valtrex) have been developed for severe or frequently returning infections. Low doses are sometimes helpful in reducing the number of herpes attacks in people with frequent outbreaks. There is some evidence that taking these will make HSV less contagious. People who have taken Famvir with the initial attack seem to have fewer recurrences.

Prevention of this disease, which is contagious before and during an outbreak, is important. If tingling, burning, itching or tenderness -- signs of a recurrence -- occur in an area of the body where there was a herpes infection, then that area should be kept away from other people. With mouth lesions, one should avoid kissing and sharing cups or lip balms. For persons with genital herpes, this means avoiding sexual relations and oral and/or genital contact during the period of symptoms or active lesions. Towels should not be shared nor clothing exchanged.

 

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The medical information provided in this site is for educational purposes only and is the property of the American Osteopathic College of Dermatology. It is not intended nor implied to be a substitute for professional medical advice and shall not create a physician - patient relationship. If you have a specific question or concern about a skin lesion or disease, please consult a dermatologist. Any use, re-creation, dissemination, forwarding or copying of this information is strictly prohibited unless expressed written permission is given by the American Osteopathic College of Dermatology.

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