What is it about ?
The Herpes simplex virus (HSV) is a member of the family of viruses that cause herpes. There are several variations.
Below, we discuss the most common infections of the skin and mucous membranes by the viruses that cause herpes.
- Cold sore, also called a cold sore, is an infection of the mucous membranes that mainly affects the mouth and lips. This infection is caused by the Herpes simplex virus type 1 (HSV-1).
- Genital herpes, which is caused by the Herpes simplex virus type 2 (HSV-2), causes damage to the genitals. Genital herpes can also be caused by the Herpes simplex virus type 1 (HSV-1), for example after oral sex with an infected person. Herpes is indeed contagious.
After a first infection, the virus remains present in the body in a latent manner. In other words, we are cured, but the virus does not disappear from our body. It nestles in the canals of the nerves, without causing symptoms. You are then a carrier of the virus, and the infection may reappear later. The reappearance of the infection is mainly caused by certain circumstances, such as fever, weakened resistance, colds, flu, sunburn, other skin lesions, menstruation, malnutrition, etc.
What is its frequency?
Infection with the Herpes simplex virus is very common because, after a first infection, the Herpes virus remains in the body for the entire life of a person. 50 to 60% of adults carry the virus.
How to recognize it?
Most carriers of the virus never have symptoms. A viral outbreak usually starts with pain and a burning, tingling sensation in the area where the lesions will develop. At this place then appears a red rash, spotted and well demarcated. Groups of small vesicles (small blisters) develop there; they are filled with clear liquid. The vesicles may coalesce to form a purulent or bloody blister. Then it bursts, leaving an erosion on the skin that looks like a scratch.
Typical places where the rash occurs are the area around the mouth, face, pubic area, area around the anus, buttocks, hands and fingers. An infection near the eye can affect the eye itself. In this case, an ophthalmologist should be consulted.
The infection usually lasts one to two weeks and then goes away on its own. Over the years, new outbreaks can occur. Extensive lesions can develop in people whose immunity is weakened as a result of a disease, such as HIV infection or cancer.
How is the diagnosis made?
Usually, the diagnosis is based on the appearance of the skin lesions. No additional technical examination is therefore necessary. The doctor should be careful to distinguish it from other skin conditions that may resemble a Herpes simplex virus infection, such as shingles (Herpes zoster virus), bacterial infections, fungal infections, and some forms of eczema. If in doubt or to confirm the diagnosis, a blood test may be done to look for antibodies. However, these are not always present.
The doctor will only consider culturing the lesions for viruses if there is doubt about the diagnosis, if there is a very serious widespread infection, or if you have severe immunosuppression. The doctor then punctures a vesicle and rubs its surface with a special cotton swab to collect as much virus as possible for culture.
What can the doctor do?
Limited lesions that do not occur frequently should not be treated in people with normally functioning immune systems. If these lesions bother you, a local cream may be sufficient, for example aciclovir. It should be applied every 2-4 hours for 5-10 days. It is important to apply the cream as soon as a tingling or burning sensation appears: the sooner the treatment is started, the more effective it is.
In case of immunosuppression, tablets are prescribed, or, in severe cases, injections. This antiviral medicine is called aciclovir or valaciclovir. The duration of treatment is 5 days, and in severe cases it may be necessary to extend the treatment up to 7-10 days. Aciclovir should be taken five times a day, valacivlovir only twice a day. With frequent recurrences of herpes, it is possible to take preventive drugs for a period of 6 to 12 months, for example, to reduce flare-ups.
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