Genital Herpes

Genital herpes is a highly contagious infection which is usually transmitted by sexual contact. When engaging in sexual intercourse with an infected person who is experiencing ulcerative lesions, there is a high chance of contracting this affection. Besides vaginal sex, herpes can be transmitted through oral and anal sex. In some cases, the lesions are not visible, yet the person is carrying the virus. Genital herpes can be transmitted to a newborn child at birth when passing through the pelvic area of the mother suffering from an active infection. Genital herpes is one of the most common sexually transmitted diseases and the incidence of it has increased by 30% over the last few years, affecting teenagers. Genital herpes occurs frequently in women.


Genital Herpes Overview

There are two main types of the herpes simplex virus:

  • Type 1, herpes simplex 1 (HSV 1) – it is responsible for most oral herpetic infections and a half of the cases of genital herpetic infections
  • Type 2, herpes simplex 2 (HSV 2) – it is responsible for most cases of genital herpetic infections

Even though both types of herpes simplex can cause genital herpes, this infection is often caused by HSV 2. During the cold season, many people experience lesions around the oral cavity because of the active HSV 1. In order to determine the type of herpes virus that causes certain lesions, the patient should consider the main appearance of the rash he is experiencing around the genitals.

The genital herpes infection is usually caused by physical contact with an infected person. This is the reason why the HSV 1 type can occur during childhood when the patient contracts it from one of the parents. The infection can also be transmitted through objects (e.g. dishes). Yet, HSV 2 is transmitted mostly through sexual intercourse. Some people that are infected with HSV 2 are not experiencing any symptoms at all.


Genital herpes images


Genital Herpes Facts

Is a person who has HSV 2 contagious all her life?

A person becomes contagious within a few days after contracting the infection with either type of herpes simplex. People with genital herpes which are experiencing rashes in the genital area become highly contagious right after their apparition. The virus will show viral symptoms during an infected person’s entire life.

Why do recurrences of genital herpes occur?

When a period of time since the infection with either HSV 1 or HSV 2 passes (usually three to four weeks), the human body increases its immunity, which protects the body against the recurrence of severe infection episodes in the future. However, a highly developed immunity can’t completely eliminate the infection in the body. When the virus is not active, it is still present in the carrier’s body. This is why, periodically, the virus switches from its inactive state to an active one and begins to multiply rapidly. In this case, the patient will experience a recurrence of the infection. According to several studies, genital herpes recurrences occur during the first year after the initial infection in over 90% of the people infected. For the HSV 2 type, the relapses occur more frequently (between six and ten times during a year).

Psychological implications

Many people tend to get depressed after they find out that they are infected with HSV 2, being capable of transmitting the virus to others if not careful enough. The best solution would be to find out more about the virus, which helps controlling its effects better and regain self-confidence. People who encounter the HSV 2 infection can have a normal sexual life with the condition to always use protection. Also, infected women can have children by carefully supervising their pregnancy with routine medical check-ups.


Genital Herpes Symptoms and Diagnosis

Genital Herpes Diagnosis

A specialist can establish the HSV diagnosis by visually inspecting the lesions found in the genital area. For further investigations, the doctor can take a sample of the lesion tissue in case it is atypical. Herpes simplex infection is extremely difficult to diagnose between two different reactivation episodes, due to the fact no lesions are present. The doctor should also examine the cervix for women and the urethra for men to discover if internal injuries occurred. Blood tests can also be helpful, although the results are not always accurate. This blood analysis allows determining the type of IgG antibodies (with no practical value) that the immune system produces in order to suppress the viral replication of the virus. The analysis won’t determine the type of herpetic virus present.

If a doctor found traces of a herpetic virus in the blood test, this indicates that your bloodstream produces IgG antibodies which the immune system produces because there is an infection somewhere in the body. Antibodies against an active herpetic virus appear in the bloodstream a few weeks after the virus is contracted. According to recent studies, these antibodies can be found in over 80% of adults, meaning that the blood tests results are not as efficient as it is generally believed.

Genital Herpes Symptoms

Most people suffering from genital herpes are asymptomatic or experience mild symptoms in the initial phase. The appearance of herpes lesions can be described as:

  • The skin around the genital area is red
  • The skin around the genital area can feel warmer and can cause itching
  • The skin can be covered in vesicles that break and build a crust after healing

Other symptoms of HSV 2 infection:

  • Lymphatic ganglia grow in volume
  • High fever
  • Constant headaches
  • Dysuria
  • Muscle pain

The incubation period of HSV can last for 26 days but it usually takes 4 days.

In the vast majority of cases, the immune system of a person can successfully inhibit the replication of the herpetic virus (both type 1 and 2). Because of this, most people get over this infection without serious complications or side effects. Yet, in some cases, the genital herpes infection can spread to other body areas like the fingers (severe inflammation around the cuticles) or the eyes (corneal lesions which gradually increase). When either of these symptoms occur, the patient is required to immediately appoint a meeting with a doctor. Eye herpes infection can eventually lead to blindness, which is a serious consequence. In rare cases, genital herpes can also cause difficulty in urination, a decreased sensitivity in the genital area or severe pain.

Rare cases (especially in people who are suffering from a weakened immune system) affected by HSV 1 or 2 include the massive destruction of the brain tissue and other internal organs such as the lungs or the liver and can eventually cause severe hemorrhages. These complications can lead to death.

HSV severe complications:

  • Muscle tension in the head/neck area (difficulty in turning head from one side to another)
  • Severe weakness, combined with both fever and chills
  • Fainting
  • Seizures
  • Non-existent taste or odor sense
  • Severe muscular weakness in arms and legs
  • Anxiety
  • Confusion


Genital Herpes Treatment

Is genital herpes treatable?

The complete elimination of the herpetic virus is not possible. Genital herpes is incurable, but it can be kept under control. This means that if no treatment is prescribed, the herpetic virus will continue spreading in the body, causing often and numerous recurrences. Yet, the virus will always remain in the cells in the infected person’s body, meaning that it is transmittable. However, currently, there are available meds that can rapidly inhibit the active replication of the herpetic virus, which greatly reduces the disease progression and also reduces the risk of encountering complications. Read below a series of detailed guidelines for the treatment.

Certainty that the patient is suffering from a form of HSV

In some cases, people can encounter vesicles that are similar to genital herpes lesions that form because of other diseases. In particular, when contracting a disease like syphilis, a large, painless lesion can form around the genital area. Unlike herpes, syphilis needs immediate treatment, otherwise, it will cause serious complications. If an eruption (either vesicles or ulcerations) are being noticed in the genital area, a doctor appointment is recommended to clarify what the causes for their apparition are. This is the first step towards deciding what treatment should be followed next.

The first case of HSV eruption

As mentioned before, the primary cause of genital herpes infection would be having unprotected sex with a person who carries the infection. According to several clinical observations, in addition to the herpetic virus, the same person can carry other types of sexually transmitted infections. Because it is highly related to the immune system, the herpetic virus puts a person at higher risk of contracting other infections, such as HIV.

Consequently, when the herpetic virus is present for the first time in a person, a gynecologist, dermatologist or an infectious disease specialist should be consulted in order to set the next steps for treatment. This is highly necessary for ensuring that the herpetic virus carrier is not infected with other types of diseases that could cause different symptoms which combined are extremely dangerous.

Can the treatment for HSV interfere with other types of treatment?

The answer is yes. In some patients, the treatment for herpes simplex virus can cause further complications because they are already undergoing a treatment for another disease. For instance:

  • A person who suffers from cancer and is undergoing anticancer treatment such as chemotherapy or radiotherapy
  • A person who is undergoing treatment that contains glucocorticoid hormones or other immunosuppressive drugs
  • A person who previously had an organ transplant and is dependent on drugs which suppress immunity
  • A person who is HIV / AIDS positive
  • A person who suffers from Diabetes
  • A pregnant woman

Treating the herpetic virus in people who are finding themselves in the aforementioned categories should be performed under permanent medical supervision. Choosing the dose and the duration of the treatment should be personalized according to each patient’s needs and requirements.

Does it depend on how many times one experienced recurrences?

When experiencing recurrent genital herpes, not suffering from any other sexually transmitted diseases and not part of the other categories of people who are experiencing trouble with HSV treatment then the best solution would be to use medical creams and antiviral drugs. If an aggravation of genital herpes lesions occurs, asking the doctor for a more effective treatment is recommended. In this situation, antiviral medication in the form of pills and injectables for longer periods might be needed. Treatment will reduce the frequency of the relapses.

Optimal treatment for rare episodes of genital herpes in both men and women are creams combined with antiviral drugs. Currently, the following substances are used for treating HSV lesions:

  • Acyclovir
  • Penciclovir
  • Valaciclovir
  • Famciclovir

The cream containing the aforementioned substances should be used immediately after the itching or pain of the lesions occur. Before applying the cream, the patient should thoroughly wash the affected area with soap and warm water without breaking them. Dying the area out with a soft towel gently and them applying a thin layer of cream every three to six hours for the next week should have visible effects. In the very first days of treating the affected area with antiviral cream, patients are still being contagious. Because of this, patients should:

  • Use cotton balls and disposable gloves
  • Wash hands frequently
  • Avoid touching other parts of the body (especially the eyes) after applying the treatment

Is the treatment effective at all times?

No. Certain patients see results after the very first day of applying creams and taking the recommended medication while others see absolutely no improvement. In these latter cases, a deeper investigation and personalized treatment is recommended. The results a patient should see include smaller and fewer blisters around the genital area.


Genital Herpes Prevention

HSV 2, which is responsible for all cases of genital herpes is transmitted mainly by unprotected sexual intercourse. A sufficiently high protection against genital herpes is represented by condoms. Condom protection can be unsafe only if the affected person has herpetic lesions outside the are that the condom covers. If one of the partners has active genital lesions, they should refrain from sexual contact until the area is fully healed. Not doing this can lead to the infection of the sexual partner and the infection of the lesions as well. Due to the fact that genital herpes infection is also possible if the carrier doesn’t show any signs of HSV 2, condoms should be used in all cases. Because genital herpes can also be caused by HSV 1 in certain cases, it can occur after oral sex as well, when the lesions are around the mouth area. In the present, vaccination against herpes simplex viruses is under development in research laboratories all around the world.


Last updated on March 2nd, 2018

Chris Riley

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