Herpes simplex is a viral infection that commonly presents with inflamed blisters and vesicles on the skin. Patients may also experience pain and burning of the affected area. There are two main types of herpes virus: herpes simplex virus-type 1 (HSV-1) and herpes simplex virus-type 2 (HSV-2). HSV-1 is usually associated with cold sores on the lips or face, whereas HSV-2 is more commonly associated with genital herpes. However, either HSV-1 or HSV-2 can cause sores on the face or genitals. Once the infection is acquired, the herpes simplex virus resides in the nerves that supply sensation to the skin. During an active outbreak, the virus travels down the nerves and onto the skin or mucous membranes (lips, mouth, genitals) where it multiplies and causes skin lesions. The virus gradually resides in one to three weeks and goes back down the nerve fibers where it rests until another outbreak. Risk factors for outbreaks include emotional stress, excessive sun exposure (for cold sores), trauma to the skin, or a compromised immune system.
Herpes Simplex Virus Type-1 (HSV-1)
HSV-1 is commonly associated with facial lesions such as “cold sores” or “fever blisters.” It’s usually acquired during early childhood and affects approximately 60-70% of the population. It’s commonly spread through skin-to-skin contact or close contact with an adult who carries the virus. Kissing a child or sharing the same utensil or cup can often spread the virus. Children can also spread the virus by direct contact or sharing toys with each other. The virus can be shed and spread even without active sores. Once acquired, the herpes virus resides permanently within the nerves and may cause periodic outbreaks. Although medications can help suppress the virus and allow for a quicker recovery, there is no permanent cure for the herpes virus. The virus continues to reside within the body.
Herpes Simplex Virus Type-2 (HSV-2)
HSV-2 is commonly associated with genital lesions and considered to be a sexually transmitted disease. Patients often experience painful blisters or ulcers on the genitals. Unlike herpes type-1 which is acquired during childhood, HSV-2 is commonly acquired after puberty and affects approximately 20-25% of the population. It is spread through skin-to-skin contact, and usually through sexual activity. Although condoms may “slightly” reduce the risk of transmission, HSV-2 can still spread if there is direct contact with affected skin. The virus can also be shed and spread without active lesions. Lesions may also be spread to other body parts if there is direct contact.
Treatment of Herpes Simplex
Although there is no permanent cure for the herpes virus, there are antiviral medications that can help reduce the frequency, duration, and severity of outbreaks. Mild cases of herpes are usually self-limited and may resolve on their own within days to weeks without need for further treatment. Patients should be careful to avoid skin-to-skin contact with others to prevent spreading the virus. Analgesics such as ibuprofen or Tylenol may be taken to help reduce pain or fever. Topical anesthetics such as lidocaine or benzocaine can also be applied to the skin to reduce pain and itching. More severe cases may require prescription medications to reduce the duration and severity of the outbreak.
Depending on your signs and symptoms our dermatologist can help determine the right treatment option for you.