What Questions Should I Ask My Doctor
You may want to ask your healthcare provider:
- What is the best treatment for me?
- What happens if I dont treat a cold sore?
- What are the side effects of antiviral medications?
- How can I reduce the risk of future outbreaks?
- Whats the best way to prevent getting another STI?
- How can I protect my partner from getting genital herpes?
- Should I lookout for signs of complications?
What Are Canker Sores
Canker sores are painful sores inside the mouth. Canker sores are twice as common in women and usually first appear between the ages of ten and twenty although they may appear as early as age two.
Symptoms: Although canker sores can appear anywhere on the mucous membranes of the mouth, they most frequently appear on the inner surfaces of the cheeks and lips, tongue and soft palate.
They are usually oval or round with a grayish-white eroded surface surrounded by a red inflamed area. The sores may occur singly or in groups and vary from about 1/8 inch to 1 -1/4 inch in diameter.
The sore may be painful for three or four days, but complete healing usually takes ten to fifteen days. Canker sores may recur many times each year.
Causes: No one knows what causes canker sores. They may be caused by a virus, may be a form of allergic reaction or may result from an auto-immune condition . Some people have also found eating citrus fruit and other acidic foods increase the occurrence of canker sores, but this has not been scientifically proven.
Factors that may trigger these sores are injury or irritation , smoking, stress, a diet lacking in vitamin B12, folic acid or iron and the onset of menstruation for some women.
Treatment: Nothing cures canker sores or prevents recurrence. There are, however, ways to ease discomfort during the 3-4 days when the sores are painful and also prevent infection.
When to seek medical care: Consult a clinician if:
Are Canker Sores Caused By The Herpes Virus
Canker sores are not caused by the herpes virus or by any other virus. In fact, the cause of canker sores is unknown, although they may be triggered by a minor injury in your mouth from dental work or brushing too hard, an allergy, a vitamin B deficiency, stress, or a food intolerance. Some medical conditions, such as celiac disease and inflammatory bowel disease, may also cause canker sores, and they often occur in families, so it’s possible genetics or environment play a part, too.
Canker sores typically appear as small, round, or oval whitish sores with a red border, according to the Mayo Clinic. They typically occur on the tongue, inside the cheeks, inside the lips, or on the gums. The medical term for a canker sore is aphthous ulcer. Canker sores can be quite painful, but they usually heal within about two weeks without leaving any scarring.
Unlike cold sores, which usually occur outside the mouth, canker sores occur only inside the mouth. Like cold sores, canker sores are recurrent, but they are not contagious: You cant give a canker sore to another person. Canker sores occur more often in teenagers and young adults, and they are more common in women than men.
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How Will My Healthcare Provider Know If I Have Genital Herpes
Your healthcare provider may diagnose genital herpes by simply looking at any sores that are present. Providers can also take a sample from the sore and test it. If sores are not present, a blood test may be used to look for HSV antibodies.
Have an honest and open talk with your healthcare provider about herpes testing and other STDs.
Please note: A herpes blood test can help determine if you have herpes infection. It cannot tell you who gave you the infection or when you got the infection.
Other Rashes That Look Similar To Herpes
Contact dermatitis can sometimes cause blistering, redness, and swelling on the skin. This is usually caused by an allergic reaction. Babies often get this on their nappy area.
Shingles, which is an infection caused by the varicella zoster virus, can also cause fluid filled blisters. Unlike herpes, a shingles rash develops on one side of your face or body and most commonly affects the back and stomach.
Scabies is caused by a parasite which burrows into your skin and lays eggs. This can cause an extremely itchy rash that looks like pimples. This can cause scaly and flushed areas of the skin and is sometimes mistaken for a herpes rash. Scabies is more likely to appear on different parts of your body than your mouth or genitals.
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What Are The Symptoms Of Herpes Gladiatorum
- Symptoms usually begin about 8 days after exposure to HSV-1.
- Swollen glands .
- A tingling feeling at the affected area.
- A cluster of clear, fluid-filled blisters that may be surrounded by redness — these blisters may or may not be painful.
- Blisters and lesions usually heal within 7 to 10 days.
- People with HSV-1 infection are infected for life, may have periodic outbreaks, and can transmit the virus to others.
|Herpes outbreak on arm|
Can Herpes Be Spread Without Symptoms
Most people get herpes from someone who doesnt have any sores. Sometimes those who know they are infected spread the virus between outbreaks when no signs or symptoms are present. This is called asymptomatic transmission. It may live in your body for years without causing any symptoms, so its really hard to know for sure when and how you got it. Thats why so many people have herpes its a pretty sneaky infection.
Because the virus dies quickly outside the body, you cant get herpes from hugging, holding hands, coughing, sneezing, or sitting on toilet seats.
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Treatment If The Blisters Come Back
Go to a GP or sexual health clinic if you have been diagnosed with genital herpes and need treatment for an outbreak.
Antiviral medicine may help shorten an outbreak by 1 or 2 days if you start taking it as soon as symptoms appear.
But outbreaks usually settle by themselves, so you may not need treatment.
Recurrent outbreaks are usually milder than the first episode of genital herpes.
Over time, outbreaks tend to happen less often and be less severe. Some people never have outbreaks.
Some people who have more than 6 outbreaks in a year may benefit from taking antiviral medicine for 6 to 12 months.
If you still have outbreaks of genital herpes during this time, you may be referred to a specialist.
What Can You Expect When Visiting A Doctor For Ocular Herpes Diagnosis
Ocular or eye herpes can be often misdiagnosed during early stages. Documenting your symptoms and when they occurred can help you receive a more accurate diagnosis. You should bring these notes to your doctors appointment and be prepared to answer questions about your medical history.
In most cases during your diagnosis appointment you can expect the following 3 things:
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How Do You Know For Sure
If the nature, location, and other characteristics of your sores are not enough for you to draw a confident conclusion, medical testing is the only way to have a definitive answer. This can mean any one of the following tests:
- Laboratory testing : A swab of the fluid sample from the blister is obtained within 48 hours of the appearance of the first symptoms to test for the viral culture.
- Blood Test : Conducted a couple of weeks after the initial symptoms, this searches for any antibodies produced against HSV-1 or HSV-2.
- Polymerase Chain Reaction : The most expensive of all, it looks for HSVs genetic material
Herpes Is A Common Infection
Herpes is a super-common infection that stays in your body for life. More than half of Americans have oral herpes, and about 1 out of 6 Americans has genital herpes. So chances are a few people you know are living with herpes.
Theres no cure for herpes, but medication can ease your symptoms and lower your chances of giving the virus to other people. And the good news is, outbreaks usually become less frequent over time, and even though herpes can sometimes be uncomfortable and painful, its not dangerous. People with herpes have relationships, have sex, and live perfectly healthy lives.
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How Does The Virus Spread
Through body fluids. Itâs usually present on an infected personâs lip, even if thereâs no obvious sore. Kisses are the main method. Because the virus often lives in saliva, you can also spread it if you share kitchen utensils or drinking glasses. Oral sex sometimes leads to infection of your partner’s genitals.
Herpes Nerve Pain: Symptoms
Herpes-related nerve pain can be extremely uncomfortable. What does it feel like? Most people describe it as a muscle and skin tenderness that makes the skin surface extremely sensitive to touch.
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Even fabric of clothes can be painful, a phenomenon known as allodynia.
Other times, its described it as an electrical shock sensation.
Herpes leg pain almost always happens on one side of the body. It usually starts at the base of the spine and down the left thigh, although it can also occur on the right leg. The nerve pain can spread over the next days or weeks down the leg, or around the low back and buttocks, and also might be felt in the genital area.
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How Is Genital Herpes Diagnosed
HSV nucleic acid amplification tests are the most sensitive and highly specific tests available for diagnosing herpes. However, in some settings viral culture is the only test available. The sensitivity of viral culture can be low, especially among people who have recurrent or healing lesions. Because viral shedding is intermittent, it is possible for someone to have a genital herpes infection even though it was not detected by NAAT or culture. 11
Type-specific virologic tests can be used for diagnosing genital herpes when a person has recurrent symptoms or lesion without a confirmatory NAAT, culture result, or has a partner with genital herpes. Both virologic tests and type-specific serologic tests should be available in clinical settings serving patients with, or at risk for, sexually transmitted infections. 11
Given performance limitations with commercially available type-specific serologic tests , a confirmatory test with a second method should be performed before test interpretation. If confirmatory tests are unavailable, patients should be counseled about the limitations of available testing before serologic testing. Healthcare providers should also be aware that false-positive results occur. In instances of suspected recent acquisition, serologic testing within 12 weeks after acquisition may be associated with false negative test results. 11
Providers are strongly encouraged to look at CDCs STI Treatment Guidelines for further diagnostic considerations.
How Can I Reduce My Risk Of Herpes Simplex
You can reduce your risk of contracting HSV-1 by avoiding physical contact with someone who has a cold sore. People can still spread HSV-1 when cold sores arent present, but its less likely.
If someone has an active HSV-1 infection, avoid:
- Sharing utensils, cups, lip balms or other personal care products.
- Touching the skin near their mouth.
If youre sexually active, you can take these steps to protect yourself and others from the herpes virus and other STIs:
- Be monogamous with one sexual partner or limit your number of partners.
- Get tested for STIs and complete any prescribed treatment.
- Tell your sexual partners if you have genital herpes so they can get tested.
- Use condoms during intercourse and dental dams during oral sex.
Wash your hands often if you have an outbreak or are around someone with symptoms.
If your sexual partner has genital herpes, these actions can lower your risk of getting the virus:
- Dont have sex when your partner has active symptoms. Condoms may not cover all sores, so you may still get the virus.
- Make sure your partner takes antiviral medication as prescribed.
- Wait to have sex until scabs fall off active lesions.
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Is Herpes Simplex Related To Herpes Zoster
Like HSV-1 and HSV-2, shingles can cause a painful, blistering rash. The shingles rash usually shows up on the back, side, abdomen , neck and face. It is often only on half of your body, following the pattern of your nerves. See your healthcare provider if you have a new rash and suspect you may have shingles.
A note from Cleveland Clinic
Herpes simplex is a virus. Once you have herpes, its a lifelong condition. A herpes infection can lead to outbreaks , but youll also have times when you have no symptoms. The main sign of herpes is sores that appear on the infected skin. Some people choose not to treat herpes, especially if symptoms are mild. Others take antiviral medications to reduce the severity and frequency of outbreaks.
Last reviewed by a Cleveland Clinic medical professional on 05/17/2022.
Syphilis: A Greater Health Threat Than Herpes
Syphilis and genital herpes are both STDs that can cause sores in the genital area. Like oral herpes, syphilis can also cause mouth sores, which often clear without treatment. But despite these similarities in symptoms, the two diseases differ in their causes syphilis is caused by a bacteria and herpes by a virus and the health risks they pose.
For most people the exceptions being infants and people who have weakened immune systems or who are chronically ill herpes is more of an annoyance than a dangerous disease. But untreated syphilis can lead to severe complications, including bone, joint, liver, heart, and brain damage.
There are four stages of syphilis, according to the CDC, each with different signs and symptoms. In the primary stage, a painless sore or sores develop where the bacteria first entered the skin or mucous membrane. In the secondary stage, you may develop a skin rash, swollen lymph nodes, fever, and other flu-like symptoms. In the latent stage of syphilis, there are no signs or symptoms, and in the tertiary stage, the bacterial infection can damage the heart, brain, and other organs of the body.
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Genital Herpes: Signs And Symptoms
Most people infected with the virus that causes genital herpes never get sores and may never know that they have the virus. If signs and symptoms occur, these can include:
- Minor rash or itching
- While most genital herpes sores appear in the genital region, the HSV-2 virus can cause sores elsewhere on the body, especially the buttocks or thighs. In women, sores can develop inside the body on the
Sores may develop between 2 to 20 days after sexual contact with an infected person. Alternatively, the virus may remain in the infected nerve indefinitely without causing an outbreak or may cause an outbreak months or years after infection. The sores typically heal within 2 to 6 weeks.
No Ulcers Doesnt Equal No Herpes So Then What
If youve never had genital ulcers and as far as you know, have never been exposed, is it worth getting tested? Thats a controversial point and in fact, the widely followed official guidelines discourage screening.
Why? Many reasons: Lets say the test comes back positive for HSV-2. This means that the patient may have been exposed to HSV-2 at some point in their lives, somehow, somewhere. Research tells us that these folks may be periodically shedding virus particles in their genital fluids. These patients would then be diagnosed with genital herpes, encouraged to share their status with future partners, and offered daily antiviral medication to prevent possibly spreading the virus.
All of this can be a tough pill to swallow, so to speak. There is significant social stigma and shame associated with herpes. In addition, there are occasionally false-positive tests. Labeling someone with the diagnosis can be devastating to their future relationships, and asking someone to take a pill for a condition they may or may not have and may or may not spread seems unreasonable.
However, many experts disagree with the official guidelines. I wrote to Dr. John Gnann, professor of infectious disease at the Medical University of South Carolina and co-author of a review in the New England Journal of Medicine . He has suggested the below guidelines, and outlines the rationale:
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Whats The Difference Between Genital Herpes And Oral Herpes
Because there are 2 different kinds of herpes simplex viruses that can live on many body parts, lots of people are confused about what to call these infections. But its actually pretty simple:
When you get either HSV-1 or HSV-2 on or around your genitals , its called genital herpes.
When you get either HSV-1 or HSV-2 in or around your lips, mouth, and throat, its called oral herpes. Oral herpes sores are sometimes called cold sores or fever blisters.
HSV-1 usually causes oral herpes, and HSV-2 usually causes genital herpes each strain prefers to live on its favorite area. But its totally possible for both types of herpes simplex to infect either area. For example, you can get HSV-1 on your genitals if someone with a cold sore on their lips gives you oral sex. And you can get HSV-2 in your mouth if you give oral sex to someone with HSV-2 on their genitals.