How Can I Best Learn To Cope With Herpes Simplex
Some people feel distressed or embarrassed about their herpes simplex infection. Its important to understand that the herpes virus is common. For most people, herpes doesnt significantly interfere with daily life.
To cope with negative feelings, you may consider:
- Connecting with others through support groups or online forums.
- Sharing your feelings with a trusted friend or loved one.
- Speaking with a therapist.
Testing For Genital Herpes
If you think you may have genital herpes you should make an appointment with your GP or local sexual health services.
If there are symptoms present such as blisters, sores and ulcers, your doctor or nurse may be able to make a diagnosis straight away.
If you have visible blisters, your doctor or nurse may take a swab for testing, to check if this is herpes and what type. This swab can also test for another STI which causes blisters called syphilis.
The genital herpes swab tests are very reliable, though if the ulcer is too dry then it may be less likely to find a positive result.
Most Outbreaks Occur Within Two Weeks Of Herpes Exposure
If youve been infected with herpes and are symptomatic, youll usually start to experience some effects of the virus within one to two weeks.
An initial herpes outbreak usually lasts for two to three weeks and involves a range of different symptoms. Many people with herpes note that the initial outbreak has the worst symptoms and that subsequent outbreaks are less severe, although this isnt always the case.
Most people start to become aware that they might have herpes after a tingling sensation starts to develop in the area affected by the virus. For oral herpes, this is the start of the development of oral cold sores for genital herpes, the sores develop on the genitals, thighs and buttocks.
For more information on spotting an outbreak, check out our guide on Herpes or Ingrown Hair? How to Tell The Difference.
Over the course of two to three weeks, this tingling/itching feeling leads to the development of blisters. The blisters eventually open into sores, then dry out and heal. Most herpes outbreaks do not leave any permanent scarring.
During your first herpes outbreak, you might also experience flu or cold-like symptoms. About 70% of women and 40% of men experience some level of flu-like symptoms, such as muscle pains, gland swelling, headaches and fever.
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Quick Answers For Clinicians
Virologic and serologic testing methods are available to confirm herpes simplex virus infection. Direct detection of the virus by polymerase chain reaction or viral culture is recommended for neonates and patients who have an active infection with lesions, to test for disseminated bloodborne infection in immunocompromised patients, and for cerebrospinal fluid testing. Serologic testing for immunoglobulin G can be used to determine if a person has ever been exposed to HSV but cannot determine exactly when the exposure occurred or the site of infection. Type-specific serologic testing for HSV-1- and HSV-2-specific glycoproteins can determine the subtype of the virus, which provides useful information about prognosis and informs treatment and counseling.
Genital herpes is most often caused by herpes simplex virus type 2 , but HSV-1-associated cases are increasing. Recurrence and subclinical viral shedding occur more frequently in cases caused by HSV-2 than in cases caused by HSV-1, which may impact treatment and counseling decisions. Therefore, subtyping HSV using polymerase chain reaction or serology testing can guide treatment decisions and patient counseling. Subtyping may also provide epidemiologic information about transmission of the virus.
Herpes And Newborn Infants
Herpes infection in a newborn can cause a range of symptoms, including skin rash, fevers, mouth sores, and eye infections. If left untreated, neonatal herpes is a very serious and even life-threatening condition. Neonatal herpes can spread to the brain and central nervous system, causing encephalitis and meningitis. It also can lead to intellectual disability, cerebral palsy, and death. Herpes can also spread to internal organs, such as the liver and lungs.
Infants infected with herpes are treated with acyclovir, an antiviral drug. They usually receive several weeks of intravenous acyclovir treatment, often followed by several months of oral acyclovir. It is important to treat babies quickly, before the infection spreads to the brain and other organs.
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Precautions And Prevention Of Herpes
It is not possible to prevent all exposure to herpes simplex.
The virus is common, and is not always transmitted via sexual contact.
Many people who have HSV-1 do not even know they were exposed. It is possible to get exposed in childhood and never have active outbreaks.
It is possible to practice safe sexual hygiene and prevent the transmission of genital herpes.
You can minimize this risk by:
- Avoiding sexual contact, kissing, or any type of contact with active sores from someone who is having a current outbreak
- Using condoms and dental dams during all types of sexual contact
- Not sharing utensils and cosmetics with someone who has an active herpes outbreak
Reactivation And Recurrent Outbreaks
- Extreme temperatures
- Menstrual periods
The virus then travels to the skin and can cause another, often milder, outbreak. However, reactivation may not cause any symptoms.
Before an outbreak, some people experience prodrome. This is characterized by tingling, itching, or pain in the affected areas before the lesions appear.
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How Long Can Herpes Go Undetected
Once youve contracted HSV, there will be an incubation period the time it takes from contracting the virus until the first symptom appears.
The incubation period for HSV-1 and HSV-2 is the same: 2 to 12 days. For most people, the symptoms begin to show up in about 3 to 6 days.
However, according to the
Types Of Tests Used To Diagnose Herpes
There are a number of tests used to diagnose herpes, depending on whether lesions are present.
- Symptomatic testing: Samples taken from lesions can be used to detect the virus with a viral culture or nucleic acid amplification test . Of the two, NAAT is more sensitive . A polymerase chain reaction test may be used if herpes is suspected as the cause of a systemic or central nervous system infection, such as encephalitis or meningitis.
- Asymptomatic testing: A blood test may be used to detect HSV antibodies. This is an option for people who had a previous outbreak or had recent exposure. Very recent herpes infections may not be detected. Retesting in a few months may be necessary for accurate results. Some blood tests can also specifically identify an HSV-1 or HSV-2 infection.
Due to the high rates of false-positives, screening for genital herpes in asymptomatic adults and adolescents is not recommended.
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How Is Herpes Simplex Diagnosed
Healthcare providers may diagnose herpes simplex based on how the sores look. Your provider may take a sample from the sore. Laboratory analysis of the sample can confirm or rule out the herpes virus.
If you dont have sores, your healthcare provider can use a blood test to check for HSV-1 and HSV-2 antibody, a marker showing youve been exposed to the virus. The blood test doesnt show an active infection . But it informs your provider whether youve been exposed to the herpes virus in the past. If this is your first infection, you may not test positive for herpes if there hasnt been enough time for your body to develop antibodies. The HSV-1and HSV-2 antibody test may be repeated in eight to 12 weeks.
How Can I Prevent Genital Herpes
If you are sexually active, you can do the following things to lower your chances of getting genital herpes:
- Being in a long-term mutually monogamous relationship with a partner who does not have herpes.
- Using condoms the right way every time you have sex.
Be aware that not all herpes sores occur in areas that a condom can cover. Also, the skin can release the virus from areas that do not have a visible herpes sore. For these reasons, condoms may not fully protect you from getting herpes.
If your sex partner has/have genital herpes, you can lower your risk of getting it if:
- Your partner takes an anti-herpes medicine every day. This is something your partner should discuss with his or her healthcare provider.
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If You Get A Positive Result Don’t Panic It Really Doesn’t Mean Much
All of this is to say that unless you have symptoms consistent with the herpes virus, why put yourself through the emotional turmoil of getting a blood test that may or may not give you legit results? As Hutcherson notes, if you do get a blood test and it comes back positive but you’re asymptomatic, what does that mean for you if you have nothing to treat? For many, due to the high rate of stigma still surrounding herpes, it can mean feelings of self-contempt, humiliation, and distress, all of which could be avoided if you aren’t experiencing any symptoms.
To recap, while there are some tests for herpes that can prove correct, none are 100 percent perfect, and blood tests are particularly problematic since they can produce false positives and negatives. We also know that the majority of the population has some form of herpes, so IMO it’s a mystery as to why we’re still making a big deal out of it. No one likes blisters or sores, but neither does anyone love having acne, a widespread condition without the same level of attached shame.
What Are The Differential Diagnoses
Other medical conditions could be confused with genital herpes or cold sores. The conditions are severe, and it is wise to consult with a medical expert. Herpes could be distinguished from these conditions with a lab test or medical exam.
- Medical reactions: Medication might lead to sensitive reactions and allergies that could appear as rashes. Although medication-induced rashes do not appear in the genital area, they are common around the patient’s mouth and lips.
- Concurrent HSV-2 or HSV-1: If the patient has either type of herpes, they could also be infected with the other. The viruses are different, and having one does not prevent or cause the other.
- Pre-cancer or Cancer: Lesions around and in your genital area could be symptoms of cancer. The appearance of precancerous or cancerous shouldn’t have blisters that come with HSV lesions. However, your doctor should be able to tell the difference.
- Syphilis: Syphilis is an STD that manifests in genital sores that could be confused with herpes. Your OBGYN should be capable of telling the difference through visual lesions inspection.
- Canker sores: Usually, canker sores are red, raw, painful, and whitish in the middle. They are due to oral trauma and can appear in the mouth. While the painful sensation of cold sores and canker sores is alike, a lesion looks different.
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There Are Two Common Blood Tests Used To Identify Herpes And They’re Often Misleading
“I had a patient once who underwent this test, which was positive, and was told she has herpes, which to her was devastating and life-altering,” Friedman says. “She burst into tears when I explained the significance or lack thereof with this test, which is very misleading.” There are two common blood tests used to identify herpes: IgG and IgM. The IgM test is still used by some doctors even though it has been denounced by the Centers for Disease Control and Prevention . According to the American Sexual Health Association , IgM tests can lead to deceptive results, as well as false assumptions about how and when a person acquired HSV.
And that’s not all: IgM tests fail to accurately distinguish between HSV-1 and HSV-2 antibodies, leading them to provide false-positive results for HSV-2. In other words, if you’ve been exposed to oral herpes , results of the IgM test could lead you to believe you’re positive for genital herpes, when in fact you simply have antibodies against HSV-1.
IgG tests, on the other hand, are more accurate, but aren’t without their own issues. For instance, ASHA says that while an IgG test can distinguish between HSV-1 and HSV-2, the problem is that the time it takes for IgG antibodies to reach a detectable level varies from person to person. This means that even with accurate results, someone could get a false-negative if they have the test administered too soon after contracting the virus .
Herpes Diagnosis In A Newborn Baby
Diagnosing herpes in children is complicated. Children aren’t screened for the infection. In other words, only symptoms should alert the parent that all is not okay. It should prompt a diagnosis that could be done with a swab sample. Nevertheless, a complicated herpes infection calls for specific tests like a lumbar puncture.
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How Can Herpes Be Prevented
Correct and consistent use of latex condoms can reduce, but not eliminate, the risk of transmitting or acquiring genital herpes because herpes virus shedding can occur in areas that are not covered by a condom.25,26
The surest way to avoid transmission of STDs, including genital herpes, is to abstain from sexual contact, or to be in a long-term mutually monogamous relationship with a partner who has been tested for STDs and is known to be uninfected.
Persons with herpes should abstain from sexual activity with partners when herpes lesions or other symptoms of herpes are present. It is important to know that even if a person does not have any symptoms, he or she can still infect sex partners. Sex partners of infected persons should be advised that they may become infected and they should use condoms to reduce the risk. Sex partners can seek testing to determine if they are infected with HSV.
Daily treatment with valacyclovir decreases the rate of HSV-2 transmission in discordant, heterosexual couples in which the source partner has a history of genital HSV-2 infection. 27 Such couples should be encouraged to consider suppressive antiviral therapy as part of a strategy to prevent transmission, in addition to consistent condom use and avoidance of sexual activity during recurrences.
Why Is The Igm Hsv Antibodies Test No Longer Recommended
The Centers for Disease Control and Prevention, the Infectious Diseases Society of America, and the American Society for Microbiology all recommend the use of the IgG antibodies test over the IgM HSV test.
IgG tests are preferred because:
- For herpes, IgG and IgM antibodies show up around the same time â normally, IgM antibodies appear first.
- IgM antibodies may only last a few months and may not be made after the first outbreak â but IgG antibodies last indefinitely and are made during all outbreaks.
- IgG antibodies can distinguish between HSV-1 and HSV-2 and IgM antibodies canât.
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Herpes Encephalitis And Meningitis
Herpes Encephalitis
Herpes simplex encephalitis is inflammation of the brain caused by either HSV-1 or HSV-2. It is a rare but extremely serious brain disease. Untreated, herpes encephalitis is fatal most of the time. Respiratory arrest can occur within the first 24 to 72 hours. Fortunately, rapid diagnostic tests and treatment with acyclovir have significantly improved survival rates and reduced complication rates. Nearly all who recover have some impairment, ranging from very mild neurological changes to paralysis.
Herpes Meningitis
Herpes simplex meningitis is inflammation of the membranes that line the brain and spinal cord. It is mainly caused by HSV-2. Like encephalitis, meningitis symptoms include headache, fever, stiff neck, vomiting, and sensitivity to light. Fortunately, herpes meningitis usually resolves after about a week without complications, although symptoms can recur.
How To Check If You Have Herpes
Many people mistake herpes symptoms for a skin rash or experience such a mild outbreak that they dont become aware theyre infected until subsequent outbreaks occur.
For more information, see our guide to Jock Itch vs. Herpes: Differences & Treatments.
Its also possible that you might experience no outbreaks at all after being infected with HSV-1 or HSV-2.
Luckily, there are several ways to check whether or not you have herpes.The best and most obvious way is to talk to your doctor about herpes testing. There are several herpes testing methods in use today, ranging from swab tests that check for viral activity to blood tests that check for the presence of IgG and/or IgM antibodies.
Each testing method has strengths and weaknesses, meaning your doctor will recommend the best option for your symptoms and potential infection type.
Most of the time, youll need to wait 12 to 16 weeks from the last possible exposure date before taking a herpes test. This gives your immune system time to produce a large enough amount of antibodies for an accurate test result.
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How Long Does It Take For Symptoms Of Herpes To Appear
It generally takes anywhere from 4 to 7 days for herpes symptoms to appear. Both genital and oral herpes outbreaks have similar symptoms.
The primary symptom of a herpes outbreak is sores that resemble blisters, called herpes lesions, on the mouth or genitals.
In addition, people may also experience the following symptoms prior to the outbreak:
- pain and redness, especially around the area the outbreak will occur
- itching and tingling, primarily in the outbreak area
- flu-like symptoms, such as fatigue, fever, or swollen lymph nodes
Most of the symptoms that occur before an outbreak indicate that the virus is replicating. Symptoms are usually the worst during the first herpes outbreak.
According to the
Some people with the herpes virus are asymptomatic, which means that they dont experience any physical symptoms of the disease. This doesnt mean that they cant spread the disease, however.
Anyone who has the herpes virus, whether symptomatic or not, can spread the virus to others.
If you have the herpes virus and your body has produced antibodies, it can be detected on a blood test, even if you have no symptoms. The only time the virus might not be detected on a test is if youve been tested too early.