Herpes Might Not Have Any Symptoms
You or your partner may not have any herpes symptoms that you can see or feel, or the signs of herpes may be so mild you dont even notice them. Sometimes people confuse herpes symptoms with other things, like pimples, ingrown hairs, and the flu.
Herpes symptoms come and go, but that doesnt mean the infection goes away or that you cant spread it to other people. Once you have herpes, it stays in your body for life.
Herpes Treatment During Pregnancy
If you develop a herpes rash during your pregnancy, talk with your obstetrician right away. Its possible that the virus can affect an unborn baby. It may also be transferred to the newborn during childbirth. See your healthcare provider if you develop symptoms, to have a physical exam, and discuss treatment options.
To soothe an outbreak of genital herpes, take your prescribed medication and try sitting in a warm bath. Applying ice to a herpes rash on the face may provide some relief as well. To help prevent outbreaks, take steps to avoid the triggers that lead to one, such as a sunburn or extreme stress.
Also, you dont want to kiss a baby if you have a cold sore because it could lead to a serious infection in the baby early in life.
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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What Are The Types Of Herpes Viruses
Herpes is a group of contagious viruses that cause blisters and sores. Some of the more common herpes viruses include:
- Type 1: HSV-1, or oral herpes, causes cold sores to form on your lips, gums, tongue and inside of your mouth. It can cause genital herpes in some cases. This type usually spreads through saliva when you kiss someone with open herpes sores. You can also get HSV-1 by sharing items like toothbrushes, lipsticks or eating utensils.
- Type 2: HSV-2 causes genital herpes.
- Herpes zoster: This virus causes chickenpox and shingles.
Tips For Managing Herpes Symptoms
The symptoms of herpes can be painful and uncomfortable. Fortunately, there are a few things you can easily do at home to help ease these symptoms, including:
- Apply an ice pack or warm compress to the affected area.
- Take over-the-counter pain relievers, such as acetaminophen.
- Keep the affected area clean and dry to reduce the risk of infection.
- Avoid tight clothing that may irritate genital sores.
- Dont pop blisters or pick at scabs that form over the sores.
- Ask your healthcare provider to recommend a painkilling cream.
Taking proper care of your skin and overall health while experiencing an outbreak can help to prevent complications like infection and assist in faster healing for your sores. Keep in mind that you are especially contagious during an outbreak, so its best to avoid intimate contact, such as kissing or sex, until the sores heal.
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How Do People Get Genital Herpes
Infections are transmitted through contact with HSV in herpes lesions, mucosal surfaces, genital secretions, or oral secretions. 5 HSV-1 and HSV-2 can be shed from normal-appearing oral or genital mucosa or skin. 7,8 Generally, a person can only get HSV-2 infection during genital contact with someone who has a genital HSV-2 infection. However, receiving oral sex from a person with an oral HSV-1 infection can result in getting a genital HSV-1 infection. 4 Transmission commonly occurs from contact with an infected partner who does not have visible lesions and who may not know that he or she is infected. 7 In persons with asymptomatic HSV-2 infections, genital HSV shedding occurs on 10.2% of days, compared to 20.1% of days among those with symptomatic infections. 8
Take Care During Pregnancy
A woman who gets genital herpes while she is pregnant could pass the infection to her baby during delivery. Herpes can make newborns seriously ill.
If you are pregnant, follow these steps:
- Tell your doctor if you have been exposed to genital herpes or have had an outbreak in the past.
- Let your doctor know if you are currently having an outbreak, especially if you are in the last part of your pregnancy.
- Avoid unsafe sex. Herpes is often transmitted by people who dont know they are infected and dont have symptoms. Use condoms.
- Avoid receiving oral sex from partners who have cold sores. Herpes in newborns can be caused by HSV-1, the virus that most commonly causes cold sores. Most experts advise pregnant women not to receive oral sex in the last 3 months of their pregnancy. It increases their risk of genital infection with HSV-1.
Antiviral medicine can be used safely in pregnancy to reduce the risk of an outbreak at the time of delivery. This lower risk, in turn, makes it less likely that delivery by cesarean section will be needed.
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Can I Be Treated To Prevent Genital Herpes Transmission To My Partner
Yes. A large study showed that if one partner has herpes and the other partner is uninfected, treating the infected partner with suppressive therapy can prevent transmission of symptomatic herpes in over 90% of cases. This is an option for couples who are interested in having unprotected sex or who are planning to become pregnant.
If you are entering into a new relationship and are aware that you have herpes simplex infection, you owe it to your partner to notify them before having sex.
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?
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When To See A Healthcare Provider
If you’ve been diagnosed with herpes, there are some circumstances where you may benefit from medical care. These may include having:
- An outbreak that isn’t helped by treatment and self-care strategies
Self-care strategies during outbreaks can help with pain and discomfort, including:
- Keeping the affected area clean and dry
- Using over-the-counter pain relievers
- Place cold compresses over affected areas
For at-home care for cold sores specifically:
- Apply non-prescription antiviral ointment
- Avoid eating spicy, acidic, or salty foods
- Use petroleum jelly to keep surrounding skin moisturized
What Are The Risk Factors For Herpes
Some risk factors for herpes may include:
-Having unprotected sex
-Having sex with multiple partners
-Kissing someone with a herpes virus that is active
-Abuse of cigarettes, alcohol, and drugs
-Spreading the virus by touching a cold sore and then touching something else
-Having an autoimmune disorder or illness, such as hepatitis or HIV/AIDS
-Poor eating habits that cause nutritional deficiencies
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Recurrence Course Triggers And Timing
Course of Recurrence
Most cases of herpes simplex recur. The site on the body and the type of virus influence how often it comes back. Recurrences of genital herpes are more likely with HSV-2 infection than with HSV-1 infection.
The virus usually takes the following course:
- Prodrome. The outbreak of infection is often preceded by a prodrome, an early group of symptoms that may include itchy skin, pain, or an abnormal tingling sensation at the site of infection. Headache, enlarged lymph glands, and flu-like symptoms may occur. The prodrome, which may last from 2 hours to 2 days, stops when the blisters develop. About 25% of the time, recurrence does not go beyond the prodrome stage.
- Outbreak. Recurrent outbreaks feature most of the same symptoms at the same sites as the primary attack, but they tend to be milder and briefer. After blisters erupt, they typically heal in 6 to 10 days. Occasionally, the symptoms may not resemble those of the primary episode, but appear as fissures and scrapes in the skin or as general inflammation around the affected area.
Triggers of Recurrence
Herpes outbreaks can be triggered by different factors. They include sunlight, wind, fever, physical injury, surgery, menstruation, suppression of the immune system, and emotional stress. Oral herpes can be triggered within about 3 days of intense dental work, particularly root canal or tooth extraction.
Timing of Recurrences
Herpes Outbreak Treatment Options
Even without treatment, most herpes outbreaks go away on their own. There are treatments available, however, which have been proven to shorten and even prevent future outbreaks. These antiviral medications work by preventing the virus from making copies of itself and spreading through your cells to cause an outbreak. If you suffer from oral herpes, a healthcare provider may recommend a topical cream or ointment that you should apply at the first sign of an outbreak. If you experience recurrent genital herpes outbreaks, you may be offered oral herpes treatments which are pills you take by mouth. Examples of antiviral drugs include acyclovir, famciclovir, and valacyclovir . These are all standard options proven to help decrease the severity and length of outbreaks from herpes .
Prescription antiviral treatments are usually very effective at prevent future outbreaks, reducing the chance of experiencing an outbreak by 7080%. Many people on antiviral therapy report experiencing no herpes symptoms at all . Using medication within the first 24 hours of symptoms can shorten outbreaks by several hours or days, ultimately reducing any discomfort in the long run .
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Herpes Signs And Symptoms
While some people realize that they have genital herpes, many do not. It is estimated that one in eight persons in the United States has genital herpes however, as many as 90 percent are unaware that they have the virus. This is because many people have very mild symptoms that go unrecognized or are mistaken for another condition or no symptoms at all.
Because signs can vary a great deal, we recommend that an individual see a healthcare provider to be tested if they have a lesion of any kind. This can be swabbed for testing.
A person may show symptoms within days after contracting genital herpes, or it may take weeks, months, or even years. Some people may have a severe outbreak within days after contracting the virus while others may have a first outbreak so mild that they do not notice it. Because of these possibilities, it can be difficult for people to know when and from whom they may have contracted 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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Timeline Of Herpes Outbreak
The timeline of a herpes outbreak can typically have a timeline like this:
- days 1 to 2: tingling feeling starts in the affected area
- days 3 to5: blisters appear and start to fill with fluid
- days 5 to 7: blisters start to burst, releasing fluid and turning into ulcers
- days 7 to 14: blisters scab over and start to heal
- day 14: outbreak usually resolved
After a first outbreak of genital herpes, you may find the length of later outbreaks gets shorter over time.
Treatment Of An Initial Outbreak
The first outbreak of genital herpes is usually much worse than recurrent outbreaks. Symptoms tend to be more severe and to last longer. Your provider will prescribe one of the three antiviral medications, which you will take for 7 to 10 days. If your symptoms persist, treatment may be extended. An acyclovir ointment may also be prescribed for topical treatment of initial genital herpes.
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Symptoms Of Oral Herpes
Oral herpes is most often caused by HSV-1, but can also be caused by HSV-2. It usually affects the lips and, in some primary attacks, the mucous membranes in the mouth. A herpes infection may occur on the cheeks or in the nose, but facial herpes is very uncommon.
Primary Oral Herpes Infection
If the primary oral infection causes symptoms, they can be very painful, particularly in children. Symptoms include:
- Tingling, burning, or itching around the mouth are the first signs.
- Red, fluid-filled blisters that may form on the lips, gums, mouth, and throat.
- Blisters that break open and leak. As they heal, they turn yellow and crusty, eventually turning into pink skin. The sores last 10 to 14 days and can be very uncomfortable.
- Blisters that may be preceded or accompanied by sore throat, fever, swollen glands, and painful swallowing.
Recurrent Oral Herpes Infection
A recurrent oral herpes infection is much milder than the primary outbreak. It usually manifests as a single sore, commonly called a cold sore or fever blister . The sore usually shows up on the outer edge of the lips and rarely affects the gums or throat.
How Long Do Sores From Herpes Simplex Last
If youre infected with HSV-1, commonly known as oral herpes, you may notice tingling or burning around your mouth in the days before a cold sore appears. These blisters break open and ooze fluid before forming a crust. Usually, sores last for seven to 10 days.
If youre infected with HSV-2, commonly known as genital herpes, your first outbreak may last between two to four weeks. Recurrent outbreaks usually last between three to seven days.
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Symptoms Of Genital Herpes
Primary Genital Herpes Outbreak
For people with symptoms, the first outbreak usually occurs in or around the genital area 2 days to 2 weeks after sexual exposure to the virus. The first signs are a tingling sensation in the affected areas and groups of small red bumps that develop into blisters. Over the next 2 to 3 weeks, more blisters can appear and rupture into painful open sores. The lesions eventually dry out, develop a crust, and heal rapidly without leaving a scar. Blisters in moist areas heal more slowly than those in dry areas. The sores may sometimes itch, but itching decreases as they heal.
About 40% of men and 70% of women develop other symptoms during initial outbreaks of genital herpes, such as flu-like discomfort, headache, muscle aches, and fever. Swollen glands may occur in the groin area or neck. Some women may have difficulty urinating and may, occasionally, require a urinary catheter. Women may also experience vaginal discharge.
Recurrent Genital Herpes Outbreak
In general, recurrences are much milder than the initial outbreak. The virus sheds for a much shorter period of time compared to an initial outbreak of 3 weeks. Women may have only minor itching, and the symptoms may be even milder in men.
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How Does Genital Herpes Affect A Pregnant Woman And Her Baby
Neonatal herpes is one of the most serious complications of genital herpes.5,16 Healthcare providers should ask all pregnant women if they have a history of genital herpes.11 Herpes infection can be passed from mother to child during pregnancy or childbirth, or babies may be infected shortly after birth, resulting in a potentially fatal neonatal herpes infection. 17 Infants born to women who acquire genital herpes close to the time of delivery and are shedding virus at delivery are at a much higher risk for developing neonatal herpes, compared with women who have recurrent genital herpes . 16,18-20 Thus, it is important that women avoid contracting herpes during pregnancy. Women should be counseled to abstain from intercourse during the third trimester with partners known to have or suspected of having genital herpes. 5,11
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More Questions From Patients:
Many people with genital herpes have no symptoms, or have very mild symptoms that go unnoticed.
The first time genital herpes symptoms appear is called the “first episode” or “initial herpes.” Initial herpes symptoms are usually more noticeable than later outbreaks.
Symptoms of genital herpes in men may include
burning when you pee if you have sores
trouble peeing if you have sores covering your urethra
itching or pain around your genitals
During initial herpes, symptoms may also include
swollen, tender glands in the pelvic area, throat, or under the arms