Treatment Of Herpes Simplex 1 On Lips

Hsv Infection Is Very Common

Around 90 per cent of adults have herpes simplex antibodies in their bloodstream, which means that they have been infected with the virus at some time. However, the first infection does not usually cause any symptoms. One-third of infected people experience cold sores, which are a recurrence of the earlier infection and do not indicate recent infection. Most of these people would not have experienced symptoms from the first infection.

Which Genital Herpes Stage Is Safest For Sex

Genital herpes spreads mainly through sexual contact, and it can be contagious even between outbreaks due to asymptomatic shedding.

Theres no genital herpes stage that completely eliminates the possibility of infecting your partner with the virus, but herpes is more contagious in some stages than others. The primary infection stage and the blister stage are the two most highly contagious herpes phases. Its important to avoid all sexual and intimate contact during these times.

The latent stage of genital herpes, however, is the safest. Its still possible to transmit herpes to your partner with asymptomatic shedding, so you will still need to take precautions. But this stage is far less risky than others.

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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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How To Treat Cold Sores

There are many that you can do at home to soothe the sting of a cold sore, such as:

Ice. You can numb the pain if you apply a cold compress to the sore. Donât put ice directly on your skin — that could damage it.

Pain relievers. When a cold sore really stings, you may get some relief from an over-the-counter painkiller like acetaminophen.

Over-the-counter creams. There are products available at the drugstore that can help reduce the pain of a cold sore or help keep the skin soft while it heals.

Prescription drugs. Because cold sores are caused by a virus, doctors may suggest an antiviral medication to help you heal more quickly. The antiviral drugs used to treat cold sores include acyclovir , valacyclovir , famciclovir , and penciclovir .

Sunscreen. Getting a sunburn may trigger a cold sore. Using sunscreen when youâre out in the sun may prevent it.

Aloe vera gel. The same gel used for sunburn may help a cold sore to heal. Lab research has shown the gel may help fight viruses, including herpes simplex.

Lysine. This supplement may be used sometimes to treat cold sores. It comes in a cream or in capsule form.

Propolis. This is a resin-like material made by bees from the buds of poplar and cone-bearing trees. It may be used like an ointment to treat cold sores.

Lemon balm. Some research has shown that lemon balm extract can help cold sores get better, too.

Tea tree oil. Some research has shown that this strong-smelling oil helps a cold sore heal more quickly.

What Types Of Doctors Treat Cold Sores

Most pediatricians and primary care providers are very familiar with cold sores and their treatment. Most cases do not need the services of a dermatologist . An infectious-disease specialist is often consulted in complicated cases, such as herpes encephalitis or herpes in a person with a weak immune system. The care of an ophthalmologist is important in managing ocular herpes, or herpes keratitis.

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What Causes Cold Sores

Cold sores are caused by the herpes simplex virus. There are two types of the herpes simplex virus. The herpes simplex type 1 virus usually causes cold sores, and the herpes simplex type 2 virus usually causes genital herpes.

The actual sores are similar in appearance for both forms of the virus. Its also possible for HSV-1 to cause sores on the genitals and for HSV-2 to cause sores on the mouth.

Visible cold sores are contagious, but they may be spread even when they cant be seen. You can get the herpes simplex virus by coming in contact with people with the herpes simplex virus. This may happen through kissing, sharing cosmetics, or sharing food. Oral sex may spread both cold sores and genital herpes.

What You Need To Know

• Fifty percent to 80 percent of U.S. adults have oral herpes.
• Oral herpes can be spread through intimate contact with someone who is infected.
• Oral herpes can be difficult to diagnose. Often confused with many other infections, it can only be confirmed with a virus culture called PCR, blood test or biopsy. PCR is the preferred test for diagnosing herpes infections.
• The best treatment for oral herpes is antiviral oral medication. Symptomatic treatment may include antiviral ointment, over-the-counter topical anesthetics or over-the-counter anti-inflammatory agents.

Whether you call it a cold sore or a fever blister, oral herpes is a common infection of the mouth area that is caused by herpes simplex virus type 1 . Fifty percent to 80 percent of U.S. adults have oral herpes. According to the National Institutes of Health, about 90 percent of adults have been exposed to the virus by age 50.

Once infected, a person will have herpes simplex virus for the rest of his or her life. When inactive, the virus lies dormant in a group of nerve cells. While some people never develop any symptoms from the virus, others will have periodic outbreaks of infections.

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What Causes Herpes Simplex

Herpes simplex is caused by one of two types of herpes simplex virus , members of the Herpesvirales family of double-stranded DNA viruses.

• Type 1 HSV is mainly associated with oral and facial infections
• Type 2 HSV is mainly associated with genital and rectal infections

However, either virus can affect almost any area of skin or mucous membrane.

After the primary episode of infection, HSV resides in a latent state in spinal dorsal root nerves that supply sensation to the skin. During a recurrence, the virus follows the nerves onto the skin or mucous membranes, where it multiplies, causing the clinical lesion. After each attack and lifelong, it enters the resting state.

During an attack, the virus can be inoculated into new sites of skin, which can then develop blisters as well as the original site of infection.

Triggers For Cold Sores

In some people the HSV infection causes cold sores, which erupt following a trigger event such as a cold. This explains the term cold sore. Other triggers that may cause an attack of cold sores include:

• feverish illnesses, like influenza, or chest infections
• hormonal changes, such as the menstrual period
• emotional or physical stress.

It is important to remember that cold sores are a symptom of ongoing infection rather than a new infection. The sores usually recur in the same place.

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Additional Treatment For Oral Herpes

Antiviral pills are often a better choice for treating oral herpes, especially if you have recurrent outbreaks . Theyre typically less expensive than oral herpes creams and are effective options to consider.

If you have persistent oral herpes infections, taking oral antiviral medications may be a better option than creams. Here are three of the most commonly used oral antivirals with their typical cold sore treatment doses:

• Valacyclovir : 2,000 mg by mouth every 12 hours for 1 day

• Famciclovir: 1,500 mg by mouth one time only

• Acyclovir buccal tablets : 50 mg dissolved in the cheek one time only. Healthcare providers sometimes prescribe different doses of oral acyclovir capsules and tablets. This is considered an off-label use, as theyre not FDA-approved for treating cold sores.

There are currently no studies that directly compare all three antiviral medications. But a review of multiple studies found that valacyclovir healed cold sores faster than acyclovir.

Suppressive Therapy For Recurrent Hsv

Suppressive therapy reduces frequency of genital herpes recurrences by 70%80% among patients who have frequent recurrences . Persons receiving such therapy often report having experienced no symptomatic outbreaks. Suppressive therapy also is effective for patients with less frequent recurrences. Long-term safety and efficacy have been documented among patients receiving daily acyclovir, valacyclovir, and famciclovir . Quality of life is improved for many patients with frequent recurrences who receive suppressive therapy rather than episodic treatment . Providers should discuss with patients on an annual basis whether they want to continue suppressive therapy because frequency of genital HSV-2 recurrence diminishes over time for many persons. However, neither treatment discontinuation nor laboratory monitoring is necessary because adverse events and development of HSV antiviral resistance related to long-term antiviral use are uncommon.

Valacyclovir 500 mg orally 2 times/day for 3 daysOR

Valacyclovir 1 gm orally once daily for 5 days

*Acyclovir 400 mg orally 3 times/day is also effective, but are not recommended because of frequency of dosing.

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Episodic Topical Treatment For Recurrent Herpes Labialis

Topical treatment for herpes labialis is less effective than oral treatment. An RCT of treatment with topical penciclovir 1% cream showed healing was marginally faster in the penciclovir group compared with placebo .16 The participants were adults in otherwise good health who had at least three episodes of herpes labialis per year. They applied penciclovir cream or placebo within one hour of the first sign or symptom of a recurrence, and then every two hours while awake for four days. Resolution of symptoms occurred more rapidly in the penciclovir group regardless of whether the medication was applied in the early or late stage. Penciclovir cream applied every two hours while awake reduced median duration of pain from 4.1 to 3.5 days, sped up the healing of classic lesions from 5.5 to 4.8 days, and did not change median time of viral shedding .16

Docosanol cream is a saturated, 22-carbon, aliphatic alcohol with antiviral activity. It is available without prescription. One RCT of 743 patients with herpes labialis showed a faster healing time in patients treated with docosanol 10% cream compared with placebo cream , as well as reduced duration of pain symptoms .17 More than 90 percent of patients in both groups healed completely within 10 days.17 Treatment with docosanol cream, when applied five times per day and within 12 hours of episode onset, is safe and somewhat effective.

Who Might Get Herpes Simplex

People of any age can contract herpes simplex. You are more likely to get the virus if you:

• Were assigned female at birth.
• Have had multiple sex partners.
• Started having sex at a young age.
• Have a history of any sexually transmitted infection .
• Have a weakened immune system.
• Dont use condoms for intercourse and dental dams for oral sex.

Who gets HSV-1, commonly known as oral herpes?

Anyone can get HSV-1. Most people contract HSV-1 during childhood. It spreads when an adult who has the virus has close contact with a child, such as when a family member kisses a child.

Who gets HSV-2, commonly known as genital herpes?

Genital herpes affects sexually active teens and adults of all genders and races. It can spread if you have multiple sexual partners and dont use condoms or dental dams.

People assigned female at birth are more at risk. Delicate vaginal tissue can tear, making it easier for the infection to get in. Black people who were AFAB are especially vulnerable, with an estimated 1 in 2 people AFAB between the ages of 14 and 49 infected with HSV-2.

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Canker Sores Versus Cold Sores

Canker sores and cold sores both cause pain and discomfort, but thats where their similarities end. Canker sores are ulcers that occur on the inside of the mouth, tongue, throat, and cheeks. Theyre usually flat lesions. Theyre not contagious and are not caused by the herpes simplex virus.

Cold sores are usually found on the lips and outside the mouth. Theyre highly contagious. Cold sores are raised and have a bubbly appearance.

Medical Treatment For Oral Herpes

Oral herpes symptoms may resolve without treatment within one to two weeks.

If needed, your healthcare provider will prescribe certain antiviral medications to treat your condition. These medications help with any pain you may be experiencing as well as alleviate symptoms more quickly.

Medications that are used to treat HSV-1 include acyclovir, famciclovir, and valacyclovir, which are most effective if taken when initial warning signs of an incoming flare-up appear and before blisters develop.

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What Is The Prognosis For Oral Herpes Can They Be Cured

Currently, there is no cure or vaccine for herpes simplex virus. Avoiding risk factors, such as sunburn and stress, can help prevent additional outbreaks. Cold sores will usually heal within 2 weeks without treatment. However, there are established cold sore treatments available to help decrease healing time, reduce pain, and in specific cases, suppress the recurrence of the virus.

Cold sores, if they recur, are most likely to do so during the first year after infection. They usually resolve on their own within 1-2 weeks. After the initial outbreak, cold sores may never appear again, or appear only when something triggers them. Usually people with cold sores lead normal lives and are not terribly affected by them unless they happen to recur very often .

Can I Treat Herpes Simplex At Home

Avoiding known triggers, such as illness or stress, can help reduce how often you have herpes outbreaks.

How can I ease my symptoms during an outbreak of HSV-1 ?

• Over-the-counter creams such as L-lysine, benzocaine or docosanol .
• Applying ice to blisters or sores.

How can I ease my symptoms during an outbreak of HSV-2 ?

• Apply an ice pack to your genitals. Wrap the ice pack in a washcloth or apply it over your underwear.
• Keep your genitals dry. Wear cotton or other nonsynthetic underpants and avoid tight-fitting clothes. Moist sores take longer to heal.
• Soak in a warm bath.
• Take nonsteroidal anti-inflammatory drugs to relieve pain.
• Topical 1% or 2% lidocaine may be used as a topical analgesic.

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How Is It Diagnosed

Diagnosis usually involves observation of your oral condition or laboratory tests. Your doctor may look around the mouth or inside to look for typical signs. If he or she is not satisfied, you may be asked to get to the lab for tests which may include viral culture, DNA test or Tzanck test.

Patients who suspect have the cold sore on their lips should see a doctor.

Herpes Simplex Virus Primary Infection

In children

Symptoms of the primary infection are most likely to develop in children younger than five years old. Symptoms include:

• swollen and irritated gums with small, painful sores in and around the mouth this is known as herpes simplex gingivostomatitis

Herpes simplex gingivostomatitis usually affects young children, but adults can also develop it. It can last 10 to 14 days, with the sores taking up to three weeks to heal. Gingivostomatitis doesn’t usually recur after the primary infection.

In adults

Primary herpes simplex viruses are rare in adults. But the symptoms are similar to those experienced by children.

Symptoms include:

• you’ll usually have a sore throat with or without swollen glands
• you may also have bad breath and painful sores in and around your mouth – these can develop into ulcers with grey or yellow centres

If you develop the herpes simplex virus at an early age, it may be triggered from time to time in later life. It can cause recurring bouts of cold sores.

After the primary infection, the symptoms are usually reduced to just the cold sores themselves.

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There Is More Than One Type Of Herpes Infection

There are two types of herpes simplex infection: herpes simplex virus type 1 and herpes simplex virus type 2 . Cold sores around the mouth are generally caused by HSV-1. Most cases of genital herpes are caused by HSV-2. Cold sores on the mouth can cause genital infection during oral sex for people who do not already carry the cold sore virus. There are many other viruses that are also in the herpes virus family, however the infection and symptoms are different. One example is varicella zoster virus which causes chickenpox and shingles.

Check If It’s A Cold Sore

A cold sore usually starts with a tingling, itching or burning feeling.

Over the next 48 hours:

Cold sores should start to heal within 10 days, but are contagious and may be irritating or painful while they heal.

Some people find that certain things trigger a cold sore, such as another illness, sunshine or menstrual periods.

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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