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.
Can Oral Herpes Come Back
Oral herpes sores can come back. The virus remains in your body forever once youve contracted it.
However, it can remain dormant for a certain period and then reactivate. When this occurs, a person is likely to develop mild symptoms, including sores.
Some people refer to this as herpes coming back, even though its better described as a flare-uporrecurrence.
When To See A Healthcare Provider
While antivirals may have benefits if started within 72 hours of symptoms, many healthcare experts recommend that you wait no longer than 24 hours.
You can even start treatment during the so-called prodromal phase that often precedes the outbreak of lesions, the symptoms of which may include:
- Itching or tingling in the area when outbreaks usually occur
- Aching or shooting pains down the back of the legs or in the buttocks
- Headache and malaise
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How To Prevent An Outbreak
Some people only take their medications if they feel the itching and tingling that means an outbreak is coming on â or when sores show up â to stop it from getting worse. Your doctor may suggest you take an antiviral every day if you:
- Have lots of outbreaks
- Want to prevent more outbreaks
- Want to lower the risk of spreading it to your partner
How Did You Get Herpes Who Spread It To You
A diagnosis of herpes often comes as a shock and can leave you asking how did I get herpes? âDid my recent sex partner gave me herpes?â. Well, there are many possibilities and some you might find surprising. Because of these possibilities, it can be difficult for you to know from whom. Contiue to read how did I get herpes.
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Primary Infection And First Outbreak
Getting infected with the herpes virus isnt the same thing as having an outbreak. You may not experience any symptoms at all when you first get the virus, because its actually an outbreak that causes symptoms. As we said above, some people who have the virus never get any outbreaks at all.
But, its quite common to get a first outbreak within 1 to 2 weeks after getting the herpes virus. During these first weeks, the virus can multiply inside your cells, until its presence causes an outbreak. The symptoms of this first outbreak can be quite mild, though it can look like a spot or an ingrown hair.
Outbreaks usually follow the same pattern. They begin with an itching or tingling sensation, then blisters appear and burst open into sore ulcers. As the outbreak progresses, the ulcers turn into scabs and heal without causing any scarring. Some patients also experience a fever, headaches and a burning sensation when peeing.
The first outbreak can last for many weeks and take a long time to heal.
Following this first episode, the virus becomes dormant again until something triggers a new outbreak. Theres more information on this further down this page.
The outbreaks following the first one tend to be less severe. Patients often learn how to recognise the early signs of genital herpes, which allows them to begin antiviral treatment, such as aciclovir, before the symptoms get too unpleasant.
Risk For Genital Herpes
According to the US Centers for Disease Control and Prevention , about 1 in 6 Americans ages 14 to 49 years have genital herpes. While HSV-2 remains the main cause of genital herpes, HSV-1 has significantly increased as a cause, most likely because of oral-genital sex. Except for people in monogamous relationships with uninfected partners, everyone who is sexually active is at risk for genital herpes.
Risk factors for genital herpes include:
- History of an STD
- First sexual intercourse at an early age
- High number of sexual partners
- Low socioeconomic status
Women are more susceptible to HSV-2 infection because herpes is more easily transmitted from men to women than from women to men. About 1 in 5 women, compared to 1 in 9 men, have genital herpes. African-American women are at particularly high risk.
People with compromised immune systems, such as those who have HIV, are at very high risk for genital herpes. These people are also at risk for more severe complications from herpes. Drugs that suppress the immune system, and organ transplantation, can also weaken the immune system and increase the risk for contracting genital herpes.
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How Is Herpes Simplex Treated
Some people have few to no herpes outbreaks and choose not to have treatment. But many people prefer to use medications that shorten outbreaks and reduce symptoms.
During an outbreak, you may use an antiviral ointment or cream to help lessen your symptoms and help them go away faster, but it only works if you start it soon after you start an outbreak. Many people with HSV-2 take daily oral medications to keep outbreaks at bay.
Your provider may prescribe a topical medication or oral medication such as:
Support And Advice For Genital Herpes
If you have just found out you have genital herpes, you may feel shocked and may have a lot of questions. It may help you to gather as much information as you can about herpes. This can help you to make fully informed decisions about your treatment, safe sex and preventing further recurrences. Talking to a counsellor about your concerns may also help.
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Prognosis Of Genital Herpes
Genital herpes can be treated and managed. Baill stresses that for most people who have healthy immune systems, the high-risk times for giving a sex partner genital herpes are during the first outbreak and during later outbreaks of sores.
Without such an outbreak, the viral load is usually not sufficient to infect a normal, healthy partner, she says. Antiviral medication can be effective at controlling the frequency and the severity of genital herpes outbreaks, Baill says.
For some people, though, even the times when no symptoms are present can be risky ones for transmission.
If you have genital herpes and your partner is taking biologic drugs for rheumatoid arthritis or MS or psoriasis, you may need to be extra careful, says Baill. It may take a lower viral load to infect people taking those medications.
In these situations, she says, you may want to take antiviral drugs in an ongoing way to keep your viral load low and protect your partner.
If You Have Genital Herpes Already Can It Be Spread To Other Parts Of The Body Such As The Arms Or Legs
No. Genital herpes cannot be transmitted to another part of your body such as your arm, leg or hand after the first infection occurs. If you have genital HSV II, you will not get HSV II at another site in your body. The immune system produces antibodies that protect other parts of your body from infection. However, there are cases where a person has multiple site infections from the same virus. This is usually acquired at the time of the first infection. For example, if someone has never had herpes but then has oral and genital sex with an infected partner, they can acquire the infection at both sites.
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Type Of Tests Used To Diagnose Herpes
There are four main types of diagnostic tests that can be used to diagnose herpes. Your doctor will determine which type of test to use based on whether an outbreak is present or not.
If youre experiencing what you believe to be a herpes outbreak, your doctor can use a viral culture test or virus antigen detection test. If youre not experiencing symptoms, you can have an antibody test.
- Viral culture test.This test is used to determine if a sore contains the herpes virus. This test can sometimes produce a false-negative, meaning that it may not detect the virus even though its present.
- Virus antigen detection test. This test is used to determine if antigens to the herpes virus are present in a sore or lesion.
- Antibody test. If youre not experiencing an outbreak yet but still believe you may have been exposed, you can opt to have an antibody test performed. This test will only show a positive result if the antibodies to the virus have been developed. Therefore, this test isnt necessarily recommended for recent exposure.
- Polymerase chain reaction test. With this test, a healthcare provider can screen a sample of your blood or tissue from a sore. They can use this to determine if HSV is present and which type you have.
Episodic Therapy For Recurrences
For a recurrent episode, treatment takes 1 to 5 days, depending on the type of medication and dosage. You should begin the medication as soon as you notice any signs or symptoms of herpes, preferably during the prodrome stage that precedes the outbreak of lesions.
In order for episodic therapy to be effective, it must be taken no later than 1 day after a lesion appears. If taken during prodrome, episodic therapy may help prevent an outbreak from occurring or reduce its severity. If taken at the first sign of a lesion, it can help speed healing.
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What To Look Out For
“Genital herpes outbreaks can differ in severity. While some people encounter multiple painful blisters, some only have one single sore.” – Dr Zenon Andreou
“Genital herpes outbreaks can differ in severity. While some people encounter multiple painful blisters, some only have one single sore.”
Signs And Symptoms For The First Genital Herpes Outbreak
If you were diagnosed with genital herpes in the last few days, you may be experiencing a number of uncomfortable or painful symptoms. Or, perhaps the symptoms are rather mild, barely noticeable, and resemble an insect bite or a rash. First herpes outbreak usually occur within the first two weeks after the virus is transmitted.
The classic symptoms that most people associate with genital herpes are sores, vesicles, or ulcers all of which can also be called lesions. These classic lesions of genital herpes often resemble small pimples or blisters that eventually crust over and finally scab like a small cut. These lesions may take anywhere from two to four weeks to heal fully. You might have these other symptoms too:
- burning when you pee if your urine touches the herpes sores
- having trouble peeing because the sores and swelling are blocking your
- pain around your genitals
During this time, some people will experience a second crop of lesions, and some will experience flu-like symptoms, including fever and swollen glands, particularly in the lymph nodes near the groin. Headache and painful urination also sometimes accompany full-blown symptoms of first episodes.
Again, while first episodes can amount to a major bout with illness, the signs of herpes come in a wide variety and in some people an initial infection produces mild symptoms or even symptoms that are ignored.
For many people, herpes lesions can so mild that they may be mistaken for:
- yeast infection
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Recognizing The Signs: The Prodrome
Early in the phase of reactivation , many people experience an itching, tingling, or painful feeling in the area where their recurrent lesions will develop. This sort of warning symptomcalled a prodromeoften comes a day or two before lesions appear. To be on the safe side, its best to assume virus is active during these times.
What Are The Symptoms Of Herpes Ii
Typically, the first signs of herpes II is a cluster of blister-like lesions in the genital area which spread and merge, break and crust over within four to 15 days. The fluid from these itching, painful sores is highly infectious. Other frequent symptoms are painful urination, urethral or vaginal discharge and swollen lymph nodes. The first exposure or primary episode consists of headache, fever, chills and muscular weakness. Recurrent episodes are less severe and are limited to the affected area.
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How Long Does The First Herpes Outbreak Last
The first herpes outbreak lasts about 2 to 4 weeks. Even though the blisters go away, the virus stays in your body and can cause sores again. Its really common to get repeat outbreaks, especially during the first year you have herpes. You might notice some warning signs a few hours or days before outbreaks flare up, like itching, burning, or a tingly feeling on your genitals. Read more about herpes recurrences.
Cold sores last a few weeks and then go away on their own. They can pop up again in weeks, months, or years. Cold sores are annoying, but usually harmless in kids and adults they can be really dangerous to newborn babies, though.
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.
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How Is Herpes Diagnosed
Your HCP can diagnose herpes by looking at the sores during a physical exam and by testing fluid taken from the sores to see if you have HSV-1 or HSV-2. There are also specific blood tests, which can be helpful in some patients to figure out which virus type caused the symptoms or to figure out if you have been infected by herpes. Testing for herpes may or may not be included when your health care provider tests for other sexually transmitted infections because the Centers for Disease Control and Prevention does not recommend routine screening.
If you think you have symptoms of herpes or have a partner with genital herpes, see your HCP right away and ask if you need testing and treatment. Its important to call your HCP right away, as you would want to start treatment within 72 hours of the symptoms starting.
Can I Still Have Sex If I Have Herpes
If you have herpes, you should talk to your sex partner and let him or her know that you do and the risk involved. Using condoms may help lower this risk but it will not get rid of the risk completely. Having sores or other symptoms of herpes can increase your risk of spreading the disease. Even if you do not have any symptoms, you can still infect your sex partners.
You may have concerns about how genital herpes will impact your overall health, sex life, and relationships. It is best for you to talk to a health care provider about those concerns, but it also is important to recognize that while herpes is not curable, it can be managed with medication. Daily suppressive therapy for herpes can also lower your risk of spreading genital herpes to your sex partner. Be sure to discuss treatment options with your healthcare provider. Since a genital herpes diagnosis may affect how you will feel about current or future sexual relationships, it is important to understand how to talk to sexual partners about STDsexternal icon.
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When Do First Symptoms Start
As with any infection, there is a delay from the time of the infection to the time that symptoms arise. This period is known as the incubation period. It varies among different infections. With oral herpes this incubation period may be around 3 to 6 days. In genital herpes the incubation period is around 3 to 7 days. Therefore a person is not aware that they have been infected.
The following signs and symptoms of both oral and genital herpes may not always arise immediately after the incubation period. At times there are generalized symptoms mentioned above after the primary infection, particularly with oral herpes. The sores may then arise much later and in this way a person may be unsure as to when they were initially infected.