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Herpes Simplex Virus Types 1 And 2

HSV (herpes simplex virus) typically causes sores and blisters around the nose, mouth, buttocks, and genitals although the sores can develop on almost any part of the body. HSV infections can be extremely bothersome due to the periodic reappearance. The sores may be unsightly and painful. For people who are chronically ill and newborn babies, the viral infection can be serious, but rarely fatal. There are two types of HSV - Type 1 and Type 2.

HERPES SIMPLEX VIRUS TYPE 1
Commonly called cold sores or fever blisters, herpes simplex virus Type 1 infections are small, fluid-filled, blisters that are typically found on the face. Less frequently, Type 1 infections can occur in the genital area. Type 1 may also develop in wounds on the skin.
There are two kinds of infections - primary and recurrent. Although most people contract the infection when they are exposed to the virus; approximately just ten percent actually develop sores. The sores from a primary infection will appear 2-20 days after contact with the infection and can last from 7-10 days.
The number of blisters differs and can range from a single blister to a group. Before the blisters appear, patients may experience and itching, stinging, burning, or tingling sensation. If the blisters break the fluid inside the blisters can ooze causing a crust to develop. Eventually, the crust will fall off; leaving slightly red skin that is healing.
The sores from a primary infection normally heal completely and rarely result in scarring. However, the virus that caused the infection remains in the body. It moves to nerve cells where it remains in a resting state.
People may then have a recurrence either in the same location as the first infection or in a nearby site. Some patients experience a recurrence of the infection every few weeks while others never experience a recurrence.
Recurrent infections tend to be mild and can be the result of a variety of factors including sun exposure, fever, trauma (including surgery), or menstrual cycle. In some cases there is no explanation for the recurrence.

HERPES SIMPLEX VIRUS TYPE 2
Infection with HSV Type 2 usually results in sores on the buttocks, vagina, penis, or cervix, 2-20 days after contact with an infected person. Sexual intercourse is the most common means of getting the infection. Both primary and repeat attacks can cause problems including: a minor rash or itching, fever, painful sores, muscle aches, and a burning feeling when urinating. HSV Type 2 can also occur in other areas of the body, but typically occurs below the waist. Similar to Type 1, both the sites and the frequency of repeated occurrences vary from patient to patient. The initial episode can be so mild that a person is not aware of the infection. Years later, when there is a recurrence of HSV, it may be mistaken for an initial attack, leading to unfair accusations about the source of infection.

HOW DO YOU GET HERPES?
Most people contract the Type 1 infection, during infancy or childhood; typically from close contact with a family member or friends who carries the virus. It can be transmitted by sharing eating utensils, kissing, or by sharing towels. The sores typically affect the mouth, lips, chin, cheeks, or nose and occur soon after being exposed. Patients may barely notice the symptoms or find the sores annoying and seek medical care. Most patients develop Type 2 infections, which result in genital sores, after sexual contact with an infected person. The virus affects up to 20% of all sexually active adults.

The lesions of both forms of herpes simplex can spread by touching an unaffected part of the body immediately after contact with a herpes lesion.

DIAGNOSING HSV
The appearance of HSV is often typical and no testing is needed to confirm the diagnosis. If diagnosis is uncertain, a swab from the infected skin for culture or smear may be taken and sent to the laboratory for analysis. These tests include a microscopic exam and blood tests for the antibodies. Some tests are only valid in the early stages, and more than one of these tests may be required to confirm the presence of herpes. Genital herpes can be mistaken for other diseases, including syphilis.

TREATMENT OF HERPES INFECTIONS
Anti-viral oral medications such as famciclovir (Famvir), valacyclovir (Valtrex), and acyclovir have been created to treat herpes. These can be used when treating an outbreak ("episodic therapy") or can be used constantly to suppress recurrences, reducing outbreaks, and spreading by viral shedding.

HOW DO YOU PREVENT TRANSMISSION?
There is no vaccine that prevents this contagious disease and unfortunately no cure yet. If burning, itching, tingling, or tenderness occurs where there is a herpes infection, the area should be considered contagious and appropriate actions should be taken. With oral herpes, HSV TYPE 1 a patient should avoids sharing lip balms cups, or kissing. For persons with genital herpes, this means avoiding sexual relations, including oral and genital contact while experiencing symptoms or active lesions. To prevent the transmission of genital herpes condoms should always be used. However, they will not protect against the virus that may be living on the nearby genital skin that is not covered.

CAN HERPES BE SPREAD IF THERE IS NO VISIBLE SORE?
Yes. Most herpes is transmitted in the absence of lesions! It is now estimated that over 80% of all genital herpes is transmitted when there are no lesions and no symptoms. This is known as asymptomatic viral shedding. Patients who cannot recall a prior outbreak of genital herpes can test positive for the herpes antibodies thus they can shed the virus and by taking antiviral medications daily they can reduce both viral shedding and disease transmission.

OTHER SERIOUS IMPLICATIONS OF HSV
HSV can be life-threatening to a person who has cancer, an individual with AIDS, a person who has had an organ transplant or anyone who has some other major illness, because their immunity to infection has been reduced. HSV infection of the eye can cause herpes keratitis with light sensitivity, pain, a gritty sensation in the eye, and a discharge. Without prompt treatment, scarring of the eye may result. Pregnant women should avoid sexual contact with a partner who has active genital herpes, especially late in the pregnancy, or they must routinely use condoms. A newborn can be infected at the time of childbirth, by the mother or healthcare worker who has active lesions on the lips or hands, and from family members and friends with active HSV.

We put academic qualifications, many years of combined experience, and training in a variety of special interest areas to work for your healthy, radiant skin. Our providers – Drs. Schachter, Hanna, Curtis, Abdulla, Pollack, and Taradash – welcome new patients for treatment at the Dermatology on Bloor practice on Park Road in Toronto. Our team is here to serve your needs

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